Grierson-Gopalan Syndrome: Causes, Symptoms, and Treatments to Burning Feet Syndrome

Grierson-Gopalan Syndrome, more commonly known as Burning Feet Syndrome, is a medical condition that causes a burning sensation, heaviness, and hypersensitivity in the lower limbs. The condition was first identified by Coluther Gopalan and J. Grierson in 1946.

This article will explore the primary symptoms, causes, and diagnostic methods for Grierson-Gopalan Syndrome, as well as explain the best treatment approaches for this condition.

What is Burning Feet Syndrome?

Burning Feet Syndrome is a collection of symptoms where the feet often become uncomfortably hot and painful. The burning sensation may intensify at night, with some relief occurring during the day. Symptoms can range from mild to severe. The heat and pain can be limited to the soles of the feet, but might also affect the tops of the feet, the ankles, and even the lower legs.

Possible Causes

What causes Burning Feet Syndrome?

The symptoms of Burning Feet Syndrome can result from various conditions or diseases. These include:

  • Nerve damage or entrapment: There are numerous possible causes of nerve damage. It may occur due to various illnesses, back injuries or slow breakdown (degenerative changes) of the spine, surgery, use of chemotherapy drugs or other medications, or exposure to toxins.
  • Peripheral neuropathy: This is one of the most common causes of Burning Feet Syndrome. It occurs when the peripheral sensory nerves connecting the spinal cord to the extremities are damaged. People who have had diabetes for a long time, or those with poorly controlled blood glucose levels, are more likely to develop peripheral neuropathy. Diabetes-related peripheral neuropathy develops gradually and may worsen over time. Other conditions that can cause peripheral neuropathy include chemotherapy agents, hereditary diseases, auto-immune disorders (including rheumatoid arthritis), exposure to toxic chemicals, infections, kidney failure, alcoholism, and nutritional imbalances (vitamin B deficiency, malabsorption syndrome).
  • Tarsal Tunnel Syndrome: The tarsal tunnel is a narrow space inside the ankle near the ankle bones. Compression or squeezing of the posterior tibial nerve (the nerve behind the largest long bone of the lower leg) inside the tarsal tunnel can result in sensations of burning, tingling, or pain in parts of the feet. The inner ankles and calves of the legs can also be affected.
  • Morton's neuroma: Nerve tissue may thicken between the bones at the base of the toes, causing pain. Shoes that are too tight can cause this type of neuroma, although it may also result from sports injury, stress, or abnormal position or movement of the foot.
  • Complex regional pain syndrome: This rare, yet extremely painful nerve disorder, may occur after an injury or surgery.
  • Charcot-Marie-Tooth disorder: This inherited neurological disorder may cause damage to the peripheral nerves of the legs and feet. The damage becomes worse over time. Charcot-Marie-Tooth affects the muscles and nerves of the extremities resulting in abnormal weakness and lifting of the arches of the feet.
  • Endocrine or metabolic disorders
    Diabetes mellitus: Type 1 and type 2 diabetes may affect the peripheral nerves of the body, especially the sensory nerves of the feet and legs. High glucose levels or poorly controlled diabetes can cause damage to the peripheral nerves, especially over the long term. High blood glucose levels affect the transmission of signals from these nerves and can weaken blood vessel walls.
    Hypothyroidism: An underactive thyroid gland may cause a sensation of burning in the feet, along with weight gain, dry skin, or fatigue.
  • Athlete’s Foot (tinea pedis): This fungal infection is caused by mold-like fungi called dermatophytes that grow in moist, warm areas of the skin. Damp shoes and socks and humid environments allow the fungi to grow and spread. Symptoms of athlete's foot may include itching, burning, and stinging between the toes and the soles of the feet.
  • Erythromelalgia/Erythermalgia: This rare disorder can result in intense burning pain, increased skin temperature, and visible redness (erythema) of the toes and soles of the feet. The hands may also be affected. Its exact cause is unknown. Attacks may occur only at certain times (flare-ups) and last from several minutes to several days, or the burning pain might be continuous. The affected area may become tender, swollen, and warm.
  • Footwear that is too tight or does not fit properly: Tight shoes or stockings can irritate sensitive feet or put pressure on certain parts of the foot.
  • Stress due to exercise or physical injury.
    Allergies: Materials used to make shoes or socks may trigger symptoms.
  • Contact dermatitis: Dyes or chemical agents used to tan leather might result in skin irritation.
  • Other causes include chronic mountain sickness, Gitelman syndrome, Leishmaniasis, multiple sclerosis, psychological disorder (psychosomatic), hereditary causes, and unknown causes (idiopathic)

The Most Common Symptoms of Burning Feet Syndrome

The most common symptoms include:

  • Sensations of heat or burning, often worsening at night
  • Numbness in the feet or legs
  • Sharp or stabbing pain
  • Feeling of heaviness in the feet
  • Dull ache in the feet
  • Skin redness or excess warmth
  • Prickling or tingling or a feeling of “pins and needles”

Burning Feet Syndrome Treatment

A comprehensive approach to treating Grierson-Gopalan Syndrome or Burning Feet Syndrome is essential to alleviate symptoms and address underlying causes. The treatment plan often involves a combination of self-care, medical intervention, and physical therapy.

Self-Care and Home Remedies

Incorporating the following self-care measures can help manage symptoms and provide relief:

  • Cooling foot baths: Regularly soak your feet for up to 15 minutes in cool water to alleviate burning sensations.
  • Elevate your feet: Keep your feet elevated whenever possible to reduce inflammation and discomfort.
  • Proper footwear: Wear open shoes and cotton socks to keep your feet cool and reduce sweating. Opt for shoes with good arch support and a roomy toe box.
  • Topical treatments: Consult your local pharmacist for topical anti-inflammatory or cooling gels to soothe your feet.
  • Over-the-counter pain relief: Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help reduce pain and inflammation.

Medical Treatment

Depending on the underlying cause of your Grierson-Gopalan Syndrome, medical intervention may be necessary:

  • Addressing metabolic conditions: If a metabolic condition such as diabetes or hypothyroidism is causing your burning feet, consult your healthcare provider for guidance on treatment and management.
  • Prescription medications: Your doctor may prescribe medications to manage nerve pain, such as gabapentin or pregabalin, or recommend topical medications like capsaicin cream.
  • Vitamin supplementation: If your burning feet are caused by a deficiency in vitamins, especially vitamin B, your healthcare provider may recommend supplementation to address the deficiency.

Physical Therapy and Orthotics

Physical therapy can be beneficial in addressing muscular or gait imbalances that can lead to conditions such as Morton's Neuroma, Tarsal Tunnel Syndrome, or Baxter's Nerve Entrapments. A physical therapist can guide you through exercises and stretches tailored to your specific needs.

Custom orthotics can offload affected nerves and optimize your gait to relieve pain and address the cause of your burning feet. Consult a podiatrist or orthopedic specialist for guidance on the most suitable orthotics for your condition.

Prevention and Maintenance

It's essential to implement lifestyle changes and preventive measures to minimize the risk of Grierson-Gopalan Syndrome or reduce the severity of symptoms:

  • Proper foot care: Maintain good foot hygiene by washing your feet daily, drying them thoroughly, and moisturizing to prevent dryness and cracking.
  • Avoid tight shoes: Choose shoes that fit correctly and avoid tight or ill-fitting footwear that can exacerbate symptoms.
  • Manage underlying conditions: If you have a medical condition that contributes to burning feet, such as diabetes, work closely with your healthcare provider to manage the condition effectively.

When to Seek Medical Help

Should you find that the burning or tingling sensations in your feet persist, intensify, or prove unresponsive to self-administered remedies, it is vital to consult a healthcare professional or podiatrist without delay. Listening to your body's subtle whispers can be the key to catching and addressing a more significant issue in its early stages, thereby preventing further complications.

Burning feet may serve as a harbinger of a serious medical condition, such as diabetes mellitus, peripheral nerve damage, or malnutrition. Ignoring the signs and leaving conditions like diabetes undiagnosed or untreated can lead to irreversible damage to your peripheral nerves.

A qualified healthcare professional or podiatrist will guide you through a thorough examination to unravel the enigmatic cause of your burning feet. They will assess your medical history, symptoms, and risk factors, and may recommend tests, including blood tests or nerve conduction studies, to pinpoint the underlying issue.

Wynne Lee, MD

Dr. Wynne Lee is a physician at Massachusetts General Hospital (MGH), where she provides primary care.

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