DEAR DR. ROACH: For about a month and a half, I wake up with burning feet one to four times a night. I am so tired. My podiatrist said to use Biofreeze, but it did not work. I sit with ice on my feet each time I wake up. I have been trying to get an appointment with a neurologist.
I am in my 80s and have had two major back surgeries, as well as a stimulator put in my back, during the past three years. I am in pain to one degree or another whenever I am not sleeping. I have had MRIs, X-rays and scans, and I have been to many doctors. I don’t know if the surgeries are connected to my feet pain. -- Anon.
ANSWER: I suspect that there is a connection between your back surgeries and your foot pain, although I can’t be sure. Burning foot pain is highly likely to be a neuropathy, which just means that some kind of nerve problem is causing the pain.
When the pain is on both sides, metabolic issues, especially diabetes, are a very likely cause. But if you have had damage to the nerves on both sides, the underlying condition for your back surgery -- or possibly the surgery itself -- could have led to nerve damage and the neuropathic pain you now have.
A neurologist can help make a diagnosis (sometimes this isn’t possible) or prescribe more effective treatments.
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DEAR DR. ROACH: I am a 67-year-old Caucasian female in generally good health. In 2022, I was found to have asymptomatic atrial fibrillation (AFib). I underwent electrical cardioversion in the hospital, but the AFib continued periodically throughout the past year, according to my heart monitor. Six weeks ago, a 14-day Holter monitor showed a 65% AFib burden, with my heart rate ranging from 34-192 bpm.
My doctor is proposing Tikosyn, since metoprolol significantly lowers my heart rate. Unfortunately, my insurance will not cover brand-name Tikosyn, but it will cover the generic version. Are there any concerns about the generic version? -- P.S.
ANSWER: AFib is a common electrical abnormality of the heart where the normal regulation of the heart rate is lost and the heart beats in a chaotic fashion. The heart rate can be variable, and your range is concerning, since 34 is very slow and 192 is dangerously high for a 67-year-old. Better control of your heart rate is essential.
If AFib recurs after an electrical cardioversion, medication is usually tried. There are several drugs, and clinical judgment by a cardiologist is essential in choosing the correct one. I never prescribe these drugs; I defer to the experts.
Tikosyn is a commonly used medicine. All anti-arrhythmic drugs have the potential, paradoxically, to create new rhythm disturbances. About 3% of the time, Tikosyn causes a dangerous rhythm called torsade de pointes, which is life-threatening.
Most of the time, this occurs within three days of starting the medicine, so it is essential to be in the hospital when starting the medication so that your heart can be continuously monitored and you have emergency treatment at the ready. If a person gets through the three days without problems (which is the usual case), then medication is continued after the person is discharged.
Because the brand name is more than 20 times as expensive as the generic version, most people do take the generic one. The generic version is the exact same drug, and a study on absorption showed them to be bioequivalent.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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FAQs
Patients that have had back surgery can present with dull and achy back pain the can radiate into the buttocks and thighs. If scar tissue is pushing on the nerve roots, there may be a shooting, burning pain in the legs and feet.
Can back surgery cause burning feet? ›
Patients that have had back surgery can present with dull and achy back pain the can radiate into the buttocks and thighs. If scar tissue is pushing on the nerve roots, there may be a shooting, burning pain in the legs and feet.
How do I stop my feet from burning at night? ›
How is burning feet syndrome treated?
- Soak your feet in cool water for at least 15 minutes. This may provide temporary relief. ...
- Avoid exposing your feet to heat.
- Raise your legs and feet.
- Take over-the-counter pain medicines (analgesics). ...
- Apply topical creams and ointments.
While fatigue or a skin infection can cause temporarily burning or inflamed feet, burning feet are most often a sign of nerve damage (peripheral neuropathy). Nerve damage has many different causes, including diabetes, chronic alcohol use, exposure to certain toxins, certain B vitamin deficiencies or HIV infection.
How do you treat burning feet syndrome? ›
Here are 9 that may provide relief:
- Soaking feet in cold water or an ice bath. Soaking the feet in cold water can help temporarily relieve the symptoms of BFS. ...
- Rest, ice, compression, and elevation (RICE) ...
- Epsom salt. ...
- Apple cider vinegar. ...
- Turmeric supplements. ...
- Fish oil. ...
- Ginger. ...
- Lidocaine or capsaicin.
Physical therapy can be helpful for some people. Medications are also helpful, but they can only relieve the pain, not the numbness. Medicines that are more specific for nerve pain, such as gabapentin or amitriptyline, are usually more effective than opiate-type medications in the long-term.
How long does neuropathy last after back surgery? ›
Nerve pain goes away after back surgery in most cases. However, it can take a year or even longer after the surgery for the nerves to completely heal. Nerves heal slowly when compared to other types of tissue. If nerve pain doesn't go away after back surgery, it may be referred to as failed back surgery syndrome.
Why is burning feet syndrome worse at night? ›
Temperature Changes: Body temperature naturally drops as the day transitions into the night. This temperature change can trigger or exacerbate the sensation of burning feet. Blood Flow: Changes in blood flow and circulation patterns at night can contribute to foot discomfort.
What medication is good for burning feet at night? ›
Some commonly prescribed medications for burning feet include:
- amitriptyline.
- carbamazepine (Tegretol)
- desipramine (Norpramin)
- duloxetine (Cymbalta)
- gabapentin (Neurontin)
- pregabalin (Lyrica)
- topiramate (Topamax)
- venlafaxine (Effexor XR)
They should contact a doctor if a burning sensation is accompanied by: a fever. swelling, warmth, or flushing of the skin. swollen and painful glands.
A podiatrist is a doctor who diagnoses and treats foot problems. They can advise you on how to take care of your feet and ease symptoms. They can also prescribe: medications.
Is burning feet a symptom of kidney problems? ›
The burning foot syndrome, which occurs in less than l0% of patients with kidney failure, represents swelling and tenderness of the distal lower extremities. The physical signs of peripheral nerve dysfunction often begin with loss of deep tendon reflexes, particularly in the ankle and knee.
Does Epsom salt help burning feet? ›
Epsom salt, when mixed with warm water, can create a soothing foot soak. Soaking your feet in this mixture for a specific time can help relax the muscles and potentially reduce burning sensations. Epsom salt contains magnesium, which can be absorbed through the skin and contribute to muscle relaxation and comfort.
What can I put on my feet to stop them burning? ›
Home remedies for pain relief
- Soak your feet in cold water or ice baths for a few minutes. ...
- Soak your feet in Epsom salts or an apple cider solution. ...
- Take a turmeric supplement. ...
- Apply a topical cream that contains lidocaine or capsaicin. ...
- Massage your foot to help improve blood flow and circulation.
Exercise such as walking is good for peripheral neuropathy as it improves circulation to the feet. Massaging the feet also increases circulation.
What deficiency causes burning feet? ›
A deficiency of vitamin B-12 is most often linked to burning feet sensations and tingling in the finger and toes. Burning and numbness may also occur in the legs, arms and hands. Though most B vitamins are readily available in foods, a vitamin B-12 deficiency is common, particularly among elderly individuals.
Can back problems cause burning feet? ›
Initially, compression of the lumbar spinal nerves can result in pain in the areas that the nerves supply, usually described as an ache or a burning feeling. It typically starts around the buttocks and radiates down the leg. As it progresses, it can result in pain in the feet.
Why is my foot burning after surgery? ›
Postsurgical nerve damage can occur for various reasons, including misdiagnosis, surgical error, and scar tissue formation. Common signs of postoperative nerve damage include tingling, numbness, weakness, or burning sensations. The most common complication following foot and ankle surgery is cutaneous nerve injury.
Does nerve regeneration cause burning sensation? ›
Is Burning a Sign of Nerve Healing? Yes, burning sensations can be a sign of nerve healing. You may experience sharp shooting or burning pain. These symptoms are common in nerve pain and are generally considered positive indicators of recovery, especially if the nerve has been severed and surgically repaired.
How can you tell if you have nerve damage after back surgery? ›
Tingling, numbness, muscle weakness, or burning are the most common signs and symptoms of nerve damage after surgery. Numbness is the most annoying and troubling problem caused after surgery. It is basically losing sensation in a particular area of the body that affects a person's lifestyle.
