The sensation of burning in the lower leg is a common but often alarming symptom that usually points to an issue within the nervous system. This feeling, medically termed paresthesia or dysesthesia, can range from a mild, irritating warmth to an intense, searing pain. Understanding the underlying cause relies heavily on whether the symptom is chronic and systemic, mechanical and localized to a nerve path, or related to blood flow.
When Burning is Caused by Chronic Nerve Damage
The most frequent systemic cause of a chronic burning sensation in the lower legs and feet is damage to the peripheral nerves, a condition known as peripheral neuropathy. This occurs when the nerves that transmit information between the central nervous system and the rest of the body become impaired. The damage specifically affects the long nerve fibers that extend to the extremities, leading to sensory symptoms that often begin in the toes and feet before progressing upward in a stocking-like distribution.
The mechanism involves the misfiring of damaged sensory nerves, which incorrectly interpret pain, heat, or touch signals as a persistent burning feeling. Uncontrolled blood sugar levels associated with Diabetes Mellitus are the leading cause of peripheral neuropathy. High glucose levels over time are toxic to nerve fibers and the small blood vessels that supply them, causing progressive degeneration.
Other metabolic and nutritional issues can also lead to this generalized, chronic nerve damage. Severe deficiencies in B vitamins, particularly Vitamin B12, are known to interfere with nerve health and the production of myelin. Chronic kidney disease also contributes to peripheral neuropathy because it allows toxic substances to accumulate in the bloodstream, which then harms nerve tissue. These systemic issues result in a symmetric pattern of burning that affects both lower legs simultaneously.
When Burning is Caused by Nerve Compression
When the burning sensation is sharp, shooting, and often limited to one leg, the cause is typically mechanical irritation or compression of a major nerve higher up the body. This phenomenon is known as radiculopathy, where the problem originates at the spinal nerve root but the pain is felt distally in the lower leg. The most common example of this is sciatica, which involves the irritation or compression of the large sciatic nerve or its contributing nerve roots in the lumbar spine.
Sciatica often produces a sharp, electric-shock-like, or burning pain that travels from the low back or buttock down the back of the thigh and calf, sometimes extending into the foot. This referred pain pattern happens because the compressed nerve root transmits a distorted signal along its entire length, which the brain interprets as pain in the leg. The compression frequently results from a herniated intervertebral disc, where the inner material pushes out and presses directly on the adjacent nerve root.
Narrowing of the spinal canal, called spinal stenosis, is another common mechanical cause, as it constricts the space available for the nerve roots. Certain muscle conditions, such as piriformis syndrome, can also mimic sciatica by causing the deep buttock muscle to spasm and compress the sciatic nerve. This type of burning pain is often made worse by specific movements like sitting, coughing, or sneezing, due to increased pressure on the nerve root.
Circulatory Problems and Localized Irritation
A less frequent but serious cause of lower leg burning is reduced blood flow, which starves the muscles of oxygen during activity. Peripheral Artery Disease (PAD) occurs when fatty plaque buildup, or atherosclerosis, narrows the arteries supplying the legs, restricting blood flow. This lack of oxygen during walking or exercise causes a cramping, aching, or burning pain in the calf, thigh, or buttock, a symptom known as claudication.
The pain from claudication is distinct because it consistently begins after walking a specific distance and reliably subsides within minutes of resting, only to return upon resuming activity. As the disease progresses, the burning sensation may appear even at rest, particularly in the feet and toes at night, when the legs are elevated. It is important to distinguish this from Deep Vein Thrombosis (DVT), which is a blood clot in a deep vein typically causing warmth, swelling, and tenderness.
Burning can also result from immediate, localized issues affecting the skin or muscle tissue. Severe skin infections, such as cellulitis, cause intense localized warmth, burning pain, redness, and swelling. Intense, unaccustomed physical activity can lead to a temporary burning sensation from lactic acid buildup within the muscles, which quickly resolves with rest. Contact with irritating chemicals or severe sunburn can also cause localized skin burning.
When to Seek Medical Attention
The sudden onset of a burning sensation in the lower leg, especially if accompanied by other severe symptoms, warrants immediate medical evaluation. You should seek emergency care if the burning is coupled with a rapid loss of sensation or an inability to move the limb. Sudden, severe pain following a traumatic injury, or the loss of bladder or bowel control, are also red flag symptoms that require urgent attention.
A persistent burning sensation that does not improve after a few weeks of self-care should prompt a visit to a healthcare professional. You should schedule an appointment if the pain becomes progressively more intense or begins to spread further up the leg. Consulting a doctor is also necessary if the burning is accompanied by unexplained skin discoloration, swelling, or if you develop sores on your feet that do not heal properly. Early diagnosis of conditions like peripheral neuropathy or PAD is important for managing symptoms and preventing further complications.