A feeling that your heels are burning, medically termed paresthesia or dysesthesia, ranges from a mild warmth to a sharp heat that may worsen at night. While sometimes a temporary irritation, this discomfort can signal that underlying body systems are not functioning correctly. Understanding the nature of this burning feeling—whether it involves nerves, skin, or mechanical stress—is the first step toward finding relief and preventing complications.
Common Reasons for a Burning Sensation
The sensation of burning in the heels most frequently points to a problem with the peripheral nervous system, a condition known as peripheral neuropathy. This nerve damage causes the nerve fibers to misfire, sending pain signals to the brain even when there is no physical injury. A significant percentage of peripheral neuropathy cases are linked to chronically high blood sugar levels from diabetes, which damages the tiny blood vessels supplying the nerves.
Other metabolic and nutritional deficiencies can also directly affect nerve health. Chronic, heavy alcohol use is toxic to nerves and often leads to deficiencies in B vitamins, particularly Vitamin B12, which is necessary for proper nerve function. When the nerve damage is localized, it may be due to a physical compression, such as Tarsal Tunnel Syndrome. This condition involves the pinching of the tibial nerve as it passes through a narrow channel in the ankle, causing a burning or tingling that radiates along the bottom of the foot.
The burning sensation may also originate from the skin itself due to dermatological or infectious causes. Athlete’s foot, or tinea pedis, is a common fungal infection that thrives in warm, moist environments and causes the skin to burn, itch, peel, and crack. Similarly, contact dermatitis occurs when the skin reacts to an irritating substance, such as chemicals in shoes or socks, leading to inflammation and a localized burning feeling.
Mechanical stress is another source of irritation that can produce a burning sensation, especially in the heel. Poorly fitting or unsupportive footwear can exert undue pressure on the foot’s structures, which may irritate sensitive nerves or lead to inflammation. The inflammation associated with plantar fasciitis, a condition affecting the band of tissue on the sole of the foot, can occasionally present as a burning discomfort in the heel area.
Immediate Steps for Symptom Relief
For temporary relief, non-prescription methods focus on cooling the area and reducing inflammation or pressure. A cool water soak can numb the nerve endings; soaking the feet in cool water for about 15 minutes provides significant temporary comfort. Applying ice packs also helps reduce inflammation, but wrap the pack in a thin towel and apply it for no more than 10 to 15 minutes to avoid tissue damage.
Elevating the feet while resting is beneficial, as this position helps improve circulation and reduce swelling that might contribute to nerve compression. If a mechanical cause is suspected, change your footwear immediately. Select shoes that are well-ventilated, supportive, and provide adequate space for the toes to prevent nerve pressure.
If you suspect Athlete’s Foot, use an over-the-counter antifungal cream to address the underlying fungal infection. For nerve-related burning, topical treatments containing capsaicin or lidocaine can temporarily interrupt pain signals. Capsaicin desensitizes nerve endings, while lidocaine is a local anesthetic.
Moisturizing lotions can soothe dry, irritated skin, but avoid using them between the toes if a fungal infection is present.
When Professional Medical Evaluation is Necessary
A medical consultation is necessary when the burning sensation is severe, persistent, or not relieved by simple home care within a few days. Burning that spreads up the legs or is accompanied by neurological symptoms—such as numbness, muscle weakness, or loss of coordination—indicates a more advanced underlying nerve problem.
Changes in foot appearance, including unexplained skin color changes, open sores, or an inability to sense temperature, require professional assessment. Individuals living with diabetes should seek immediate attention for any foot symptom due to the increased risk of complications.
A physician begins diagnosis with a physical examination and a review of your medical history. They use blood tests to check for systemic causes, including diabetes, thyroid dysfunction, and B12 deficiencies. To evaluate nerve damage, a doctor may order a nerve conduction study (NCS) and electromyography (EMG).
These specialized tests measure the speed and strength of electrical signals passing through nerves and muscles, helping to pinpoint the issue’s location and severity. Treatment focuses on addressing the underlying cause, such as managing blood sugar levels or supplementing a vitamin deficiency. Prescription treatments may also include specific medications designed to modulate nerve pain signals.