Few sensations are more uncomfortable—or more puzzling—than the feeling of burning feet at night.
This distressing symptom often creeps in when you’re trying to relax, sleep, or simply sit still. And while it might seem minor at first, over time it can disrupt sleep, increase stress, and decrease quality of life.
At Arizona Pain, one of the most common late-night symptoms we hear about is burning or tingling in the feet.
Let’s break down what could be causing this, what it means, and why it’s so important to get an accurate diagnosis—especially if you’ve been living with this pain for weeks or months.
What Causes Burning Feet At Night?
There are many potential causes for burning feet, but neuropathy—or nerve damage—is by far the most common. Neuropathy affects the small sensory nerves in the feet and legs, often leading to symptoms such as:
- Burning
- Tingling or pins and needles
- Numbness
- Pain with light touch or temperature changes
- Restlessness or discomfort at night
The Most Common Types Of Neuropathy We See:
- Diabetic Neuropathy – Often due to long-standing blood sugar elevation damaging the microvasculature around nerves.
- Chemotherapy-Induced Neuropathy – A side effect of certain cancer treatments.
- Post-surgical or trauma-related nerve injury
- Idiopathic Neuropathy – Sometimes, no clear cause is found, but the pain remains very real.
Why Does It Get Worse at Night?
Many patients ask, “Why does the burning happen more at night?”
There are a few reasons:
- Less distraction – When your body is still, you may become more aware of pain.
- Temperature changes – Cooler nighttime temperatures can exaggerate nerve symptoms.
- Circulation differences – Lying down changes how blood flows through the limbs, sometimes making symptoms more noticeable.
Other Possible Causes Of Burning Feet
Although neuropathy is the most common culprit, burning feet can also stem from:
- Peripheral arterial disease (PAD) – Poor circulation in the legs.
- Thyroid issues – Particularly hypothyroidism.
- Vitamin deficiencies – Especially B1, B6, B12, and folate.
- Chronic kidney disease – Can cause nerve buildup of toxins.
- Infections – Like HIV or Lyme disease.
Because of these many potential causes, it’s critical to get evaluated by a medical provider rather than self-diagnosing or ignoring the problem.
What Can You Do For Burning Feet?
If burning feet are keeping you up at night, the first step is a proper work-up. At Arizona Pain, we conduct a thorough evaluation that could include any of the following:
- Full medical history
- Physical exam including Neurologic exams
- Blood work to rule out vitamin deficiencies or metabolic issues
- EMG/Nerve conduction studies when needed
- Diagnostic blocks for nerve localization
Treatment Options: From Conservative To Advanced
Depending on the underlying cause, treatment may include:
- Medication – Such as gabapentin, and other prescription medication or even topical pain relievers
- Physical therapy – For gait training and desensitization
- Nutritional support – Including B-complex and alpha-lipoic acid
- Peripheral nerve blocks – To provide short-term relief
Neuromodulation: A Game-Changer For Chronic Neuropathy
If conservative therapies fail, many patients find life-changing relief through neuromodulation, a field that uses electrical stimulation to modulate pain signals directly at the nerve level.
There are two advanced neuromodulation options we offer:
1. Spinal Cord Stimulation (SCS)
SCS works by placing a thin wire near the spine to interrupt pain signals before they reach the brain. Studies—including those from leading device manufacturer Nevro—show that patients with painful diabetic neuropathy experience:
- Up to 76% pain reduction
- Improved sleep and physical activity
- Decreased sensitivity to temperature and touch
2. Peripheral Nerve Stimulation (PNS)
PNS targets the specific peripheral nerve responsible for the burning pain in the feet, offering relief without systemic side effects.
These treatments can be life-changing, especially for those who have been told they simply have to “live with it.”
Why Early Intervention Matters
When burning feet are ignored, the underlying nerve damage may worsen. Left untreated, neuropathy can lead to balance issues, wounds, infections, and loss of mobility.
But there is hope. Treating nerve pain early doesn’t just help with sleep—it can get you moving again. And for patients with diabetic neuropathy, becoming more active can improve blood sugar control, cardiovascular health, and overall wellness.
Key Takeaways
- Burning feet at night is often a sign of neuropathy, but other medical conditions can cause similar symptoms.
- Accurate diagnosis is essential — don’t wait for symptoms to worsen.
- Neuromodulation, including Spinal Cord Stimulation (SCS) and Peripheral Nerve Stimulation (PNS), offers hope to patients who haven’t found relief through traditional medications.
At Arizona Pain, we combine compassionate care with cutting-edge tools to help you find the cause and create a plan that works.
