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What Causes Burning Sensation In Feet During The Night?
Question: My wife XXXX has burning feet, especially at night. Neurology Drs (3) don't know anything about it. She is 90 and they say she is just getting old. It is PN. Any ideas? Nothing is wrong with her feet that I can see, as they feel normal. She sprays with Lidocaine which helps her get to sleep, but it only lasts a short time and the burning wakes her up again
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from your description it seems like typical peripheral neuropathy (PN). Now peripheral neuropathy can have many different causes like diabetes, nutritional deficiencies, electrolyte imbalance, hormonal alterations, kidney or liver disease, some infections etc etc. The list is really long. For that reason some tests are needed to search for the possibility of those conditions. It is unclear from your account what type of tests she's had. I can't believe that the neurologists simply said it was due to age without conducting any test. If they did conduct tests which were negative then perhaps the cause just can't be identified. It is not uncommon. Even after extensive testing in 25% of peripheral neuropathies the cause remains unknown, even in young patients. So if they have done the necessary tests you shouldn't be thinking that they have given up because of her age as I sense you do. If no tests are done on the other hand you have every right to complain.
Now regarding treatment...when a cause is found naturally it is addressed. Even when no cause is found though there still is treatment available to alleviate the symptoms. The Lidocaine may be used but there are other first line options available as well which may be used. They include medication like Gabapentin or Pregabalin (initially used for seizures but with time have proven to be very effective for PN symptoms). Another option are some antidepressants such as Duloxetine which also have shown to be effective in alleviating PN symptoms. So you should speak with your primary physician about having a prescription for one of those drugs.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from your description it seems like typical peripheral neuropathy (PN). Now peripheral neuropathy can have many different causes like diabetes, nutritional deficiencies, electrolyte imbalance, hormonal alterations, kidney or liver disease, some infections etc etc. The list is really long. For that reason some tests are needed to search for the possibility of those conditions. It is unclear from your account what type of tests she's had. I can't believe that the neurologists simply said it was due to age without conducting any test. If they did conduct tests which were negative then perhaps the cause just can't be identified. It is not uncommon. Even after extensive testing in 25% of peripheral neuropathies the cause remains unknown, even in young patients. So if they have done the necessary tests you shouldn't be thinking that they have given up because of her age as I sense you do. If no tests are done on the other hand you have every right to complain.
Now regarding treatment...when a cause is found naturally it is addressed. Even when no cause is found though there still is treatment available to alleviate the symptoms. The Lidocaine may be used but there are other first line options available as well which may be used. They include medication like Gabapentin or Pregabalin (initially used for seizures but with time have proven to be very effective for PN symptoms). Another option are some antidepressants such as Duloxetine which also have shown to be effective in alleviating PN symptoms. So you should speak with your primary physician about having a prescription for one of those drugs.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your observations. I have researched much deeper into the PN mysteries and found Neuropathy Hope Newsletter to be a good "support" publication. As to Gabapentin, no help and bad side effects. See: www.WNAinfo.org. Best help has been "Lanacane" spray can. You spray your feet and burning feeling goes away and lets you get to sleep. (Available from Walgreens.)Also there is "Chillow" a small plastic blue pillow that transfers body heat to coolness. It goes into the bottom of your bed and you put your hotfeet on this which helps you get back to sleep. Three Neurologists have said they can't help, it is now heredity and not diabetes. Since it is both legs the bad (pinched, crossed, broken, insulation gone) nerves are near the base of my spine where I have had a number of epidermal cortisone shots. Eeg finds nothing, so I guess it is back to searching NIH references. Most cures are only bandaids. If you hear of anything, let me know. Thank you for your answer.
Brief Answer:
Read below.
Detailed Answer:
Hello and thank you for the additional information.
I do not really understand why did you have an EEG for neuropathy, it doesn't have any utility at all...or did you mean EMG?
I am sorry Gabapentin hasn't worked for you, usually is effective in a good percentage of my patients. There are other options like Lyrica (Pregabalin) or Cymbalta (Duloxetine), those are the first line therapies advised by guidelines.
Otherwise I am afraid that medication is limited to local anesthetics like Lanacane which you mention.
Let me know if I can further assist you.
Read below.
Detailed Answer:
Hello and thank you for the additional information.
I do not really understand why did you have an EEG for neuropathy, it doesn't have any utility at all...or did you mean EMG?
I am sorry Gabapentin hasn't worked for you, usually is effective in a good percentage of my patients. There are other options like Lyrica (Pregabalin) or Cymbalta (Duloxetine), those are the first line therapies advised by guidelines.
Otherwise I am afraid that medication is limited to local anesthetics like Lanacane which you mention.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your followup. This is XXXX writing for my wife XXXX, and to say thank you also. Gabapentin does work very well for a friend of mind, says he couldn't live without it. Lyrica was suggested by Dr. Sodeifi in Pleasant Hill, but side effects would confound her problems. Dr. Sodeifi scheduled "sleep deprivation" tests to determine cause of 3 seizures she has had that the Dr. feels is related. EEG is wrong, sorry, instead a Dr. Wei in Walnut Creek, CA used a lot of electrodes on Betty's legs and gave up, saying in a nice way I can't help you, go somewhere else. More tests are scheduled by Dr. Min, a heart doctor. There are Dr.s that can help, but not on our health plan, example Dr. XXXXXXX Skaff, Carmichael, CA. We will try to see him and pay big. Do you want to continue this dialogue for your own information? Dr. Skaff has a DVD that is excellent. Should I get one for you and where do I send it. Share information?
Brief Answer:
Of course thank you!
Detailed Answer:
Thank you for your feedback!
I would certainly appreciate it if you could keep me up to date. Also if you sent me the DVD (Work address: QSUT Nene Tereza, Stroke Unit, Rr Dibres Nr 370, 1012, Tirana, Albania).
I wouldn't want you to incur extra expenses for that though, especially with me living in another country with mail expenses being higher. So have no worry if you are not able to send it.
Wishing you good health.
Of course thank you!
Detailed Answer:
Thank you for your feedback!
I would certainly appreciate it if you could keep me up to date. Also if you sent me the DVD (Work address: QSUT Nene Tereza, Stroke Unit, Rr Dibres Nr 370, 1012, Tirana, Albania).
I wouldn't want you to incur extra expenses for that though, especially with me living in another country with mail expenses being higher. So have no worry if you are not able to send it.
Wishing you good health.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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