aetiology

Last reviewed 01/2018

aetiology

• no specific aetiology for BFS - often the cause is idiopathic
• can occur as an isolated symptom or as part of a symptom complex in association with a variety of unrelated clinical settings.
  • Causes of BFS can be divided into the following categories:
    • nutritional causes:
      • vitamin B deficiency
        • vitamin B deficiency may result in a disturbance in cellular metabolism in the tissues causing accumulation of intermediate metabolites
          • may cause abnormal and excessive stimulation, or lower the pain and temperature threshold of peripheral sensory nerve endings
        • BFS may also be an early clinical phase of vitamin B12 deficiency related neuropathy before frank neurological signs appear
      • malabsorption syndrome, chronic alcoholism - may cause BFS because of associated nutritional deficiencies
    • metabolic/endocrinal causes:
      • diabetes mellitus
      • renal failure (dialysis patients)
      • hypothyroidism
    • hereditary causes:
      • autosomal dominant BFS
        • familial disorder with an autosomal dominant inheritance
        • clinical picture is that of bilateral symmetrical pain with no muscle weakness, atrophy or foot deformity
    • mechanical (entrapment neuropathies) causes:
      • tarsal tunnel syndrome
      • traumatic nerve compression
      • nerve entrapment due to sciatic mononeuropathy and spinal arteriovenous malformation can also cause burning feet (1)
    • psychosomatic
    • miscellaneous
      • erythromelalgia
        • uncommon disorder characterised by burning pain and redness of the extremities
        • may be primary or secondary to systemic disorders such as diabetes, collagen vascular disorders, or myeloproliferative disorders such as polycythemia vera or essential thrombocytosis.
      • chronic mountain sickness
      • Gitelman syndrome
      • leishmaniasis
      • multiple sclerosis

Reference:

1. Makkar RP et al. Burning feet syndrome. A clinical review. Aust Fam Physician. 2003 Dec;32(12):1006-9.