Burning feet can be surprisingly difficult to describe. Some people feel as though the soles of their feet are hot even though they are normal to touch. Others describe tingling, electric shocks, pins and needles, stabbing pain or a painful sensitivity to socks and bed sheets.
For some people, burning feet are caused by something relatively simple such as tight footwear or irritated skin. But persistent burning — particularly when it affects both feet — can also be a sign that the nerves supplying the feet are not working normally.
Diabetes is one of the most important causes to consider, but it is far from the only one. Vitamin B12 deficiency, excess vitamin B6 supplements, alcohol, certain medicines, trapped nerves and several other medical conditions can all produce similar symptoms.
The pattern of symptoms often provides useful clues. Burning that begins in the toes and gradually spreads upwards is different from pain affecting one small area of one foot. Burning accompanied by numbness or loss of balance is also more suggestive of a nerve problem than feet that simply feel hot after walking.
This guide explains the common causes of burning feet, what tests may be useful and when you should seek medical advice.
Why Do Feet Feel Like They Are Burning?
One of the most common explanations is peripheral neuropathy.
The peripheral nerves carry information between the brain and spinal cord and the rest of the body. Sensory nerves tell your brain about touch, temperature and pain. When those nerves become damaged or irritated, they can send abnormal signals.
The result may be burning, tingling, stabbing pain or numbness even when there is no heat or injury affecting the skin itself.
The NHS lists burning or sharp pain in the feet, pins and needles, numbness and reduced ability to feel temperature among the typical symptoms of peripheral neuropathy.
Neuropathic symptoms often begin in the toes and feet because the longest nerves in the body are commonly affected first. Over time, symptoms may spread further up the legs and sometimes into the hands.
Not every burning sensation comes from nerves, however. Skin infections, inflammation, footwear, circulation problems and conditions affecting individual nerves can also cause burning discomfort.
The pattern matters just as much as the sensation itself.
Can Diabetes Cause Burning Feet?
Yes. Diabetes is the most common cause of peripheral neuropathy in the UK.
Over time, persistently raised blood glucose can damage both nerves and the tiny blood vessels that supply them. This can lead to diabetic peripheral neuropathy.
Typical symptoms include:
- burning or shooting pain in the feet;
- pins and needles;
- numbness;
- unusual sensitivity to touch;
- reduced ability to feel heat or cold;
- loss of balance;
- weakness in the feet or ankles.
Some people experience considerable pain. Others lose sensation without experiencing much pain at all.
This loss of feeling can actually be more dangerous than burning pain because injuries may go unnoticed. A blister, small cut or badly fitting shoe can damage the skin without causing enough pain to alert you.
If you already have diabetes and develop burning, tingling or numb feet, mention it at your diabetes review rather than assuming it is an unavoidable part of the condition.
Regular foot checks are particularly important. Look for blisters, cracks, ulcers, redness, swelling, changes in colour and areas where footwear has rubbed.
If you are wondering whether symptoms such as burning feet could be an early sign of previously undiagnosed diabetes, our guide to the early signs of type 2 diabetes covers thirst, frequent urination, tiredness, weight changes and other symptoms.
Diabetes is usually assessed using blood tests such as HbA1c or fasting glucose rather than symptoms alone. Our guide to understanding diabetes blood test results explains what these tests measure.
Can Vitamin Deficiencies Cause Burning Feet?
Yes, although it is important not to assume that burning feet mean you simply need to buy a vitamin supplement.
The vitamin most closely associated with peripheral nerve symptoms is vitamin B12.
Vitamin B12 deficiency
Vitamin B12 is important for normal nerve function. Deficiency can cause numbness, pins and needles, muscle weakness, problems with balance and other neurological symptoms.
Burning sensations in the feet can occur as part of this nerve involvement.
B12 deficiency may be caused by dietary deficiency, but absorption problems are also important. Pernicious anaemia, some stomach and bowel conditions, previous stomach surgery and certain medicines can interfere with B12 absorption.
It is therefore possible to eat foods containing B12 and still become deficient.
A straightforward blood test can often identify deficiency, although interpreting borderline results sometimes requires additional testing.
It is worth diagnosing and treating B12 deficiency promptly because neurological damage can become harder to reverse when deficiency has been present for a long time.
You can read more in our guide to vitamin B12 deficiency symptoms, causes and treatment.
What about vitamin B6?
Vitamin B6 is slightly unusual because too much can damage peripheral nerves.
This is especially relevant to people taking several supplements at once. Vitamin B6 may appear in multivitamins, magnesium products, vitamin B complexes and other supplements, so the total daily amount can be higher than expected.
NHS advice says that high supplemental doses of vitamin B6 can cause peripheral neuropathy and advises adults not to take more than 10mg a day in supplements unless a doctor has recommended it.
If burning or tingling started after you began taking supplements, check the labels of every product rather than looking only at one bottle.
Do not stop prescribed medicines simply because they contain a vitamin or because you suspect them of causing symptoms. Discuss prescribed treatment with a clinician first.
What Other Conditions Can Cause Peripheral Neuropathy?
Diabetes gets much of the attention because it is common, but neuropathy has many other possible causes.
These include excessive alcohol use, an underactive thyroid, kidney disease, some autoimmune conditions, certain infections and inherited neurological disorders.
Some cancer treatments can damage peripheral nerves as well. Chemotherapy-induced neuropathy may cause burning, tingling or numbness in the hands and feet and can sometimes continue after treatment has ended.
Certain other medicines can also cause neuropathy. The NHS therefore recommends reviewing medications as part of the investigation when peripheral neuropathy is suspected.
Alcohol can contribute in more than one way. Long-term heavy alcohol use can be directly toxic to nerves and may also be associated with nutritional deficiencies.
Occasionally, despite appropriate investigations, no clear cause is found. This is known as idiopathic peripheral neuropathy.
That does not mean the symptoms are imaginary. It simply means a specific underlying cause has not been identified.
Could a Trapped Nerve Cause Burning in One Foot?
Yes. Burning that affects a specific part of one foot may be caused by a local nerve problem rather than a generalised peripheral neuropathy.
One example is Morton's neuroma, which affects a nerve in the forefoot. People often describe burning or shooting pain around the ball of the foot and toes, sometimes accompanied by the sensation that there is a pebble inside the shoe.
Tarsal tunnel syndrome is another possibility. It involves compression of the tibial nerve around the inside of the ankle and can produce burning or tingling in the sole of the foot.
Problems in the lower back can sometimes irritate nerves that travel into the leg and foot. Sciatica, for example, may cause burning, tingling or altered sensation extending down one leg.
The location can therefore provide useful clues:
- both feet beginning at the toes may suggest a generalised neuropathy;
- one small area in the forefoot may suggest a local nerve problem;
- burning running from the back or buttock down one leg may suggest spinal nerve irritation;
- symptoms linked closely to particular shoes may point towards pressure or compression.
A clinician will usually assess sensation, reflexes, muscle strength and where the symptoms occur before deciding whether further tests or imaging are needed.
What If the Feet Are Actually Hot and Red?
There is an important difference between feet that feel hot because of abnormal nerve signals and feet that are genuinely warm, red or swollen.
Skin inflammation, infection, injury and some circulation-related conditions can cause true warmth.
A fungal infection such as athlete's foot may cause itching, burning, cracking or peeling skin, particularly between the toes.
Cellulitis can cause an area of skin to become hot, painful, red and swollen and usually needs prompt medical assessment.
A less common condition called erythromelalgia causes episodes of intense burning pain, redness and warmth, usually affecting the feet or hands. Heat and exercise can trigger symptoms in some people.
Do not repeatedly apply ice directly to burning feet in an attempt to cool them. Very cold temperatures can damage skin, particularly if neuropathy has reduced your ability to judge temperature accurately.
Gentle cooling and comfortable footwear are safer until the cause is understood.
How Are Burning Feet Investigated?
If burning sensations continue, recur regularly or are accompanied by numbness, weakness or loss of balance, a GP can begin by taking a detailed history.
They will want to know when the symptoms started, whether one or both feet are affected and whether the sensation is constant or intermittent.
You may also be asked about alcohol, diet, medicines, supplements, diabetes risk and other medical conditions.
The physical examination may involve checking:
- light-touch sensation;
- temperature or vibration sensation;
- reflexes;
- muscle strength;
- balance;
- pulses and circulation in the feet;
- skin and nails.
Blood tests are often useful because several treatable causes can be identified this way.
Tests might include blood glucose or HbA1c for diabetes and vitamin B12 levels. Depending on your symptoms and medical history, tests for thyroid function, kidney function, blood count or other conditions may also be considered.
The NHS notes that blood tests for diabetes and B12 deficiency are commonly used when investigating peripheral neuropathy.
If the diagnosis remains unclear or symptoms are significant, you may be referred to a neurologist.
Further investigations can include nerve conduction studies, which measure how effectively electrical signals travel through nerves, and electromyography (EMG), which examines electrical activity in muscles.
Most people with burning feet do not need every possible test. Investigations are guided by the symptom pattern and initial examination.
How Are Burning Feet Treated?
Treatment depends on the cause.
If diabetes is contributing to neuropathy, improving blood glucose control can help reduce the risk of further nerve damage. Existing nerve damage does not always disappear, so prevention of progression is an important goal.
If vitamin B12 deficiency is responsible, B12 replacement may be given as tablets or injections depending on the cause and severity of the deficiency.
If excessive vitamin B6 supplementation is suspected, the supplement regimen needs to be reviewed.
If a particular medicine may be causing neuropathy, your doctor may consider changing the dose or treatment. Do not stop prescription medication without discussing it first.
Nerve pain itself sometimes needs specific treatment. Ordinary painkillers such as paracetamol or ibuprofen often do not work particularly well for neuropathic pain.
Medicines used for neuropathic pain may include treatments such as amitriptyline, duloxetine, gabapentin or pregabalin, depending on the person's circumstances.
These medicines are not suitable for everyone and can cause side effects, so treatment needs to be individualised.
Footwear can also make a significant difference. Shoes should be comfortable, roomy enough around the toes and free from seams or pressure points that repeatedly rub the skin.
If sensation is reduced, check inside shoes before putting them on because small stones or objects may cause injury without producing much pain.
When Should You See a Doctor About Burning Feet?
Occasional mild burning after spending a long day on your feet is different from persistent unexplained nerve-type symptoms.
Arrange a GP appointment if burning or tingling:
- keeps returning;
- lasts for several weeks;
- is gradually spreading;
- affects both feet;
- is accompanied by numbness;
- causes problems with balance;
- is associated with muscle weakness;
- started after a new medicine or supplement;
- occurs when you have diabetes.
The NHS advises seeing a GP for early symptoms of peripheral neuropathy such as pain, tingling or loss of sensation in the feet.
People with diabetes should be particularly cautious about foot problems.
Seek prompt medical advice if you have diabetes and develop a blister, cut, ulcer, swelling, colour change or other foot injury, especially if it is not healing normally.
Sudden weakness, rapidly worsening numbness, difficulty walking or new problems with bladder or bowel control need more urgent medical assessment because they may indicate a more significant neurological problem.
Frequently Asked Questions
Why do my feet burn mostly at night?
Neuropathic symptoms often feel more noticeable at night when there are fewer distractions and the feet are resting under warm bedding. Even light contact from sheets can feel uncomfortable when nerves are unusually sensitive. Night-time burning does not by itself identify the cause.
Does burning feet mean I have diabetes?
No. Diabetes is an important and common cause of peripheral neuropathy, but burning feet can have many other explanations. Vitamin B12 deficiency, medications, alcohol, trapped nerves and other medical conditions can all produce similar symptoms. A blood test can help establish whether diabetes is present.
Can prediabetes cause burning feet?
Nerve problems have been reported in people with abnormal glucose metabolism before established diabetes, although burning feet should not automatically be attributed to prediabetes. Other causes still need to be considered. If you are concerned about your glucose levels, testing HbA1c or fasting glucose is more useful than trying to diagnose diabetes from symptoms alone.
Which vitamin deficiency causes burning feet?
Vitamin B12 deficiency is an important nutritional cause of peripheral nerve symptoms. It may cause tingling, numbness, weakness and problems with balance as well as burning sensations. However, symptoms alone cannot confirm B12 deficiency, so testing is usually preferable to taking large doses of supplements without knowing your level.
Can too many vitamins cause burning feet?
Yes. High doses of vitamin B6 can cause peripheral neuropathy. This is one reason it is worth checking the total amount of B6 in all supplements you take, particularly if you combine several different products.
Can metformin cause burning feet?
Metformin does not usually cause burning feet directly, but long-term metformin treatment can reduce vitamin B12 levels in some people. Because B12 deficiency can affect nerves, clinicians may check B12 if somebody taking metformin develops symptoms that could suggest deficiency. Do not stop metformin without medical advice.
Why do my feet burn but feel cold to touch?
This can happen with neuropathic pain. The burning sensation is generated by abnormal nerve signals rather than by the foot actually becoming hot, so the skin may feel completely normal or even cool when touched.
Can poor circulation cause burning feet?
Circulation problems can cause foot symptoms, but reduced arterial blood flow more commonly causes coldness, colour changes, pain during walking or slow-healing wounds. Burning pain is particularly characteristic of nerve irritation, although nerve and circulation problems can occur together, especially in people with diabetes.
Can anxiety cause burning feet?
Anxiety can heighten awareness of bodily sensations and hyperventilation can produce tingling, but ongoing burning in the feet should not automatically be attributed to anxiety. Persistent or progressive symptoms deserve a medical assessment, especially when numbness, weakness or balance problems are also present.
Can alcohol cause burning feet?
Long-term heavy alcohol use can contribute to peripheral neuropathy. It can also be associated with poor nutrition and vitamin deficiencies, which may further affect nerve health.
Can burning feet go away?
That depends on the cause. Symptoms caused by a correctable vitamin deficiency, pressure on a nerve or a medication may improve when the underlying problem is treated. Neuropathy caused by long-standing nerve damage may improve only partly or may persist, although treatment can sometimes reduce the discomfort and prevent further deterioration.
Should I take B12 for burning feet?
B12 treatment can help when B12 deficiency is genuinely causing nerve symptoms. It is better to establish whether you are deficient rather than assuming all burning feet are caused by low B12. If neurological symptoms are present, speak to a GP because prompt diagnosis can be important.
This guide provides general information and is not a diagnosis. Persistent burning, tingling, numbness or weakness in the feet should be assessed by a healthcare professional, particularly if you have diabetes or the symptoms are getting worse.
