Need to Know: Why Are My Feet Burning?

Need to Know: Why Are My Feet Burning?

Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the forum topic “MS Burning Feet and Hands Could Be Erythromelalgia,” from Aug. 14, 2018.

Burning sensations in the hands and feet

You might be sitting on the couch watching TV. Or you could be sleeping. Maybe you’re working at your desk (like I am right now). Suddenly, it feels as if your feet have caught fire and your toes are alight.

Perhaps it’s your fingers that feel like they are shooting flames from their tips. No, this isn’t a sign that you have a hidden superpower — rather it suggests that as a person with multiple sclerosis (MS), you are experiencing something that is known clinically as erythromelalgia.

Erythromelalgia: The basics

Burning sensations generally belong to the broad spectrum of symptom clusters referred to as “pain syndromes.” Pain takes on a variety of sensations, especially in those with a neurological condition such as MS. It can be felt as throbbing, stabbing, cramping, itching, aching, tingling, or burning.

Erythromelalgia falls into the last category affecting the feet or hands, which is clinically described as peripheral pain. In rare cases, it may spread to upper or lower limbs, or even to the face.

The skin may look reddish and feel hot to the touch. However, the condition doesn’t occur as a result of direct exposure to heat, but rather is due to the dysfunction of the peripheral nervous system.

The peripheral connection

The peripheral nervous system comprises the nerves that serve the extremities and include motor nerves (muscle control), sensory nerves (sensations), and autonomic system nerves (involuntary processes like core body temperature and blood pressure).

Erythromelalgia is an example of peripheral neuropathy, where mixed signals from the brain — due to demyelination activity and MS lesions — can result in chronic unpleasant sensations akin to someone holding a match to your hands or feet.

This intense burning nerve pain can happen in brief episodes or linger continuously; it may be mild and gradual or acute and severe.

The vascular connection

The condition shares a critical connection with vascular health. According to the National Organization for Rare Disorders (NORD), “Erythromelalgia is thought to result from vasomotor abnormalities or dysfunction in the normal narrowing (constriction) and widening (dilation) of the diameter (caliber) of certain blood vessels, leading to abnormalities of blood flow to the extremities.”

Triggers

For people with MS, a common trigger is heat intolerance, either because of the environment or due to exercise. However, about 5 percent of primary erythromelalgia cases are familial, regardless of neurological health status.

What you can do if you feel like you’re on fire

In her column “Faith of the Mustard Seed,” Debi Wilson outlines ways to address your “burning issues.” Following are Debi’s suggestions and some of my tips for relief of your erythromelalgia:

  • Apply a cooling lotion. I’ve found products containing peppermint essential oil do the trick, as do those with capsaicin.
  • Try topical products such as magnesium spray or cream that includes CBD — if available and legal in your area.
  • Consider oral supplements of magnesium or CBD edibles.
  • Place your feet or hands in a bath of cool water.
  • Drink a tall glass of cold water to prevent overheating and dehydration.
  • Remove socks or avoid tight-fitting shoes. Or conversely, wear compression stockings.
  • Avoid drinking alcohol or eating spicy food.

Medications that might help include nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen. Some patients may find relief with prescription gabapentin or lidocaine patches to cool the affected areas. Others may respond to pregabalin.

However, no single solution is consistently effective in treating erythromelalgia. NORD suggests that this indicates the presence of subtypes of the condition. You may need to try various medications and therapies to find the treatment that works best for you.

As always, consult your doctor before deciding to take any medications or treatments.

Do burning feet or hands wake you at night? Have you conquered erythromelalgia? What has helped you to manage this unusual MS symptom? Post your replies in the comments below or at the original “MS Burning Feet and Hands Could Be Erythromelalgia” forum entry.

***

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.

23 comments

  1. Tim Hiley says:

    I experience restless foot syndrome nearly every night when I am laying in bed prior to sleep. I’ve had MS since 1996 and this is probably one of the most annoying symptoms. Of course, this ceases to bother me once I fall asleep.

    • Tamara Sellman says:

      RLS is definitely an annoyance and can significantly disrupt your sleep. However, it’s not the same thing as erythromelalgia (just to make sure people don’t confuse the two).
      Tamara

  2. Debbie Fogel says:

    I have burning feeling in my feet and redness. Basically on my right foot which is my drop foot. I sleep and sit with a them raised

    • Tamara Sellman says:

      Thanks for writing, Debbie. I, too, find some relief in putting up my feet. I’m sure changes in circulation can help at least a little bit.
      Tamara

      • C S Laughran says:

        I was finally diagnosed with MS (RR) in 1983 & have stabbing feet pains & cramping for years, but thought it was also due to arthritis. This now makes total sense. Thank you.

        • Tamara Sellman says:

          Happy to help! I also have RA, so the battle of knowing what is MS and what is RA, or just plain ol’ aging, is a constant one! Good luck to you <3
          Tamara

    • Sally says:

      I’m using Pure Spectrum CBD but doesn’t seem to be helping my feet at all. My discomfort is in my heel. Keeps me up at night. What kind of exercises do you do?

      • Tamara Sellman says:

        CBD topicals with a cooling element have helped me, at least temporarily. For me, exercises don’t fix the burning, it’s a neurological thing.

  3. Shirley A. Nobbs says:

    I apply Goldbond ultimate for diabetics for dry skin. I apply it to my legs before I go to bed and I usually get through the night with out the burning starting up.

  4. Sarah says:

    I have something similar happening to me with my foot and calf, but instead of hot and burning, my foot is cold, discolored (red and purple) and painful. I am being treated by a cardiologist for my peripheral pain with gabapentin and a low dose blood pressure med amlodipine to open my arteries to improve blood flow. It has been somewhat successful in controlling the pain.

    • Tamara Sellman says:

      That sounds very uncomfortable! It may or may not be related to MS nerve pain and discomfort… sounds like you have some artery issues (which I also have). I hope you continue to control your pain issues, I feel like we just don’t know how important our hard-working feet are until they become painful to walk on! Tamara

        • Tamara Sellman says:

          It can also be simple neuropathy. I have a similar problem with a toe that turns blue or white, on occasion. It’s not Raynauds, though, it’s related to nerve damage from a procedure I had to undergo in the past. As they say, it is what it is. Good circulation helps keep it from being too cold or hot or uncomfortable (at least for me).
          Tamara

  5. Cheryl says:

    Anything cool changes the sensation of burning – sometimes I soak my feet in a cool tub, sometimes I put them on a cool pack, etc. Also, I find rubbing my feet can help – again, it just changes the sensation & the burning sometimes stops.

    • Tamara Sellman says:

      All great ideas! I was gifted a foot bath at the holidays and though it feels great to use with hot water, sometimes it’s also perfect just filling up with cool water for these very moments. I think you’re right, changing the sensation can help alleviate it if only by confusing the pain receptors in some way. Thanks for sharing, Cheryl.
      Tamara

  6. Pamela Mosca says:

    I suffer with erythromalgia nut I do not have MS but my daughter does.
    I belong to an EM group and it has been found that soaking the feet in cool or cold water or putting a fan on them only creates a viscous cycle. After the feet have cooled they heat up again only getting worse because they need to keep being cooled off. There is a process that a lot of us have tried and found to be very successful. Instead of cooling the feet constantly we heat them everyday by soaking them in hot water for 20 – 30 minutes a day. This actually desensitizes the feet to getting use to heat. It has worked amazingly well for so many of us.

  7. Sally says:

    I have had MS since 1997 but lately been a lot of heat and discomfort in my heels and legs for about the last 6 months or so. This keeps me up at night to the point I just want to cry. Talked to my doctor and she didn’t think it has anything to do with my MS. Looking for any kind of relief.

    • Tamara Sellman says:

      Did you talk to your primary about it, or your MS specialist? Usually the primary care physician doesn’t have all the info on MS… just curious.
      Tamara

  8. Donna Weppler says:

    My husband has MS and lately he has been complaining about burning from his butt to his feet. His doctor prescribed a med for restless leg syndrome. It really hasn’t eased the discomfort he feels at night. I am going to try some of your remedies.
    Thank you.

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