Burning Sensation

Sensory Symptoms· Also known as: burning feet, hot feetUpdated Oct 2026

Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026

At a Glance

A burning sensation is a disturbed feeling in the limbs, most often the feet. It can feel like burning, tingling or sharp pain, sometimes with numbness. It is often linked to nerve damage, and diabetes is the leading cause. Other causes include vitamin problems, alcohol, some medicines, poor blood flow, a squeezed nerve at the inner ankle and a rare condition called erythromelalgia. Pain with nerve-pain features affects an estimated 6.9 to 10 per cent of people. The outlook depends on the cause, so it is worth getting it checked.

What is it?

A burning sensation is a disturbed feeling in the limbs, most often in the feet. You might feel burning, tingling or sharp pain, and sometimes numbness as well.

It is often linked to damage to the nerves in the feet and legs (peripheral neuropathy). But that label fits only some people with these symptoms. Burning isn't always harmless nerve pain, and it has several possible causes.

Nerve damage of this kind usually starts in the toes and affects both feet. It affects the nerves that sense things more than the nerves that move your muscles. Over time it can slowly spread up the leg.

What can cause it?

The most common cause is nerve damage, and diabetes is the leading cause of that. Here are the main causes, starting with the most common.

Diabetes. Diabetes accounts for more than half of nerve damage in Western populations. The most common form is distal symmetric polyneuropathy (nerve damage that affects both feet in the same way), which makes up about 75 per cent of nerve problems caused by diabetes. Early signs include less feeling in the feet, burning that may be worse at night and when touched, tingling, and occasional shooting pain.

Small-fibre neuropathy. This is a nerve disease that most often affects middle-aged and older people, who develop burning pain in their feet. Causes include diabetes, long-lasting infections, genetic changes, medicine side effects and autoimmune disease (when the body's defences attack its own tissue). Often the cause isn't found.

Vitamins, alcohol, toxins and medicines. Too little vitamin B12 or too much vitamin B6 can damage nerves. So can heavy alcohol use, contact with toxins and several types of medicine. Inherited nerve conditions are another cause.

Poor blood flow. Arteries narrowed by high blood pressure or atherosclerosis (a build-up of fatty material in the artery walls) reduce the oxygen reaching your nerves. Smoking does the same. Your practitioner will work out whether your symptoms come from the nerves or from blood flow.

Tarsal tunnel syndrome. This happens when a nerve is squeezed near the inner ankle. Burning is its most common symptom, along with numbness and tingling in the area that nerve supplies. It can be hard to spot in people with diabetic nerve damage, because the symptoms overlap and both can be present at once. Sometimes a lump or swelling near the inner ankle is pressing on the nerve.

Erythromelalgia. This is rare. It causes attacks of burning pain, redness and warmer skin in the hands or feet. The form that runs in families or has no known cause is estimated to affect fewer than 2 in 100,000 people. It can also be caused by another condition, such as nerve damage, certain medicines or a blood disorder called myeloproliferative neoplasms.

Who gets it?

The closest figure we have is for pain with nerve-pain features, which affects an estimated 6.9 to 10 per cent of people, within a reported range of 3 to 17 per cent. Burning feet are one part of that.

People with diabetes are at higher risk. Painful nerve damage affects 13 to 26 per cent of people with diabetes. About two thirds of people with diabetes have some kind of nerve problem that can cause numb, tingling or burning feet. Up to half of people with diabetic nerve damage have no symptoms at all, so it can go unnoticed.

Small-fibre neuropathy most often affects middle-aged and older people. Most people with nerve-pain symptoms are looked after in primary care, by their GP or another health professional, and only some need a specialist.

How is the cause found?

Finding the cause starts with your story and an examination. Your practitioner will ask where the burning is, whether both feet are affected, when it happens, what makes it better or worse, and whether you have tingling or numbness. They will also ask about diabetes, alcohol and any other health conditions.

They will check your feet and test your feeling for touch, vibration and temperature. They may check your ankle reflexes and look for weakness in the feet and toes. They will think about whether poor blood flow or another cause could explain your symptoms. Your GP can arrange blood tests to look for other causes of nerve damage, such as vitamin levels.

For a suspected squeezed nerve at the inner ankle, practitioners use tests that try to bring on your symptoms, most often one called the Tinel sign. There is no single standard approach, and results need careful reading in people with diabetes. If a lump or swelling is suspected near the inner ankle, your practitioner will also consider whether something is pressing on the nerve.

Erythromelalgia has no blood test or scan to confirm it. It is diagnosed from your history and the pattern of burning pain, redness and warmth in episodes. Signs are often gone between attacks.

Treatment

Treatment depends on the cause, so finding the cause comes first. Most of what is known about treating burning nerve pain is in adults with diabetes.

Looking after it at home

If you have diabetes or reduced feeling in your feet, you can injure them without noticing. Loss of feeling can hide pressure injuries that turn into sores and infections that are hard to heal. These steps help protect your feet:

Wear shoes and socks at all times, including indoors. Don't walk barefoot.
Don't put hot water bottles or heating pads on your feet. Test bath water with your elbow, or ask someone else to.
Check both feet every day for cuts, blisters, colour change, warmth or swelling.
Leave hard skin and corns to your podiatrist. Cutting them yourself or using corn remedies from the shop can damage the skin and cause ulcers.

If you have erythromelalgia, try to avoid the things that trigger your attacks. Wear loose clothing and shoes, drink plenty of fluids and try to manage stress. During a flare-up, raise your feet on a chair or pillow. You can cool your feet for a short time with a fan or a cool (not cold) gel pack. Don't use ice or cold water, because they can damage your skin.

Treatment from your podiatrist

Your podiatrist can check the feeling and skin of your feet and look for causes. They will think about whether poor blood flow or another cause could be behind your symptoms. Finding and treating foot problems early lowers the chance of serious infection.

They will treat hard skin and corns safely and advise you on caring for your feet. If they find something that needs more care, such as a foot ulcer, they will send you on to the right service, such as a diabetic foot team or your GP.

Other options

If burning nerve pain is bothering you, your GP or another prescriber may suggest a medicine. The main choices are gabapentin or pregabalin, duloxetine or venlafaxine, and amitriptyline or nortriptyline. Some are better known for treating depression or epilepsy, but they also calm nerve pain.

The benefit is modest. Any one treatment gives worthwhile relief (usually at least half the pain gone) to only 10 to 25 per cent more people than a dummy tablet (placebo). Side effects often limit their use. In adults with type 2 diabetes, duloxetine has given the most consistent pain relief, while pregabalin has given only modest relief. Amitriptyline and nortriptyline work but can have serious side effects, so they are used with caution.

Opioid pain medicines are not recommended as a first or second choice for this kind of pain, because of the high risk of addiction and other problems. Lidocaine patches or capsaicin cream (made from chilli) may help small painful areas.

These medicines can cause drowsiness and dizziness, which raises the risk of falls, especially in older people. Talk to a doctor before starting or stopping any medicine, and don't change your dose yourself. A simple pain diary helps you and your prescriber see whether the medicine is worth continuing. If the first medicine hasn't helped enough, go back to your prescriber, and ask whether a specialist pain service is right for you.

Will it get better?

The outlook depends on the cause. Medicines give only modest relief, and side effects can limit their use. Even so, many people with nerve damage can manage their symptoms without medicine. As nerves heal, many people can reduce their dose or stop, but talk to a doctor before stopping any medicine.

It isn't clear how often burning comes back, so ask your practitioner what to expect for your cause.

The biggest risk is losing feeling in your feet. Without the pain warning, a sore can be walked on and become long-lasting or infected. That is why looking after your feet matters so much.

Preventing it

The best step is to protect your feet if they have lost feeling: check them daily, wear shoes and socks indoors and out, and avoid heat on your skin. Keep up regular podiatry visits if you have diabetes, and ask about regular foot checks even if you have no symptoms.

If you have erythromelalgia, keep a note of your personal triggers and try to avoid them.

When to see a podiatrist

Book an appointment if

You have new burning in your feet and would like them checked. Or you have diabetes and haven't had a recent foot check, you have hard skin or corns, or the burning is getting in the way of sleep, work or daily activities.

Seek prompt assessment if

Call your local emergency number if your leg, foot or toes suddenly turn cold and pale or blue, with pain or numbness, or if you suddenly can't move your leg or foot. Also call if you have a foot wound or infection and you feel very unwell, with confusion or slurred speech, severe shivering or muscle pain, severe breathlessness, mottled or discoloured skin, or little or no urine. This could be sepsis. If you have diabetes and a foot problem and you feel very unwell in any other way, go to the nearest emergency department.

If you have diabetes, contact your GP, podiatrist or diabetic foot team today if your foot becomes painful and swells quickly. Do the same for a cut, blister or bruise that hasn't started to heal after a few days, skin on your foot that becomes red, warm or painful, a foot that suddenly turns red, warm, swollen or numb or changes shape, severe pain, an open wound, or an infection that turns black and smelly. Don't wait to see whether it settles. If your GP can't see you today, go to an urgent care clinic or an after-hours GP.

See your GP soon if the burning keeps going, gets worse or has no clear reason. Also see your GP soon if it follows the path of one nerve, if you notice a lump or swelling near your inner ankle, or if you think nerve damage is affecting your blood pressure control or other body functions that work automatically.

Frequently asked questions

Can a vitamin problem cause burning feet?

Yes. Too little vitamin B12 and too much vitamin B6 are the best-known vitamin causes of nerve damage. Your GP can check this with blood tests, along with other causes of nerve damage. Don't start or stop vitamin supplements without talking to a doctor or pharmacist first.

Can my medicines cause burning feet?

Some can. Several types of medicine can damage nerves, including some used for cancer, HIV, heart or blood pressure problems, infections, seizures and alcohol dependence. Tell your practitioner if the burning started after a new medicine, and bring a list of what you take. Talk to a doctor before stopping any medicine.

Do I need to see a specialist?

Often not. Most people with nerve-pain symptoms are looked after in primary care, by their GP or another health professional such as a podiatrist. Only some people are referred on for specialist assessment. Your practitioner will tell you if you need more tests or a different service.