burning feet syndrome (BFS)

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  • burning feet syndrome (BFS) is characterised by a sensation of burning and heaviness in the feet and lower extremities
    • Grierson was, in 1826, was the earliest to document the symptom of burning feet. However a detailed description was given by Gopalan in 1946, hence, BFS is also known as Grierson-Gopalan syndrome

  • no specific aetiology for BFS - often is idiopathic

  • may be associated with nutritional/endocrine causes e.g.
    • vitamin B deficiency
    • diabetes mellitus
    • renal failure (dialysis patients)
    • hypothyroidism

  • most common in those over 50 years; although can occur in any age group
    • symptoms characterised by a burning sensation, heaviness, numbness, or a dull ache in the feet
      • burning is usually limited to the soles of the feet but may ascend to involve the dorsum, ankles or lower legs
        • arms and palms of the hands are spared
        • sometimes a patient may complain of 'pins and needles' or tingling in the lower extremities
        • symptoms show worsening at night and a day time improvement
    • on examination, there is a paucity of objective signs

  • investigations
    • first line investigations include FBC, ESR, U+Es, B12, TFTs, fasting glucose

  • treatment
    • specific measures
      • depend on the cause
    • general measures
      • wearing open and comfortable shoes, particularly those with arch supports, and wearing cotton socks is helpful (1)
      • symptomatic relief can be brought about by soaking the feet in cold water (not ice cold) for around 15 minutes
      • avoidance of feet exposure to heat
      • pharmacological therapies include tricyclic antidepressants and membrane stabilising agents (such as carbamazepine or gabapentin)

Reference:

  1. Makkar RP et al. Burning feet syndrome. A clinical review. Aust Fam Physician. 2003 Dec;32(12):1006-9.

Last reviewed 07/2021

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