Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Hills, MI
Last reviewed: May 2026
Burning feet near Brighton that are worst at night point to a specific nerve pathway — and the exact location of the burning narrows the diagnosis to one of four causes, each with completely different treatment. Most patients with burning feet have been given the wrong cause and the wrong treatment. Call (810) 206-1402 — same-day burning feet evaluations in Brighton.
Medically Reviewed by: Dr. Tom Biernacki DPM · Board-Certified Podiatrist · Balance Foot & Ankle PLLC · Updated 2026
Burning Feet Treatment Near Brighton, MI
Burning feet treatment near Brighton, MI is available at Balance Foot & Ankle in Howell. Dr. Biernacki DPM evaluates the cause of burning, tingling, or painful feet — distinguishing between diabetic neuropathy, tarsal tunnel syndrome, small fiber neuropathy, nutritional deficiency, and other causes — and coordinates treatment to reduce pain and protect foot health. Call (810) 206-1402.
Burning Feet: What the Sensation Is Actually Telling You
A burning sensation in the feet — whether constant or worse at night, in the soles, the toes, or the whole foot — is a symptom, not a diagnosis, and the underlying cause determines both the treatment and the prognosis. The most common cause in our Howell-area patient population is diabetic peripheral neuropathy, affecting up to 50% of patients with long-standing diabetes, where small fiber nerve damage produces the classic burning, tingling, or “walking on gravel” sensation that worsens at night. But several other causes must be systematically evaluated: tarsal tunnel syndrome (entrapment of the posterior tibial nerve at the ankle) produces burning, numbness, and tingling in the sole — and is surgically correctable; vitamin B12 deficiency (especially in patients on metformin, proton pump inhibitors, or with pernicious anemia) causes reversible neuropathy that many practitioners miss because they don’t check B12 levels; hypothyroidism and alcohol use are additional common causes; and idiopathic small fiber neuropathy — now diagnosable via skin punch biopsy — accounts for many “unexplained” burning feet cases. Identifying the cause is the first step to effective management.
Key Takeaway: Burning feet = systematic workup, not just “neuropathy.” Check B12, TSH, HbA1c, and ABI. Tarsal tunnel syndrome is surgically correctable — positive Tinel’s sign at the ankle differentiates it. B12 deficiency neuropathy reverses with supplementation. Diabetic neuropathy requires tight glycemic control + topical and systemic agents for pain management.
Causes and Treatment
Diabetic neuropathy: Optimize HbA1c (target <7%). Topical capsaicin or lidocaine for localized burning. Systemic agents for moderate-severe: duloxetine (FDA-approved for diabetic peripheral neuropathic pain), pregabalin, gabapentin. Protective footwear and daily foot inspection to prevent ulcers. Tarsal tunnel syndrome: Tinel’s sign test at the tarsal tunnel (medial ankle). Electromyography/nerve conduction study for diagnosis. Conservative: custom orthotics, corticosteroid injection. Surgical: tarsal tunnel release for failed conservative treatment — excellent results. B12 deficiency: Serum B12 and methylmalonic acid levels. High-dose B12 supplementation (1000–2000mcg/day oral methylcobalamin) or IM injections. Metformin patients: screen annually. Idiopathic small fiber neuropathy: Skin punch biopsy for definitive diagnosis (intraepidermal nerve fiber density). Alpha-lipoic acid 600mg/day has best evidence for symptomatic improvement. Lifestyle: Cooling foot soaks at night, compression socks for venous-related burning, supportive footwear to reduce nerve compression.
⚠️ See a Podiatrist If:
- Burning, tingling, or numbness in the feet — especially if worsening at night
- Diabetic patient with any foot burning or sensory change — annual exam mandatory
- Burning limited to the bottom of the foot and one or both heels — tarsal tunnel pattern
- Burning with “electric shock” sensations — small fiber neuropathy pattern
- Burning feet with unsteadiness or balance problems — coordination involvement needs evaluation
Recommended Products for Burning Feet Relief
Burning feet can stem from peripheral neuropathy, nerve compression, or circulatory issues. While identifying the root cause is essential, these products provide meaningful symptom relief for most patients. Dr. Biernacki recommends them as part of a comprehensive management plan.
Alpha Lipoic Acid 600mg — Neuropathy Nerve Support
Alpha lipoic acid (ALA) is the most evidence-backed supplement for peripheral neuropathy burning and tingling. Multiple randomized controlled trials show 600mg daily reduces neuropathy symptom scores by 30–50% in diabetic and idiopathic neuropathy. ALA is a powerful antioxidant that protects nerve tissue from oxidative stress and improves nerve conduction velocity. We recommend this to patients with burning feet before escalating to prescription neuropathy medications.
Doctor Hoy’s Natural Pain Relief Gel Pain Relief Gel — Cooling Nerve Symptom Relief
Doctor Hoy’s Natural Pain Relief Gel’s menthol-based formula activates cold-sensitive nerve receptors that compete with burning pain signals — a process called gate control. Many patients with burning feet find immediate 30–60 minute relief from topical application. It doesn’t treat the underlying neuropathy, but it provides safe, drug-free symptom relief between treatments. Apply to the bottom and top of both feet before bed when burning is typically worst. Available in gel, spray, and roll-on formats.
PubMed: Burning Feet Syndrome — Etiology and Treatment
Getting to Our Office From Brighton
Our Howell office at 4330 E Grand River Ave, Howell, MI 48843 is about 10 minutes from Brighton via US-23 N. We accept most major insurance. Call (810) 206-1402 or book online.
Burning Feet Disrupting Your Sleep? Get Answers
Balance Foot & Ankle · Serving Brighton & Michigan
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Dr. Tom’s Recommended Topical Relief
Doctor Hoy’s Natural Pain Relief Gel
Our clinic switched from Doctor Hoy’s Natural Pain Relief Gel to Doctor Hoy’s because the arnica base adds genuine anti-inflammatory action — not just cooling. Same TRPV1 pain relief, no synthetic dyes, better for sensitive skin.
Shop Doctor Hoy’s on Amazon →📋 Dr. Tom Biernacki, DPM, FACFAS answers:
Burning feet is one of the symptoms that most benefits from early specialized evaluation because the underlying causes range from easily correctable to serious systemic disease. Brighton and Livingston County residents come to our Balance Foot and Ankle clinic when burning foot pain is affecting their sleep, work, or daily activities. Our evaluation follows a systematic approach: peripheral neuropathy screening with monofilament and vibration threshold testing, review of metabolic risk factors including blood glucose and HbA1c for undiagnosed or poorly controlled diabetes, thyroid function, B12 levels, and medication history. Tarsal tunnel syndrome — compression of the tibial nerve at the inner ankle — is a structural cause of burning that is specifically worsened by prolonged standing and can be confirmed with nerve conduction studies or diagnostic ultrasound. For diabetic patients in the Brighton area, burning neuropathy often responds to improved glucose control combined with medications such as gabapentin, duloxetine, or topical capsaicin when appropriate. For non-diabetic small fiber neuropathy, identifying and treating the underlying cause — nutritional deficiency, autoimmune conditions, toxic exposure — provides the best long-term outcome. If you are a Brighton, Howell, or Livingston County resident experiencing burning or tingling feet, contact our office for a thorough neurological and vascular assessment.
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.