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Lee Sanders, DPM, responds: A painfully hot or burning sensation in the feet, especially in middle-aged and older people, could be caused by small fiber neuropathy. Diabetes is the most common cause of this condition; symptoms typically start with burning feet and numb toes.hough this sensation is not uncommon in people with diabetes, hot or burning feet can have many other causes. Since your friend says his feet feel very hot from time to time, but not all the time, he and his doctor should rule out other causes. A person's occupation and footwear are frequently responsible for hot feet.
Common causes of tingling feet include: 1  Peripheral neuropathy (nerve damage). 2  Nerve dysfunction, such as a pinched nerve. 3  Nerve entrapment. 4  Poor blood circulation. 5  Medication (tingling could be a side effect). 6  Systemic diseases, such as hypothyroidism or multiple sclerosis. 7  Trauma or injury to a nerve, such as with a broken foot.