burning feet mystery

[tom579]

10 yrs with same proplem.. been there, done that.. no one seems to have solution... soles of feet burn.. ONLY WHEN I LAY DOWN.. am..pm.. lay down.. in about 1/2 hr both feet start to burn. longer i stay the worse it gets!.. get up walk around 5-10 minutes, all gos away!! lay down again, same thing! all nite long.. been on simbolta and methadone.. both almost tore me apart!!  

[Cleveland Clinic, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Your symptoms of burning in the feet can be consistant with peripheral neuropathy, which is a condition caused by damage to the small nerves in your legs, usually happens in a length-dependant fashion, meaning it typically affects the peripheral parts first then as time goes by it can progress to involve more proximal areas like the legs.

There are different causes for peripheral neuropathy, the common ones include Diabetes, thyroid disease, vitamin/mineral deficiency (like vitamin B12, folate, copper), alcoholism.

You need to be examined by a neurologist to detect any neurological deficits, in typical neuropathy there might be some loss of sensation perception in the affected areas. Then workup involves lab work to detect the common causes of neuropathy (check for diabetes or "pre-diabetes", thyroid disease, vitamin levels, protein abnormalities...etc), depending on the result of the neurological exam and the initial workup you might need some additional testing to detect any nerve damage (this might include electro-diagnostic testing with EMG or nerve conduction studies, nerve/skin biopsy..etc)

treatment includes treating any underlying condition (if any is detected), and symptomatic treatment for pain control, several medications can be used, like Neurontin, Lyrica, Cymbalta...etc.

Thanks for using the forum. Good luck.

[spankyandrex]

I have been trying since October to post on here and I seem to not be hitting it right.  Would you be so kind to help me this way?

Dear Dr.  I have the same condition burning feet, but in a different way.  Mine is only when I am sitting down does it get very bad.  Neurotonin has not helped - made my throat swell.  PN has pretty much been ruled out with Nerve Studies.  The only thing i have not had done is an EMG. I just posted on the Orthopedic Board, but would you be so kind to answer here. I am trying to get int o see a neurosurgeon possibly for spine surgery.  Thank you - here's the post.

I am 38 yo female, in reasonably good health.  A bit overweight.  I have been dealing with back/neck issues for years (26 to be exact seeing a chiropractor).  I was hit by a drunk driver when 12 had severe cervical sprain at that time.  Fast forward through a lot of pain and appointments to when I was 34.  Diagnosed with DDD or osteoarthritis.  I've had 3 lumbar MRI's, two cervical and one brain because they thought I had MS most recently which I do not.  EVERYTHING has been ruled out and I will post all that info as well, but I wanted to give you my most recent MRI's within last 3 months and let me know if you think I am heading for surgery soon.  I am in a lot of pain in all 3 areas.  Cervical - neck/arm/shoulder pain.  Thoracic - pain in mid-back - heartburn (related?) never had it before - Lumbar - the MOST pain.  No sciatica like pain in one leg, but lower back pain, aching like pain down backs of both legs and into feet with burning feet when I sit for long periods.  Neurologist  exam revealed no reflexes in ankles (haven't for 3 years)  and mute bilateral plantar reflexes.  There's so much more info, but I'll stop here.  Any comments on these MRI's?  THANK YOU so much.

MRI Thoracic Spine without Contrast - 10/07. T1, T2 and T2 fat saturation sagittal sequences, and T1 and T2 weighted axial images were obtained.  The vertebrae are normally aligned.  The stature of the vertebral bodies is maintained.  Disk spaces appear to be preserved.  The spinal cord is of normal signal and morphology.   At T7-8 there is is a small right paramedian protrusion of the nucleus polposus which effaces the ventral aspect of the thecal sac and appears to touch the cord.  There is no foraminal stenosis seen.

Impression:  Small right paramedian protrusion of the nucleus pulposus at T7-8. This small protrusion appears to touch the ventral aspect of the spinal cord, but there is no evidence of spinal or foraminal stenosis.  The spinal cord is unremarkable in appearance and signal.

MRI Cervical Spine without Contrast - Oct/07.  The vertebrae are normally aligned.  Stature of the vertebral bodies is maintained.  Spinal cord is of normal morphology with exception of ventral impression on the cord in the left paramedian location at C6-7 secondary to moderate protrusion of the nucleus pulposus.  There is no evidence of tonsillar herniation, and the foramen magnum is normal in appearance.    There is mild/moderate broad-based bulging in the disk/endplate complex at C5-6, but this finding does not cause impression on the spinal cord, there is no spinal or foraminal stenosis at this level.

Impression:  Significant protrusion of the nucleus pulposus at C6-7, finding is positioned in the left paramedian location and causes mild ventral impression on the spinal cord.  It is also possible that this finding may impinge the traversing left C8 root.  Otherwise unremarkable MRI of the cervical spine.

Lumbar Spine 12/31/07.  Results:  Normal through L3/4 level.   L4/L5 level: There are some mild deg facet changes w/out other significant deg osseous changes. The disk is narrowed and dessicated and does show a broad base disc bulge with a small central disc protrusion. There is also some increased signal in the posterior annulus which could be due to a small tear. These findings do cause mild canal stenosis and foraminal recess narrowing. The neural foramina themselves show minimal narrowing without affecting the exiting nerves. The spinal nerve roots are normal.

L5/S1 level. Minimal facet arthropathy is present without other bony degenerative changes. The disc is narrowed and dessicated with a mild broad base disc bulge with a small to moderate central protrusion which appears to abut up against the proximal left S1 exiting nerve and possibly the right S1 exiting nerve. No significant canal stenosis is identified. The foramina bilaterally show no significant narrowing. The exiting L5 nerves are unaffected. The spinal nerve roots are normal.

This is what has been RULED OUT or is NORMAL:

NORMAL RESULTS/Ruled Out:
08 – Diabetes (Glucose Tolerance Test – A1C was 5.3-normal)
08-Bloodwork Ceruloplasmin (copper test).
08-Lumbar MRI