(instrumental music playing) – Do you have burning feet? Do you have foot pain at night when you're resting on the couch? This might be a weird one but it's called, Grierson-Gopalan syndrome, this is also known as burning
feet and leg syndrome. The studies are not robust, they're kinda confusing, but this is nerve pain, and we're gonna go over
the best home remedies, what you can do to get rid of your burning nighttime
foot and ankle pain. We're starting right now. Guys, thank you so much
for watching this video. We appreciate your likes,
your subscribes, your comment. We really love hearing
if this stuff helps, it really makes a big
difference for us, so thank you. When I did a research article study this is basically as sparse as I have ever found any disease, because it's so hard to
do studies on something that's so poorly defined, but Grierson-Gopalan syndrome, is another name for burning
foot and burning leg syndrome.
So that means it can get really achy, and tender at nighttime. You can have hot, sweaty chills, your feet can turn red, they can turn achy. If this sounds like you this might be Grierson-Gopalan syndrome. Grierson-Gopalan syndrome is a tricky one because Dr. Grierson
studied it in the 1800s, and Gopalan described
it again in the 1940s. And the way they kinda described it is a little bit different than right now, but basically malnourished people that didn't have any vitamin B, and potentially some other vitamins, the thing is they didn't really define it, they did not have enough nutrients, and they found it that people would have burning, numbness and tingling, in basically vitamin deficient people that if not corrected fairly
quickly they would die. That's not how we really
think of it these days, burning feet and burning like syndrome is likely more of a
peripheral neuropathy change.
And we're gonna go over
the correctable stuff. But if you're malnourished
I know it's not as easy as saying go get better. Number one, lemme start
with this is nerve diseases are extremely difficult, even though we're gonna go over
some amazing home remedies, and treatments that are very
effective for nerve disease lemme say number one, there are 600 plus articles
that I personally have looked at that contribute to peripheral neuropathy, and Grierson-Gopalan
syndrome type disorders. This gets very tricky 'cause there's a lot
of different vitamins, there's a lot of different treatments.
So the first thing you wanna
do is go see your podiatrist, and if you're in Michigan come see us. But what happens is most of
the comments in these videos, or even that come see us in clinic, it's not quite nerve
pain which is great news, so a burning, hot feet
could be something else, and I would say in my
opinion over 50% of the time it's not nerve disease
it's quickly fixable stuff, but people are taking pain medication, they're trying all this difficult stuff that's costing them a lot of money, and it's not getting their problem better. So go check with your doctor, go check with your podiatrist, and we'd love to do that
if you're in our area.
But what we would do is number one, we'd get an assessment
because a lot of the time burning feet and leg pain
could be a skin condition, it could be a muscle condition, it could be a tight
tendon, a tight ligament, and that's usually what it is, it's not these undefinable nerve diseases. And even if it is a nerve disease all this extra stuff adds to it.
Just because you have
Grierson-Gopalan disease, or peripheral neuropathy, does not mean we can't make
this other stuff better because the fact that
you have a nerve problem makes this other stuff more likely, and that's probably
why your nerve problems developed in the first place. So what we would do is number one, we would get an x-ray. We would evaluate your foot structure, is there arthritis? Is there damage? Are you tight in that joint? For most people it is. Number two is I would look at your skin. Is there athlete's foot? Is there bacteria? Sometimes you could get
a biopsy of the nerves to see how much or how little
nerve fiber density there is, and that could contribute
to assessing nerve disease, and why you're getting burning, hot feet that are causing tenderness. The next thing we would
do is grab a lab test.
How's your blood sugar? A lot of people are diabetics even though they didn't
know they had diabetes, and this could be diabetic
peripheral neuropathy. And if you have that click above because as we have that in
great detail in our videos. Blood tests, are you deficient
in certain nutrients? Do you have kidney problems? Do you have heart problems? Do you have blood flow problems? So we work in a clinic
where we have access to a vascular specialist, and they could essentially
test your blood function. They can put a number on it, and what that does is it
tells us if there's a blockage if there is narrowing
of your blood vessels. If there is narrowing of the blood vessels sometimes medication changes, sometimes a procedure
called an angioplasty, which is a balloon that
expands your blood vessels, sometimes a stent needs to be put in.
Sometimes there's heart
work that needs to be done. So all this stuff is possible because more blood flow
will make your feet ache and burn less. That's pain called
intermittent claudication. That means because they're
too narrow, the blood vessels, you're not getting enough
blood flow in your skin, and your toes are aching and throbbing. And that happens at nighttime when you put your feet up in the air it has to fight gravity to get there, so sometimes that happens to people. And that's just many things, you know, we can grab like I mentioned, nerve fiber density test. So if we rule out all the other
stuff sometimes it's like, hey, these nerve endings are not there, this is clearly the problem. And maybe that's where these more advanced nerve diseases get diagnosed. And there's a lot of
advanced nerve diseases, and genetic diseases out there that are something
different than this disease.
But in my experience out of hundreds, and hundreds,
and hundreds of people, maybe even thousands, and thousands, this is rarely the problem, like I mean rarely, I can't even remember how infrequently I have to send people to a neurologist because usually people get better before we get to that point. Another common cause is a back injury. If you have a crushed
back, a lumbar vertebrae, or a thoracic vertebrate, this back injury could
lead to sciatic pain, compression nerve pain, this is called the radiculopathy, and radiculopathy means in your back you have a squeezed nerve
that's always aching, and it makes it feel like
your feet are hurting, especially when you're up
on the couch and sitting that can cause that type of pain. So lemme rule out some basic stuff is before you even get to the
nerve problems skin problems, the most common one I see is
athletes foot and sweating.
So red, hot burning feet
could be athlete's foot. So there's easy things
to try ahead of time. So the easy things to try ahead of time are getting a good shoe. So getting a good shoe, see how it's soft, breathable material, get a breathable shoe. This could let you sweat, this could get rid of
the fluid a lot easier, this could make a big difference. Another one is, do you wear
big fixed socks like that? Maybe get a lighter athletic sock, a lighter athletic sock
could make a big difference. It lets you breathe more, plus a breathable shoe that could really make a big difference. How often do you take a
shower and clean your feet? If you don't take a shower every week, or maybe multiple weeks go by, you're gonna have a lot of dry itchy skin with a lot of fungus and a lot of bacteria built up on that dry itchy skin, that's essentially what athlete's foot is. It gets the name athlete's foot because athletes sweat a lot, and bacteria and fungus live on that dead, dry sweat and skin.
They chew it up, and before you have a
chance to shower, you know, like 24 hours go by it gets really itchy, it gets really red, this is called eczema and dermatitis. These are red itchy conditions, and then you scratch your feet they burn, it gets very irritated. And at a certain point
cleaning is not enough because you're sore, and now you're scrubbing, and irritating that already sore skin, and people get stuck in this vicious loop where the burning, tingling
is not getting better. So what I'm a big fan of
doing is soak your feet, Epsom salts are really good. I have some great links down in the bottom for tubs and Epsom salts soaks.
These can be very effective, and that could get rid of itching. I also have links to my
athlete's foot guide, and video that could be very effective. So some easy home prevention is, are you a smoker? So number one, smoking associated with
blood flow problems. So there's two things smoking does, it makes your red blood
cells carry less oxygen, and then number two, it actually
narrows your blood vessels. So if you're a smoker
and you have nerve pain where you're having a hard time sleeping, there's no question about it you've gotta give up the smoking.
No vascular surgeon, well,
at least a reputable one, will probably not do
surgery until you take steps to at least cut back or
get rid of your smoking. You know, it's dangerous for us as doctors to work on someone who's
endangering their health by continually doing the same
thing that put them in danger. I personally don't like
doing surgery, I hate it, because I know it can get a great result but I always think why is this happening? Was it a fluke traumatic incident, or is it something that this person will continue to keep doing? Because usually foot surgery
at least in my experience is the vast majority of
the time it works great, but it can develop a tougher reputation because sometimes people who
are gonna do the same thing that caused the problem, get the surgery, and they're never gonna be happy, there's 0% chance it will be
happy so stop the smoking.
Alcohol. Alcohol is one of the top causes of nerve pain and nerve disease. So it actually has a name it's called, alcoholic peripheral neuropathy. So if you have burning,
numbness, tingling, and you drink alcohol. And I mean, not just
like a couple of beers on a birthday party or something
a couple of times a month, but if you're doing it
multiple times a week, and you're doing more than
like two to three beers it's probably gonna be a problem because it associates bad health. You know, you're probably eating
bad food at the same time, you're probably eating
junk food at the same time when you're out and
doing this kinda stuff, and so there's a large
link between sugar levels, alcohol, and nerve disease. So if you can and it's
constantly enough problem cut that stuff out, you can do it occasionally
just don't do it regularly. Ice and massage. Is ice and massage effective? This isn't for everyone
but for a lot of people this could really improve nighttime pain.
Take a look right here. My right foot can bend up
more than my left foot. So I've had some injuries,
I tore my hamstring, so I don't have equal flexibility. And this is true for
everybody, you're not equal, that your muscles work differently, you're a little bit off balance, this causes some muscles to
get more sore, more swollen, the nerves to get more stretched out, and then they can ache when
you're resting at night, and when they're swollen.
So take a look right here, my feet are not equal. So this is the whole point of
the massaging and exercising. So freeze a frozen water bottles, just be careful that it doesn't explode, and massage all your muscles. So right here I'm massaging
my plantar fascia. These balls don't work great
on the bottom of your foot, but they can work great
on your calf muscle, on your hamstring, on your chest, on your butt muscles, for the bottom of the
foot these rubber balls that you can stand on they work great. On a soft surface like a carpet, you have your softer
ones and your harder ones it should never hurt.
Let me repeat, should never hurt. I love the massage roller stick. Simply getting something like this online it'll massage your
muscles, your hamstrings, your calf muscles. For most people it's their
calf muscles that get sore for restless legs type
symptoms that I see. Your peroneal tendons
right here on the bottom, don't do it on the bone
because the bones will hurt, so like on the front of your shin. So I'll see on the bottom of the foot it's probably easier to use a ball.
Then after you massage for a minute or two then you do some light stretching. So your hamstring, your calf muscles, if you can't reach your toes which most people with
nerve pain probably can't use a towel, you can
use some elastic bands. This stuff is extremely helpful. It's very beneficial. I love doing this one to
two minutes for a massage, one to two minutes for a stretch. Icing probably won't help it that much but there's a couple of medications, so capsaicin is a cream
that could be put on. It makes the skin feel red hot, but eventually that does cool down, it does start to feel better
so that can be very effective. Number two is, I got Biofreeze right here. It's a roll-on that works really well. You roll it on the bottom of the foot. So you can see right here I
got my foot with its nerves, you can roll it on the skin. It tingles for a few minutes but then it actually starts to do better.
So that's more of a home remedy, there's not a lot of science
behind it but it is effective, I've had lots of patients
have great success with it. Essential oils. Essential oils on skin
can be very beneficial. Number one, it can help
the skin stay moisturized, and number two, it just
feels good on the skin. If you have it feel free to use it, don't go out and spend
crazy amounts of money because lots of lotions work well. You could get the Gold
Bonds, the Sierra Bees, you know, even the
Vaselines, the coco butters, all that stuff will work well. Creams are thicker and
they stay on longer.
Lotions go in quicker, get better results but don't last as long. Usually they say put creams
on the bottom of the foot, and lotions on the thinner skin, but you can't go wrong with either one, get a high quality one. Lotions and creams can be very effective. They can both help skin conditions, and stop some of the
irritation of the skin that bothers the synopsis on the edges of the peripheral nerves. So what's the downside. It's low cost, it's effective. You know, don't go spending
crazy amounts of money like my dermatology friends I
always joke around, you know, every is at least 200 bucks.
But realistically the more
you use the better it is as long as you don't go crazy, and like dip your foot in a whole tub. A warm bath before you
go to sleep can help. A bath does two things, it warms the blood flow so
you're getting more circulation, you know, make sure it's not too hot, but number two is it
also cleanses the skin, it makes the skin feel a whole lot better you can get some great results that way. Vitamins. There's a lot of vitamins. I'm gonna touch on some of the big ones. So alpha-lipoic acid. This
can be a great one to take. There's some studies out there. But when I say they're studies, listen, they're not great studies.
There's so many variables
with nerve diseases that alpha-lipoic acid like
when they say this stuff works, it's like 50 people take
it and 50 don't take it. The ones that took it are like
5% better over five years. It's not like, hey, it
completely cures it. You know, if you're expecting that a vitamin will never help you. If you're deficient, like if you're living on a ship, and you're not eating the
right nutrition then maybe, but make sure you get a
good daily multivitamin.
Alpha-lipoic acid can help. Another two big ones are
vitamin B6 and vitamin B12. This is probably the
number one studied one. You know, at least in our
profession as foot doctors we see this a lot for peripheral
neuropathy for the feet. Vitamin B6 and B12 can be very effective in reducing foot pain, this numbness, burning,
and tingling type pain. But again over a couple of years it's maybe a little bit of an improvement, it's not a huge improvement, so don't make this your only solution. Vitamin E the same thing, can be helpful but the
studies aren't great. Magnesium, calcium, same kinda thing. These are supplements you can take, you know, especially in
chemotherapy type patients they've done some studies. They're not great studies but they can help maybe a little bit. Sometimes it can help somebody a lot, but I wouldn't put my
sites on just the vitamins, but I know that's an easy one so people really want this one to work. But the reality is the studies
aren't overwhelmingly great.
There's all these
acetylcysteine, glutathione, all that stuff, sometimes the study
short helps a little bit, nothing overwhelming. Acupuncture. You know, personally I don't
have a lot of experience in acupuncture. Does it have great studies? I don't think so. I don't know of a lot of great studies. I check occasionally I just don't see it. But a lot of people swear by it. Just because there's no study
doesn't mean it doesn't work. But the fact that there is no study it's certainly not in the
benefit of acupuncture especially in the face
of skeptics, you know, so I'll kinda leave it at that. Nerve injections. So nerve
injections can work really well. So when you come see a
podiatrist at the office a nerve injection at the
posterior tibial nerve, top of the nerve, you know, if there's a compression
injury or inflammation this could really help.
I've seen these if diagnosed properly really reduce the pain, and stay away for a long time. But again, it's part of the treatment. Walk it off, when you get up
in the middle of the night there's two forms of exercise
that I recommend people do is number one, if you have a
stationary bike maybe get up, get the blood flow going a little bit. This can help the blood flow, it can reach the nerves, it can make it feel a bit better. Sometimes just getting up
and walking back and forth in the hallway can make
that burning and tingling get a little bit better. That's more of a vascular
which is blood flow, and nerve component at the same time. Get good sleep. So a lot of the times sleeping
will make nerve pain better. I know it's almost like a catch 22, hey, buddy, I wish I could sleep, and then I wouldn't have this nerve pain but I can't sleep because
I have this nerve pain.
And that's kind of the tough problem. It's a vicious cycle
because you're not sleeping the nerve pain bothers you more. So sometimes that's where
things like medications could come in. So when you come see a podiatrist we could get you numbing
medication as a cream, you could get anti-inflammatory
compound medication and a cream, although insurance is no longer really supporting this stuff, at least in my experience. And the next thing is,
is there's medications. You know, when you come
see your podiatrist, and your primary care doctor neurologist there's gabapentin, there's Lyrica, there's the antidepressant
medications that can really help, and then there's the
actual pain medications. So, you know, the narcotic medications, and there's also sleep aids. I'm not gonna get into these details because you should really talk
about this with your doctor.
You know, I personally don't rely on the medications a lot because I find we can get a
lot of relief before then. But the reality is some people like if you dislocated your spine, or you have a severe
uncorrectable root cause problem, this might be the solution for you. And we would set you up with
a pain management specialist to help you manage that pain. So the biggest thing is here's where we really get
into my favorite solutions is you're wearing good socks, you're wearing breathable shoes, get a good supportive slipper.
So I linked some below
and our favorite shoe guys but look at. Even slippers with an
orthotic built into them, I'll go over that in a while, but wearing something inside the house because most people with severe pain probably don't leave the house, you know, but if you do a slipper
is really effective. And then what you wanna
do is same kinda thing, this is an over-the-counter orthotic, they don't have to be expensive. They're down in the
show notes but look at, without the orthotic look at
how the foot flattens out, this stretches all the nerves here, and can cause nerve damage.
It stretches out the ones at the bottom it could cause stretching
and nerve damage there. And on the outside of the ankle right here it squeezes this joint right
here causing joint pain. All three of those mechanisms cause a lot of joint and nerve pain, and in your feet at the
end of the day will ache, and that aching and swelling
will stretch your nerves, and cause red, hot nerve pain.
This is probably the
most common thing I see. So you wanna get good shoes, and you wanna get a good orthotic. So look at, right now it's not flattening 'cause it has an arch, and this is a low-cost
orthotic but look at, without it look at that stretch, look at that ankle collapse. But with the orthotic
look at how stable it is, but without it boom. So that almost seems like a trick, but I'm not asking you for
crazy expensive solutions here, and these are simple, low cost solutions where what do you have to lose? And I already mentioned
getting a good shoe, a stiff heel, stiff bottom. I'll tell you I have an injury, and I wear a great shoe right here, and a great customer orthotic, so see the customer
orthotic it's pretty strong, it supports the foot really well.
So right here it does a really good job. And then what you wanna
do is cross-training. So cross training works really well. If you're walking and standing all day, or you're running with exercise, go on a bike, go in a pool. If you're heavy like 3, 400 pounds, get in a water aerobics pool. You know, COVID is ending now, pools are certain open up, get in there, soaking
in the water can help. You know, the chlorine can
kill the fungus and bacteria on your skin as well, and you're getting some exercise, you're getting the blood flowing. And that gets you in great shape, gets your muscles stronger, it gets you exercising more. Do some cross-training,
some weightlifting, some water aerobics, some
swimming, some biking. It doesn't have to be standing
where you're stretching, and damaging your feet the whole time. If that still didn't do it an ankle brace can work really well. An ankle brace can hold
your foot fairly straight. And these braces basically prevent things like tarsal tunnel, or stretching of your
ankle and plantar fascia.
This is gonna be a quicker routine here. But when you get up in the morning, and you're tight or at night just rotate your ankles a little bit. So I like to warm up, you
know, rotating your ankles, get the blood flow, loosen
everything up a little bit. You know, ideally you would
have done the massage earlier, and I showed why you want to do this, but now you can use the towel, and just stretch your foot
back, stretch your hamstring. So right here I'm just gonna
hold it for 15 to 30 seconds just to loosen you up. And consistency is the key. It's not going crazy and
doing half an hour every day, it's just doing a couple
of minutes every day, and keeping up with it.
This is probably my favorite
stretching exercise, put a towel on your feet so it's cushion and the ball
of your foot doesn't hurt. And what you do in this case is you just use your body weight. It stretches out your
hamstrings, your calf muscles, but again it should not hurt. You don't have to go crazy, you don't have to do
anything that hurts you. I love the massage board right here, this is my favorite one out of
all the stretching supplies. I'm showing it here barefoot
but it could hurt your foot, especially the people having nerve pain, or restless leg syndrome. But the idea is you want
to measure your progress. So see how this moves
from about 15 degrees all the way to about 45
degrees on the last level. So see right there that's
supposed to be about 45 degrees or so. So I love the ankle stretch board, that's probably my favorite
one I like using that.
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