What would be your provisional diagnosis for this patient suffering from a burning sensation of the soles of his feet, and what other differential diagnoses should you consider?
Kim presented with a history of ‘burning’ of the soles of his feet that particularly worried him at night and often interfered with his sleep. He said that when he got up and walked around the discomfort lessened, and his symptoms did not worry him at all during the day.
Kim had retired at the age of 60 years from a sedentary job, and despite having some early osteoarthritis of his hips and knees, he played tennis weekly and went for walks regularly. He was not overweight but had a family history of ischaemic heart disease and was taking an ACE inhibitor, which controlled his hypertension. He did not smoke and his fasting lipids and glucose levels were within the normal range.
What is the mechanism of this patient’s ‘burning’ soles?