Burning Feet: 7 Causes and What Each One Means

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Township, MI. Last updated April 2026.

A burning sensation in the feet is one of the most common and most diagnostically varied complaints in podiatric medicine. The burning quality of pain provides important clues about its origin — neurological, vascular, infectious, or mechanical — and points toward very different treatments. Here’s a systematic approach to understanding what’s causing your burning feet.

1. Peripheral Neuropathy (Most Common Cause)

Peripheral neuropathy — damage to the nerves outside the brain and spinal cord — is the #1 cause of burning feet. Diabetic neuropathy affects up to 50% of people with diabetes and causes burning, tingling, and electric-shock sensations typically worse at night. Other causes of neuropathy include: vitamin B12 deficiency, hypothyroidism, chemotherapy, alcohol use disorder, and HIV. If you have burning feet and diabetes or any of these risk factors, see a physician promptly.

2. Athlete’s Foot (Tinea Pedis)

Fungal infection of the skin can cause burning and itching between the toes and on the soles. The “moccasin” type of athlete’s foot affects the entire sole with scaling and burning. Often underdiagnosed because it’s assumed the burning is neurological. Check for skin peeling, scaling, or redness — and treat with antifungal cream if present.

3. Tarsal Tunnel Syndrome

Entrapment of the posterior tibial nerve as it passes through the tarsal tunnel behind the inner ankle causes burning along the nerve’s distribution — the arch and sole of the foot. Distinguished from plantar fasciitis by the burning, neurological quality of the pain and the positive Tinel’s sign on nerve palpation.

4. Erythromelalgia

A rare condition causing episodic burning, redness, and warmth — often triggered by heat or exercise. The feet become intensely hot and red, and symptoms are relieved by cooling. Can be primary (genetic) or secondary to myeloproliferative disorders. Requires specific investigation and management.

5. Contact Dermatitis or Allergic Reaction

Some people develop burning sensations from allergic reactions to shoe materials, socks, or topical products. Rubber accelerators in shoe linings are a surprisingly common sensitizer. The burning is typically accompanied by visible skin changes (redness, blistering, scaling) in the distribution of the contact.

6. Poor Circulation (Peripheral Artery Disease)

Reduced blood flow to the feet can cause burning, particularly at rest and at night. Unlike neuropathy (which causes diffuse burning), PAD-related burning may be more focal and is typically accompanied by cold feet, skin changes, and claudication (calf pain with walking). Requires vascular evaluation.

7. Vitamin Deficiency

B12 deficiency is a well-established cause of burning feet and other neuropathy symptoms. B1 (thiamine) and B6 deficiencies also cause peripheral neuropathy. This is particularly common in: vegans and vegetarians, those on metformin (depletes B12), the elderly, and those with autoimmune gastritis (impaired B12 absorption). A simple blood test identifies deficiency.

When to See a Podiatrist or Physician

Seek evaluation if burning feet: are severe or worsening, interfere with sleep or daily activities, occur with numbness or weakness, are associated with diabetes, or don’t improve after treating suspected athlete’s foot.

Clinical References

1. Mold JW, Holtzclaw BJ, McCarthy L. Night sweats: a systematic review of the literature. J Am Board Fam Med. 2012;25(6):878-893. doi:10.3122/jabfm.2012.06.120033
2. Callaghan BC, Price RS, Feldman EL. Distal symmetric polyneuropathy: a review. JAMA. 2015;314(20):2172-2181. doi:10.1001/jama.2015.13611
3. Papanas N, Ziegler D. New diagnostic tests for diabetic distal symmetric polyneuropathy. J Diabetes Complications. 2011;25(1):44-51. doi:10.1016/j.jdiacomp.2009.09.006

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your neuropathy, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

The most important clinical decision with Burning Feet Causes Treatment isn't which treatment to start with — it's which subtype or underlying cause you actually have. Our podiatrists regularly see patients who've been treated for months for the wrong diagnosis. The correct identification changes the entire treatment path. Call (810) 206-1402 — Dr. Tom evaluates this condition at both Howell and Bloomfield Township locations.