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[4] Reminder: there is no magic pill and no magic peptide, however, used in combination with low hanging fruit like diet, exercise, and simple lifestyle modifications, a lot is possible

Elevating Care at Flex Spine and Sport At Flex Spine and Sport, we are committed to staying at the forefront of healthcare innovation and providing our patients with the highest quality of care possible

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The most important drug classes to review in any burning feet workup: Chemotherapy agents: Taxanes (paclitaxel, docetaxel), platinum compounds (cisplatin, oxaliplatin), and vincristine produce chemotherapy-induced peripheral neuropathy (CIPN) in 3040% of treated patients Fluoroquinolone antibiotics: Ciprofloxacin, levofloxacin FDA black box warning for peripheral neuropathy that may be permanent Metronidazole: Prolonged use associated with peripheral neuropathy Statins: Rare but documented association with peripheral neuropathy in some patients Metformin: Indirectly via B12 depletion (see above) Amiodarone, isoniazid, thalidomide: Additional agents with established neuropathy risk Burning feet symptoms requiring urgent evaluation New or worsening burning feet in a diabetic patient neuropathy progression, needs A1c optimization and ulcer risk assessment Burning feet with systemic symptoms: weight loss, fatigue, night sweats possible malignancy or systemic disease Rapidly progressive bilateral burning with leg weakness Guillain-Barr syndrome or other acute neuropathy, emergency evaluation Burning feet with episodes of red, hot, swollen feet relieved by cold erythromelalgia, needs hematologic workup Burning feet plus balance problems or falls large fiber neuropathy or CNS cause, neurology referral warranted Diagnosis: The Workup We Run Our standard evaluation for burning feet syndrome in the podiatric setting: detailed history (diabetes status, medications, alcohol use, diet, B12 risk factors, symptom distribution and timing)

The following databases were searched: Ovid MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, Ovid Embase, Wiley Cochrane, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), and Centre for Reviews and Dissemination/International Agency for Health Technology Assessment

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