Why Is My Leg Burning Below My Knee?

A burning sensation below the knee can be due to many different causes, including nerve damage, leg injury, back problems, cancer, multiple sclerosis, rheumatoid arthritis, and others.

A burning sensation in the leg below the knee can be caused by many different conditions ranging from nerve damage and circulation problems to injury and chronic conditions. 

Causes of a burning feeling in the leg below the knee include: 

• Damage to nerves in the legs 
  • Exposure to extreme heat or cold 
  • Exposure to toxic substances
• Skin damage in the legs and surrounding tissues
  • Burns from chemicals or extreme heat
  • Exposure to poisonous substances
• Circulation problems that impair blood flow to the legs
• Leg injury
• High-intensity exercise
• Meralgia paresthetica
  • Pain in the outer thigh due to compression of the lateral femoral cutaneous nerve, one of the main nerves in the thigh
• Back problems such as sciatica or disk problems
• Chronic conditions, such as multiple sclerosis
• Peripheral neuropathy
  • A disorder in which there is loss of function of peripheral nerves that relay signals between the body and the brain and spinal cord 
  • Can be caused by a number of diseases and disorders, such as
    • Alcoholic neuropathy
    • Diabetic neuropathy 
    • Guillain-Barre syndrome, an autoimmune nerve disorder 
• Certain diseases 
  • Cancer
  • Multiple sclerosis 
  • Peripheral artery disease (PAD, also called peripheral vascular disease, or PVD)
  • Rheumatoid arthritis 
  • Shingles 
  • Spinal stenosis, disc disease, or other conditions of the spine
  • Systemic lupus erythematosus 
  • Vitamin deficiencies
• Life-threatening causes of burning sensation in the legs
  • Stroke
  • Transient ischemic attacks (TIA)
  • Severe burn

A leg burning sensation may be accompanied by other symptoms, depending on the cause.

Other symptoms that may accompany leg burning sensations include: 

• Tingling
• Numbness
• Pain
• Redness
• Warmth 
• Swelling
• Blistering
• Bleeding
• Aching or pain in the groin or buttocks
• Outer thigh pain
• Sensitivity to touch
• Changes in sensation
• Problems walking
• Foot problems, such as ulcers and bone and joint pain
• Problems with coordination
• Muscle weakness
• Nerve pain
• Other unusual sensations in the legs

Serious symptoms that might indicate a life-threatening condition that may accompany a burning sensation in the legs may include: 

• Numbness or weakness on one side of the body 
• Change in level of consciousness or alertness, such as passing out or unresponsiveness
• Change in mental status
  • Confusion
  • Delirium
  • Lethargy
  • Hallucinations and delusions
• Garbled or slurred speech or inability to speak
• Paralysis or inability to move a body part
• Sudden change in vision, loss of vision, or eye pain
• “Worst headache of your life”

Call 911 and get to a hospital’s emergency department right away (do not drive yourself) if you experience any of these symptoms, as they may be signs of a stroke, which can be life-threatening. 

A leg burning sensation below the knee is diagnosed with a patient history and a physical examination in which the doctor will check for any sensory differences between the affected leg and the other leg. An abdominal and pelvic examination may be performed to exclude problems in those areas.

Tests used to help diagnose the cause of a leg burning sensation below the knee may include:

• X-rays 
• Magnetic resonance image (MRI) scan
• Computed tomography (CT) scan
• Nerve conduction study 

Treatment for a leg burning sensation below the knee varies depending on the cause. 

Some causes of lower leg burning sensation can be managed with home care, such as:

• Heating or cooling pads
  • May help with sore muscles or swelling due to injury
• Rest
  • May help provide relief for burning sensation associated with injury or straining like spinal stenosis, slipped disk, or sciatica
• Exercise
  • Some cases of lower leg burning sensation such as blood vessel blockage may improve by steadily and gradually increasing exercise to encourage blood flow and strengthen blood vessels
• Eat a healthy, balanced diet
  • If the burning sensation is caused by nutritional deficiencies, especially B vitamins such as thiamine, B12, and folic acid
  • Fish, poultry, eggs, dairy, leafy green vegetables, beans, and pe are good sources of B vitamins
  • May also help prevent some causes of leg tingling including diabetes, stroke, and blood vessel problems caused by high blood pressure
• Don’t smoke
  • Smoking is associated with diabetes, stroke, and blood vessel problems from high blood pressure, all of which can result in a burning sensation in the legs 

If a burning sensation in the legs is due to nerve problems, medications may be prescribed, such as:

• Corticosteroids
  • Can help reduce inflammation-associated leg burning sensations that occur with multiple sclerosis, Guillain-Barre syndrome, and other autoimmune disorders
• Nerve blocks
• Antivirals or antibiotics
  • May be used if the burning sensation is due to a viral or bacterial infection
• Other medications to treat the underlying condition causing the burning sensation, such as medication for diabetes, high blood pressure, liver or kidney problems, or medications to increase blood flow

Other medical treatments for a burning sensation in the legs may include: 

• Physical therapy
  • May be recommended if the problem is due to back strain and/or nerve injury
• Surgery
  • May be needed if other treatments have not helped
  • Used for conditions such as spinal stenosis, slipped disk, sciatica, and tumors/abnormal growths