Grierson-Gopalan Syndrome

Original Editors - Habibu Salisu Badamasi

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This article is currently under review and may not be up to date. Please come back soon to see the finished work! (5/03/2023)

Introduction[edit | edit source]

Grierson-Goepalan Syndrome, also known as "Burning feet syndrome (BFS)", is characterized by burning and heaviness in the feet and lower extremities. Grierson-Gopalan syndrome was first described by Grierson, in 1826, the earliest to document such a symptom, but Gopalan later gave a detailed description in 1946.[1]

Clinical features[edit | edit source]

BFS is most common in those over 50 years, although it can occur in any age group and mostly reported in Asian and Far East countries during a hot summer. The symptoms characterized by a burning sensation, heaviness, numbness, or a dull ache in the feet and occasionally complain of ‘pins and needles’ or tingling in the lower extremities. The burning may be limited to the sole of the feet but may ascend to involve the dorsum, ankles or lower legs.[1]

The skin and blood vessels are normal in most while in some patients there may be accompanying erythema of the feet with warm overlying skin as in erythromelalgia. There is no local tenderness over the affected parts. Neurological examination is essentially normal in most patients. There are no signs of upper motor neuron involvement such as extensor plantars or increased tone. Motor power is maintained and there is no atrophy or wasting of the overlying muscles.[1]

Diagnosis[edit | edit source]

BFS is identify by a group of symptoms that can identify the likelihood of having Grierson-Gopalan Syndrome, including testing reflexes and identifying signs of infection. Blood tests is recommended alongside nerve function tests to rule out serious pathologies.

Causes of BFS[edit | edit source]

Nutritional Metabolic/endocrinal Hereditary Mechanical (entrapment neuropathies) Others
Vitamin B deficiency

Malabsorption syndrome

Chronic alcoholism

Diabetes mellitus

Renal failure (dialysis patients)


Autosomal dominant BFS Tarsal tunnel syndrome

Traumatic nerve compression


Chronic mountain sickness

Gitelman syndrome

Leishmaniasis Multiple sclerosis


Miscellaneous Idiopathic

Management[edit | edit source]

Conservative management[edit | edit source]

includes regularly soaking your feet for up to 15 minutes in cool water. Keep your feet as cool as possible and elevated when you can. Wear open shoes and cotton socks to keep your feet cool and reduce sweating.

Pharmacology management[edit | edit source]

Topical anti-inflammatory or cooling gels alongside some non-steroidal medication such as ibuprofen.

Physiotherapy[edit | edit source]

Depending on the cause of your Grierson-Gopalan Syndrome, Physical Therapy can be beneficial to address muscular or gait imbalances that can lead to conditions such as Morton’s Neuroma, Tarsal Tunnel Syndrome or Baxter’s Nerve Entrapments.

Custom orthotics can offload affected nerves and optimise one’s gait to relieve pain and address the cause of your burning feet.

If a metabolic condition causes your Grierson-Gopalan Syndrome, it is best to consult your GP for guidance on treatment

References[edit | edit source]

  1. 1.0 1.1 1.2 Makkar RP, Arora A, Monga A, Gupta AK, Mukhopadhyay S. Burning feet syndrome. A clinical review. Aust Fam Physician. 2003 Dec;32(12):1006-9