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Q
Are Your Feet Burning?

I have numbness and burning in my feet and its worse at night. Is there anything I can do for this?

A
Answer (Published 1/10/2005)

What you describe sounds like a common condition called peripheral neuropathy, which stems from damage to the peripheral nerves that branch out through the arms, legs, fingers and toes. The symptoms include weakness, numbness, tingling and burning or painful sensation.

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Peripheral neuropathy is often due to diabetes but can occur as a result of toxic trauma (such as chemotherapy) or mechanical injury, such as carpal tunnel syndrome. Sometimes, it is due to prolonged use of crutches or even sitting in the same position for too long. Other disorders that can lead to peripheral neuropathy include atherosclerosis, autoimmunity, infections, advanced kidney disease and hypothyroidism as well as a number of drugs and environmental toxins.

Your first step should be a general medical checkup to rule out underlying disease as the cause of your symptoms and to determine exactly what the problem is. Your doctor should do complete blood work and may refer you to a neurologist who will probably do an EMG (electromyelogram) to assess muscles and nerve conduction.

If you have no underlying disease, you can try one or all of the following strategies to deal with your symptoms:

  • Take one B-100 B-complex vitamin daily. The B vitamins are necessary for normal nerve function, and supplementing is a good preventive measure. (Don't take more than 200mg of B-6, as higher daily doses can actually cause symptoms of neuropathy.)
  • Take 100 mg of alpha lipoic acid once a day. This antioxidant protects microcirculation to the nerves. You can gradually increase the dose to 300 mg twice a day over the next month.
  • Try acupuncture. You can find a qualified acupuncturist in your area through NCCAOM (National Certification Commission for Acupuncture and Oriental Medicine ) or the AAOM (American Association of Oriental Medicine).

Other therapies that can help include Chinese medicine. A practitioner can provide you with herbs that may speed recovery. You can also try reflexology for neuropathy of the legs, feet and toes. If a toxic exposure is the cause, time is your greatest ally - injured nerves will slowly recover once the exposure ends.

Conventional treatments include tricyclic antidepressants such as amitriptyline HCl (Elavil, Endep) and imipramine (Tofranil), which act on the central nervous system and may reduce pain independent of their action as antidepressants. It usually takes a few weeks for results to become noticeable. Anti-seizure medications like phenytoin (Dilantin), carbamazepine (tegretol) and gabapentin (Neurontin) are also used effectively for peripheral neuropathy.

Andrew Weil, M.D.

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