Have you ever felt an ouch-moment when your feet start experiencing pain and burning sensations? In this article, we will discuss one such condition: the Grierson-Gopalan Syndrome.
Grierson Gopalan syndrome is also known as Burning Feet Syndrome.
J. Grierson and Coluther Gopalan were the first to coin this term, hence the name.
Grierson Gopalan syndrome is a medical condition causing severe burning and aching in the foot.
It is also associated with the following:
- Warm overlying skin
- Vasomotor changes in the feet
- Hyperesthesia- increased sensitivity to any senses like touch, sound, sight, and smell.
- Excessive sweating
- General body wasting- marked weight loss and muscle loss.
This syndrome can also affect the eyes, causing:
- Amblyopia or lazy eye- poor or dim vision in just one eye.
- Scotoma- a blind spot in the visual field in which vision is absent.
This condition occurs most commonly in women between 20 to 40 years of age.
This condition manifests as burning pain, especially in the bottom of the feet and the top of the foot, the ankle, and the lower legs.
What Are The Symptoms Of Grierson Gopalan Syndrome
The Grierson Gopalan syndrome symptoms range from mild to severe, depending on to which extent the nerves have been damaged. Some of the symptoms of Grierson Gopalan Syndrome are:
- Sensations of heat or burning may be limited to the soles of the feet but may also ascend towards the ankles or lower legs.
- Heaviness in the feet
- Sharp stabbing foot pain
- Pins and needles or tingling sensation in the foot and ankle
- Visible redness of the skin or erythema due to heat
- Tenderness- pain on touch
- Numbness in feet and legs
- Night numbness
- Excess warmth and sweating
- The heat symptoms become worse as the day progresses and at night
- Flat feet- sometimes, the feet may lose their arches and become flat.
- Skin irritation
What Are The Causes Of Grierson Gopalan Syndrome
This sensation of burning feet can come from a wide range of causes. It is important to find the underlying cause of this syndrome to set a treatment protocol as soon as possible.
1) Athlete’s feet
This contagious fungal infection is caused by a virus affecting the skin on the feet. It develops in warm and damp areas, like in between the toes, where sweat is mostly found.
It is commonly seen in athletes and is known as Athlete’s foot. Even if this might not be a serious condition, it may sometimes be challenging to treat, especially if there are comorbidities like diabetes or a weak immune system.
The Athlete’s foot occurs when there is a growth of tinea fungus on the feet. This may also infect the toenails.
Symptoms of Athlete’s foot:
- Severe burning and itching between toes and in the soles of the feet
- Blisters on the feet
- Raw and dry skin on the feet
- Thick, discolored toenails
- Peeling skin
As this is a contagious infection, it needs to be cured immediately.
Over-the-counter medications like topical antifungals such as Clotrimazole and Miconazole are used to recover from this infection. Also, oral antifungal medications and antibiotics are given.
Topical steroidal medications help reduce inflammation. The doctors also recommend that the patients soak their feet in salt water as salt has natural healing properties, making them feel relaxed.
2) Nutritional Deficiencies
Vitamin deficiency can lead to nerve damage or peripheral neuropathy leading to nerve pain. This nerve pain causes a burning sensation and other related symptoms of Grierson Gopalan syndrome in the foot.
What is peripheral neuropathy?
Peripheral nerves are nerves carrying information from the brain and spinal cord to the body parts. Peripheral neuropathy is when these peripheral sensory nerves don’t carry out their function properly, as they suffer from damage. Hence, the parts of the body which the peripheral nerves supply, like the hands and feet, feel pain, weakness, and numbness.
Vitamin B deficiency, mainly Vitamin B12 deficiency, is said to cause neuropathies. The function of the myelin sheath is to surround and protect the nerves. Therefore, reduced vitamin B12 leads to conditions like peripheral neuropathy.
Other vitamin deficiencies like – vitamin B6 and B9 are also said to cause peripheral neuropathies.
Vitamin B supplements help improve the condition.
3) Diabetic Neuropathy
High blood sugar levels cause impairment in the transmission of signals from nerves and gradually damage the nerve tissue, nerves, and blood vessels.
Uncontrolled high blood sugar levels affect the sensations in the body parts. When nerve damage is in the feet and legs, it is known as peripheral neuropathy. As a result, symptoms of Grierson Gopalan syndrome are seen.
Peripheral neuropathy is a common type of Diabetic Neuropathy.
This condition presents numbness, tingling, heaviness in the legs, stabbing pain, and excessive sweating.
Controlling the blood sugar level, exercising, and dietary changes can slow down the course of nerve damage. Still, they cannot stop the damage as this is one of the commonest hereditary diseases and has no complete cure.
4) Tarsal Tunnel Syndrome
Nerve entrapment is one of the most typical causes of Grierson-Gopalan syndrome.
A Tarsal Tunnel is a narrow space present on the posteromedial aspect of the ankle. It is a passageway for nerves, tendons, and vessels. The human body connects the talus to the medial malleolus, calcaneus, and flexor retinaculum.
Tarsal Tunnel Syndrome is a condition with repeated pressure on the posterior tibial nerve passing through this tunnel. This repeated pressure causes nerve damage leading to numbness, tingling, and burning pain.
These symptoms are aggravated by physical activity. As this condition progresses, the symptoms are also felt at rest and at night.
The causes of Tarsal Tunnel Syndrome are:
- Flat foot as it can stretch the tibial nerve
- Masses like tumors near the nerve
- Bony growth in the tarsal tunnel
- Trauma like an ankle sprain or fracture
- Non-steroidal anti-inflammatory drugs
- Elevation to promote blood flow
- In severe cases, surgery may be required to release the pressure
5) Charcot-Marie-Tooth Disorder
This is the most common inherited neurological disorder, affecting the nerves which control voluntary muscle activities, causing symptoms of burning feet syndrome. This condition is named after the three physicians who discovered it.
- Difficulty in standing and walking
- Frequent stumbling
- Pins and needles sensation
- Difficult in ascending steps
- Abnormal weakness in leg and foot muscles
- Deformities of foot
CMT is a congenital disease meaning that it is present by birth.
Physical therapy is the most common and effective treatment for Charcot-Marie-Tooth disorder. Orthopedic devices like splints and braces are used for support. If deformities are present, surgical correction may be required.
6) Endocrine disorders
Endocrine disorders like Hypothyroidism or Hyperthyroidism may be associated with peripheral neuropathy leading to burning feet syndrome.
7) Complex Regional Pain Syndrome
CRPS is chronic pain in the limbs developing after an injury or surgery. It presents as a burning sensation, pain, swelling, and skin color and texture changes.
This condition may become severe, affecting the immune system.
Other Causes of Grierson Gopalan Syndrome
- Malabsorption syndrome
- Rheumatoid Arthritis – auto-immune disorder
- Toxic chemicals or Chemotherapy drugs
- Allergic reaction to socks or shoe material
- Excessive alcohol consumption
- Infectious diseases like HIV and Syphilis
- Chronic kidney disease or patient on Dialysis
- Morton’s Neuroma-constriction of nerve takes place
Diagnosis of Grierson Gopalan Syndrome
When you first visit the doctor, he will first conduct a physical examination and ask for medical history regarding the symptoms of burning feet syndrome. He will look for infections, structural deformities, redness, sensations, and reflexes.
1. Blood Tests
Blood tests to rule out a history of excess alcoholism, diabetes, endocrine diseases, kidney function, vitamin deficiency, and HIV.
X-rays or magnetic resonance imaging (MRI) if tarsal tunnel syndrome is suspected.
Nerve Conduction Velocity test to assess the speed at which the electrical impulses travel along the nerve.
Electromyography is done to see how the muscle responds to nerve stimulation.
Treatment of Grierson Gopalan Syndrome
Apart from the ones mentioned above, the patient with burning feet syndrome should:
- Avoid wearing tight shoes
- Wear open and comfortable shoes to allow adequate ventilation to avoid sweating. Also, tight footwear can irritate sensitive feet.
- Soak the lower leg or feet daily in cold water but not ice cold. This provides symptomatic temporary relief.
- Avoid feet exposure to heat
- Wear comfortable shoes with arch supports to relieve pain and reduce the risk of deformities
- Getting used to wearing cotton socks
According to the overview of the Grierson Gopalan Syndrome or the Burning Feet Syndrome, we can conclude that this is a condition of emergency.
Still, it can be well managed if diagnosed and treated earlier before it worsens.
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