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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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  • BFS has been mainly reported in Asian and Far East countries during a hot summer (1)
  • 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
    • overlying skin and blood vessels are normal in most - however in some patients there may be accompanying erythema of the feet with warm overlying skin as in erythromelalgia
    • no local tenderness over the affected parts
    • neurological examination is essentially normal in most patients; however some may exhibit a varying degree of hypo or hyperaesthesia
    • knee and ankle jerks show normal to brisk reaction
    • no signs of upper motor neuron involvement
    • motor power is maintained - no atrophy or wasting of the overlying muscles
  • if nutritional deficiency is the cause then most patients develop signs and symptoms of burning feet after approximately 4-5 months of deficient diet
    • skin manifestations of vitamin deficiency such as scrotal dermatitis or pellagra-like rash can precede the onset of burning sensation in the feet
  • physical examination may be entirely normal (as in familial BFS)

Reference:

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

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