The sensation of “burning legs” describes an uncomfortable feeling, ranging from mild warmth to intense, fiery pain. This symptom signals an underlying issue. Discomfort can be constant or intermittent, varying in severity, prompting many to seek medical attention.
Understanding Common Causes
Peripheral neuropathy, or nerve damage, is a frequent cause of burning legs. In diabetes, high blood sugar levels can harm nerve-supplying blood vessels, leading to impaired nerve function and symptoms like burning, tingling, or numbness. Up to 50% of people with diabetes may develop this condition.
Alcoholism can contribute to peripheral neuropathy (alcoholic neuropathy), where excessive alcohol consumption damages nerves. Alcohol also interferes with the body’s absorption of essential B vitamins like thiamine (B1) and B12. Nutritional deficiencies, especially of vitamin B12 and B6, can directly cause paresthesia, a burning or tingling sensation.
Restless legs syndrome (RLS) is a neurological disorder causing an irresistible urge to move the legs, often with uncomfortable sensations. These can include burning, tingling, itching, or throbbing, and often worsen during rest or inactivity, especially at night. Moving or rubbing the legs often provides temporary relief.
Nerve compressions can also lead to burning sensations. Sciatica, for instance, is pain radiating along the sciatic nerve, from the lower back down through the buttocks and into each leg. This pain often feels sharp, burning, or like an electric shock, and is often caused by a herniated disk or bone overgrowth pressing on nerve roots in the lumbar spine. The pain can be worse with coughing, sneezing, or prolonged sitting.
Skin irritations and infections can also cause burning legs. Athlete’s foot, a fungal infection, often presents as an itchy, stinging, or burning rash. This infection thrives in warm, moist environments like sweaty shoes and socks.
Recognizing Serious Conditions
Deep vein thrombosis (DVT) involves a blood clot in a deep vein, commonly in the lower leg or thigh. A DVT can cause throbbing or cramping pain, swelling, and warmth in the affected leg, sometimes described as burning. This condition is serious because the clot can break loose and travel to the lungs, leading to a pulmonary embolism.
Severe infections like cellulitis can also manifest as burning in the legs. Cellulitis is a bacterial skin infection causing painful inflammation, swelling, and warmth in the affected area, often the lower legs. The skin may also appear red, tight, or glossy, and blisters can form. Untreated cellulitis can spread to the bloodstream, becoming life-threatening.
Complex Regional Pain Syndrome (CRPS) is a chronic pain condition usually affecting an arm or a leg, characterized by continuous burning or throbbing pain disproportionate to any initial injury. CRPS can also cause changes in skin temperature, color, and texture, along with swelling and increased sensitivity to touch. Its exact cause is not fully understood, but it often follows an injury, surgery, stroke, or heart attack.
Certain autoimmune diseases can also lead to burning leg sensations. Systemic lupus erythematosus (lupus) can cause inflammation and nerve damage, leading to burning pain, numbness, and tingling. Lupus can also cause erythromelalgia, a skin condition with warm sensation, discoloration, and swelling, often affecting hands and feet. Similarly, rheumatoid arthritis (RA), primarily affecting joints, can cause nerve compression or damage due to inflammation, leading to numbness, tingling, or burning in the hands and feet.
Severe arterial insufficiency (peripheral artery disease or PAD) occurs when narrowed or blocked arteries reduce blood flow to the legs and feet. This reduced blood supply can cause severe burning or aching pain, especially in the feet or toes, that may worsen at rest or at night. Other signs include skin color changes, non-healing sores, and hair loss on the legs.
When to See a Doctor
Seek medical attention for burning leg pain if:
It is sudden and severe, especially if accompanied by significant swelling, redness, or warmth in the affected leg, as these could indicate deep vein thrombosis or cellulitis.
A fever is present alongside burning leg pain, suggesting a possible infection.
Numbness, weakness, or a loss of sensation in the leg or foot occurs, particularly if sudden or rapidly worsening.
The burning sensation interferes with daily activities, sleep, or is progressively worsening.
Diagnosis and Treatment Approaches
Diagnosing burning legs involves a comprehensive approach. It often begins with a thorough review of medical history, including existing conditions and medications, followed by a physical examination to assess sensation, reflexes, and muscle strength. Further diagnostic tests may include blood tests for diabetes, vitamin deficiencies, or inflammation markers.
Nerve conduction studies and electromyography (NCS/EMG) evaluate nerve function and identify nerve damage or compression. Imaging studies (X-rays, MRI, or ultrasound) might visualize bones, soft tissues, or blood vessels, helping detect issues like herniated discs, blood clots, or arterial blockages. Specific tests depend on the suspected underlying cause.
Treatment for burning legs depends on the accurate diagnosis. For nerve-related pain, medications like nerve pain relievers may be prescribed. Anti-inflammatory medications can help reduce swelling and discomfort. Physical therapy may be recommended to improve strength, flexibility, and nerve function, especially for conditions involving nerve compression or muscle weakness.
Lifestyle changes often manage symptoms, such as dietary adjustments for vitamin deficiencies or blood sugar control in diabetes, and avoiding alcohol in alcoholic neuropathy. For infections, antibiotics or antifungal medications are used. In cases of blood clots or severe arterial blockages, specific medical interventions or procedures may be necessary to restore proper circulation.