Numbness or burning sensation on the soles of feet is not uncommon in the general population. There are many causes responsible for the same. Finding out the exact cause is challenging. At times, the symptoms could be very distressing and could interfere with sleep and routine activities.

What are the common causes of burning feet?

Vitamin B 12 deficiencies and long-standing diabetes top the list in India. Multiple B Complex Vitamin deficiencies as in chronic alcohol abusers can be an important factor.

What are the common symptoms?

Usually, the burning sensation could be on the soles bilaterally and could be severe at night. In diabetics, it could be so severe that it may interfere with sleep. At times, the abnormal sensation can be restricted to single or multiple toes. Numbness or poor sensations could result due to associated poor blood supply to the feet, as in diabetics or those who have heavy smoking habits. Loss of sensation on the feet or toes could be a part of leprosy.

Why do you get a burning sensation in the feet in diabetics?

This is because of the nerves to the feet that are affected. The nerves require proper blood supply for their functions. In diabetics, the blood supply to the nerves gets affected, depriving the nerves of proper nutrients. This affects the myelin sheath and the cells of the nerves, causing burning sensation or in severe forms numbness or loss of sensation.

What are the other important features of B 12 deficiencies?

This deficiency is more common amongst vegetarians. This is also more common in certain families, thus a genetic basis cannot be ruled out Exhaustion, body ache, recurrent mouth ulcers, palpitations due to anemia, memory loss, inattentiveness and burn-ing, tingling, numbness on the palms and feet, and excess pigmentation of the skin is common. Some have unexplained weight loss.

What are the features of nerve involvement in diabetics?

Burning sensation in any part of the body associated with numbness is common. Cramps in calf muscles, itching, excess sweating in the upper part of the body, recurrent fungal infections, loose stools with increased frequency, muscle weakness as in wrist drop are common features in diabetics. Few diabetics may have sexual inadequacy. The treatment involves achieving an HBA1C of less than 7% and having a fasting blood glucose to 110 mg and Post meal up to 180 mg.

What about numbness and burning sensations in alcohol abuse?

Most of them suffer from inadequate nourishment. This results in multiple vitamin deficiencies. These vita-mins like B 12, Folic acid, B 6, Thiamine, and Niacin are necessary for the normal functioning of nerves. Stopping alcohol intake and giving these supplements should help in most instances.

What tests are necessary for such individuals?

The diagnosis is evident in many just by a proper history and clinical examination. History of taking certain antituberculosis drugs, certain anti-cancer drugs, estimation of serum B 12 and Folic acid levels, and estimation of certain trace elements like arsenic, mercury, cadmium, Zinc may be helpful. Evaluation for autoimmune disorders like SLE and Rheumatoid disorders may be helpful. Sometimes evaluation for internal malignancy may help. Nerve conduction studies, electromyography, and even nerve biopsy is indicated in certain cases. All these tests are safe and easy.
What precautions need to be taken to prevent numbness and burning sensations? Please see your doctor. He would do a neurological evaluation and come to a diagnosis. Other relevant tests would be advised. Proper specific and supportive treatment or the myelin sheath that engulfs the nerves should help in most cases. Peripheral neuropathy as it presents in individuals may occur due to various disorders. These symptoms may be the first signs of an underlying disease like diabetes, deficiency disorders, complications due to excess alcohol intake, or even a tumour pressing on the nerves in the spine. Certain autoimmune diseases and certain side effects of medications may be the cause.

Categories : Health

Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.

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