What Causes Hot Feet? All You Need to Know

Feet that feel hot or burning, especially at night, can be caused by several medical conditions.

Sometimes the heat feels like tingling, numbness, stabbing, or a “pins and needles” sensation. 

In this article, we discuss what can be causing your feet to feel hot. Then, read on to learn how your primary care clinician can diagnose and treat the problem.

Lastly, check out the most commonly asked questions about hot feet.  

Causes

There is a wide range of possibilities for what’s causing your feet to feel hot.

Some of them include neuropathy, infections, and vitamin insufficiencies. 

Vitamin deficiencies

Healthy nerves require specific vitamins and minerals to function correctly.

For example, low levels of vitamin B12 and folate can lead to neuropathy, which can cause your feet to feel hot.  

According to research, reasons why you may be deficient in these vitamins include:

• Poor diet
• Stomach conditions preventing absorption
• Intestinal conditions preventing absorption
• Certain medications
• Pregnancy
• Cancer
• Sickle-cell anemia 

Nerve damage

Nerve damage, also called neuropathy, is a common problem with many causes. 

Neuropathy is a disruption of the nerve’s ability to communicate with the rest of your body due to:

• Physical injury
• Diabetes
• Blood flow problems
• Autoimmune diseases
• Hormonal imbalances
• Kidney and liver problems
• Vitamin B12 deficiency
• Certain cancers or chemotherapy drugs
• Certain infections

Fungal infection

Athlete’s foot is a common fungal infection. It likes to grow in warm, moist areas of the skin.

Symptoms are red and itchy skin with burning hot pain. 

Diabetic neuropathy

Diabetes is a leading cause of neuropathy in the United States.

Having high levels of sugar in your blood leads to nerve damage. This nerve damage in your feet can lead to pain, feelings of them being hot or “on fire”, and, in some cases, it makes your feet feel numb. 

In addition, this neuropathy can lead to further issues with your feet because it’s difficult to discern when there is a problem, like an injury, which may result in chronic foot wounds and infections. 

Kidney disease

Your kidneys filter toxins from your blood and balance levels of electrolytes.

People with chronic kidney disease tend to have electrolyte imbalances in their blood because their kidneys aren’t working as well, which can lead to nerve damage.

Hypothyroidism

Hypothyroidism is when your thyroid gland cannot produce enough thyroid hormone.

Not having the right levels of thyroid hormone in your body can lead to a burning or tingling sensation in your feet, weight gain, thinning hair, and dry skin. 

Hormonal changes

Hormonal imbalances can disrupt the body’s normal functions, leading to some swelling of tissues that can press on nerves.

In the long term, this pressure on the nerves damages them and causes hot feet, numbness, and tingling. 

Pregnancy: During pregnancy, the body goes through significant hormonal changes, leading to changes in body temperature and swollen, hot feet. These changes are generally temporary and resolve as hormone levels gradually go back to normal after giving birth.

Menopause: It’s common to hear about people going through menopause experiencing hot flashes. These hot flashes happen because of the hormonal shifts occurring in their bodies and resolve within a few years. 

Guillain-Barré syndrome (GBS)

Guillain-Barré is a rare syndrome when the immune system attacks the nerves.

It causes weakness, tingling, and burning sensations starting in the feet and legs and progressing up the body over a few hours to days. 

Guillain-Barré is a medical emergency, as it can cause paralysis of the diaphragm—the muscle that helps you breathe—and should be evaluated by a doctor right away. 

Erythromelalgia

Erythromelalgia is a very rare condition in which people experience burning pain, warmth, redness, and swelling, particularly in the hands and feet.

In many cases, the cause of the disease is never found; in some cases, the reason is genetic. 

Lifestyle factors

Smoking: Smoking causes the blood vessels to constrict. This constriction can lead to the nerves not getting enough blood flow, which can cause long-term damage. 

Alcoholism: Drinking too much alcohol leads to decreased vitamins in the body, particularly folic acid, B6, and B12 (also known as thiamine). When your body doesn’t get these needed vitamins, it can lead to chronic nerve pain

Improper Footwear: Improper footwear, especially when worn for long periods of standing or walking, can lead to burning pain in the feet. 

Stress: Chronic stress can impact the blood flow to the nerves. When nerves get decreased blood flow, they become damaged. 

Certain medications

Some chemotherapy medications cause neuropathy. Radiation can also have the same effect. 

Other medications used to treat seizures or high blood pressure have also caused peripheral neuropathy. 

Diagnosis

The first step in diagnosing what is causing your hot feet is to see your primary medical clinician. 

Physical exam

Your primary clinician will ask you questions about your medical history, medications, vitamins and supplements you take, and your family’s health history.

They will also want to know about the symptoms you are experiencing: When did they start, and are there things that trigger or relieve them?

The physical exam will include your vital signs and a basic overview of how all your systems are working. They may also do some simple nerve tests to see if there is any change in how your nerves are working.

Blood tests

Blood tests check for vitamin deficiencies, diabetes, liver or kidney dysfunction, infection, metabolic disorders, or signs that your immune system is behaving abnormally. 

Nerve function tests

Nerve conduction velocity (NCV): A probe stimulates the nerves and tests the strength and speed at which the nerve is working.

Electromyography (EMG): Fine needles are placed into muscles to test their electrical activity when they contract and relax.

Nerve biopsy: A small sample of nerve tissue is removed to see whether it is damaged. However, this is usually avoided because it can further damage the nerves, and other testing is typically done first.

Imaging

Magnetic resonance imaging (MRI): An MRI can show if the nerves in the spine are being compressed in any way, leading to your feet feeling hot.

Computed tomography (CT): A CT scan can show if there is any narrowing of the spinal canal (spinal stenosis), herniated discs, tumors, or other bone issues which could be causing nerve problems. 

Treatment

Treatment depends on what type of nerve damage is happening and causing your discomfort. As long as the nerve cell has not died, treating the cause of the problem can improve your hot feet. 

At-home care

Try soaking your feet in cool water for 15 minutes before bed. 

Be sure that your shoes fit correctly and that your socks allow your skin to breathe.

Don’t wear the same shoes every day and enable your shoes to air out thoroughly between uses. 

Practicing healthy lifestyle habits like these can decrease any damage to your nerves:

• Maintain a healthy weight
• Avoid exposure to toxic materials
• Eat a balanced diet
• Correct vitamin deficiencies
• Stop smoking
• Get regular exercise
• Control your blood sugar

Medical care

If inflammatory or autoimmune conditions are causing your hot feet, immunosuppressive medications may help. 

Fungal infections can be treated by using topical antifungal creams, keeping your feet clean and dry, and if needed, taking oral medications.

Aids such as foot braces and orthopedic shoes can help when the source of the problem is mechanical.

For neuropathy, common medications used to bring relief are gabapentin and pregabalin. Preventing ongoing causes of neuropathy, such as through controlling your blood sugar, are also important ways to find relief.

Creams containing lidocaine or capsaicin can alleviate some discomfort as well.

When To See a Medical Provider

Let your primary medical clinician know if your burning feet do not respond to at-home treatment or continue to worsen. 

Hot and burning feet can be a sign of an underlying disorder that could be serious. 

How K Health Can Help

Did you know you can access online urgent care with K Health?

Check your symptoms, explore conditions and treatments, and if needed, text with a healthcare provider in minutes. 

K Health’s AI-powered app is based on 20 years of clinical data.