Burning Feet at Night: What It Means in St. Thomas, U.S. Virgin Islands

The sheet touches your toes and it feels like a burn. You kick the blanket off, dangle a foot over the edge of the bed, and it barely helps. Some nights it is pins and needles instead, a crawling feeling that will not let you get comfortable. Tradewinds Chiropractic & Wellness in Estate Thomas hears this complaint often, and burning feet at night is one symptom with a long list of possible causes, several of which have nothing to do with the spine and are not something a chiropractor treats.

What this feels like

Most people describe a hot, burning or stinging sensation on the soles or across the top of both feet, worse once the lights go out and there is nothing left to distract from it. A few people get the opposite: numbness so complete they do not notice a blister until morning. Some feel an urge to move their legs, a restless, crawling discomfort more than true burning, that eases only when they get up and pace the floor.

It is usually both feet, roughly even.

What is usually going on

Burning feet at night sorts into a few patterns, and how the pain behaves, not just where it sits, is the clue that matters most:

• Both feet, evenly, in a stocking pattern that starts at the toes and creeps toward the ankle over months. This is peripheral neuropathy, damage to the small nerves in the feet. Diabetes and prediabetes are by far the most common cause, and diabetes is common in the U.S. Virgin Islands. Vitamin B12 deficiency, thyroid disease, heavy alcohol use, and certain medications, including some chemotherapy drugs, can all produce the same pattern. Our numbness and tingling in the feet page and our diabetic neuropathy page cover this in full.
• An urge to move the legs more than true burning, worse sitting still or lying down in the evening, relieved by getting up and walking. That is closer to restless legs syndrome, a distinct neurological condition, not neuropathy, and not something we treat here.
• Burning or aching that worsens when you lie flat with your feet raised and eases when you sit up and dangle a foot off the bed. That pattern points toward poor circulation in the legs, a vascular problem, and it needs a physician's evaluation, not a spine exam.
• One foot only, a stripe of burning or tingling running down the leg with back or buttock pain behind it. That is more likely a pinched nerve in the low back, closer to sciatica, and it is the one pattern on this list a chiropractor actually treats.

Some of these need blood work and a physician, not an adjustment. If you have never been screened for diabetes and your feet burn at night, see your doctor for blood sugar and A1c testing before anything else.

How we treat it at Tradewinds

The first visit sorts out which pattern you have: sensation testing, reflexes, balance, and an exam of the low back to check for a spinal cause.

Dr. Keys is the Chair of the Virgin Islands Board of Chiropractic Examiners, a member of the Virgin Islands Chiropractic Society, and the International Chiropractors Association representative for the U.S. Virgin Islands.

If the exam points to a pinched nerve in the back, we treat that directly, the same approach used for sciatica. If it points to peripheral neuropathy in the feet themselves, you may be a candidate for our peripheral neuropathy program. The program has four parts: in-office therapy, red light therapy, electrical stimulation, and nutrition. How long it runs depends on how severe the neuropathy is, anywhere from a few months to more than a year. In-office treatment usually starts at two or three visits a month, and treatment continues at home between visits. Dr. Keys runs the check-ins himself, monthly at first and then quarterly, depending on severity. What the program does and does not promise is on our diabetic neuropathy page. If the exam points to restless legs syndrome, a vascular problem, thyroid disease, B12 deficiency or a medication side effect, we say so plainly and refer you to your physician. We do not treat those here.

When you should see someone else

Go to the emergency room, not our office, if burning or numbness comes on suddenly with weakness, trouble speaking, a drooping face or confusion. See your primary care doctor now, not eventually, if:

• You have never been tested for diabetes and your feet burn at night
• One foot turns cold, pale or blue, or the pain becomes sudden and severe
• You have a foot wound that is red, hot, swollen or draining, especially if you are diabetic
• Numbness is spreading quickly, involves your hands as well as your feet, or comes with muscle wasting or weakness

See a neurologist for nerve conduction testing if the cause is still unclear after your physician's blood work.

Visitors, crew and cruise passengers

Charter crew standing a full watch on a wet deck and visitors who have walked more in a week here than they do in a month at home both show up with tired, burning feet. If a visitor's burning feet turn out to be new-onset diabetic neuropathy, that is worth knowing before flying home, not after. Visitors on a short stay can enrol, not just be evaluated, because most of the program continues at home.

Getting seen

Tradewinds Chiropractic & Wellness is in the VI Medical Foundation Building, Suite 202, 9150 Estate Thomas, St. Thomas, USVI 00802, just east of Charlotte Amalie. Hours are Mon, Wed, Thu: 10:00 am to 1:00 pm and 3:00 pm to 7:00 pm. Tue, Fri: 7:00 am to 2:00 pm. Closed Sat and Sun.

Call (340) 690-4994 or email info@tradewindschiropractic.com. We take walk-ins and same-day appointments. We see patients from St. Thomas, St. John and Water Island and have more than 180 five-star Google reviews. New patient forms can be downloaded and printed from our website.

Questions patients ask

Why do my feet burn at night?

Burning feet at night usually comes from nerve damage in the feet, most often peripheral neuropathy, though restless legs syndrome, poor circulation, and a pinched nerve in the low back can all cause similar complaints. Tradewinds Chiropractic & Wellness examines the feet and the back to sort out which pattern you have. Call (340) 690-4994.

Is burning feet at night always diabetes?

No, but diabetes and prediabetes are by far the most common cause, and it is common enough here that anyone with burning feet who has not been screened should see a doctor for blood sugar testing. B12 deficiency, thyroid disease, alcohol use, medications, and a pinched nerve in the back can all cause similar symptoms.

What is the difference between neuropathy and restless legs syndrome?

Neuropathy is usually described as burning, tingling or numbness that stays roughly the same whether you move or not. Restless legs syndrome is more of an urge to move the legs, a crawling discomfort that actually improves once you get up and walk. They are different conditions and are managed differently.

When should I worry about burning feet?

Get seen right away if numbness comes on suddenly with weakness or confusion, if a foot turns cold, pale or blue, if you have a wound that is red, hot or draining, or if numbness is spreading quickly and involves your hands as well as your feet. Most burning feet is not an emergency, but those signs are.

Can a chiropractor treat burning feet from diabetes?

A chiropractor cannot treat diabetes itself, and blood sugar control has to come from your physician. Tradewinds Chiropractic & Wellness runs a non-surgical peripheral neuropathy program that works alongside your medical care once diabetic neuropathy is confirmed. Our diabetic neuropathy page covers what that program can and cannot promise.