Question
Dear Dr. Katz:

First, a heartfelt thanks for trying to help people with foot problems - hopefully you can help?

My background...39 year old male in excellent health apart from persistent burning sensation in soles (moreso on the heals/balls) of BOTH feet.  First had this sensation intermittently in left heal/lateral foot going back 8 + years after a minor sprain.  Came/went for years, but seemed to improve when I would flex the heal at rest.  NEVER sought MD help during this time since it was tolerable and NOT nearly as constant as it can be now.

Fast forward to 2006, and I have this sensation in BOTH feet.  Problem is far, far worse while SITTING and STANDING stationary.  I can actually walk fine and burning is hardly noticeable while walking.  Problem is also greatly improved by application of cool/cold to soles and by assuming a lying position.  Although I can walk in my running shoes, these same closed shoes are absolutely miserable (burning) while standing/sitting, at which point I get some relief by going barefoot.  Cool temps, walking and lying down are my only respite.

In the last 2 years I've seen a variety of 'professionals' - most have no answer other than idiopathic neuropathy.  This seems hard to believe in an otherwise healthy young male (diabetes neg, and negative for all the conditions that can cause neuropathy - have had much testing including normal EMG/NCV).  

The only apparent abnormality is in my spine (cervical and lumbar).  The lumbar problems are at the L4-S1 levels and 'could' explain this neurological burning, but I really need guidance in trying to determine if this is more a 'foot' or 'back' problem in origin or both?  Would someone with burning feet and occassionally burning lateral calves get near total relief from application of cool IF the problem was only from the spine?

In summary, I've seen several chiros, 2 neurologists and an internal medical doctor.  The internal medical doctor has done the most 'brainstorming' and has suggested it could be plantar fasciitis and/or of lumbar origin.  Apart from my general great health, I do have a few extra lbs. (195 / 5' 10") but the problem existed even when weighing less).

A sincere thanks for any suggestions of a highly perceptive podiatrist (nerve related symptoms) in the NE Florida area?  I could also travel to central Florida, just need to find some answers and relief.

Kindest Regards, JB

Answer
Hi Jim,

What I would do in this case is treat the foot and see if you feel better.  I would recommend seeing a podiatrist and getting custom orthotic devices. If the source is your foot this should help.  Also better alignment of the foot can lead to less back problems.

I would start on a vitamin that is specific to neuropathy called Benfotiamine, twice daily and give it several months to see if it works.  

If you are not getting relief I would consider an injection in the appropriate area of your back to see if this relieves the foot pain.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com



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