A burning sensation in your legs may have an obvious explanation, like a leg injury or during or after intense exercise. It could also be the result of damage or exposure to extreme heat, cold, or a toxic substance.

A burning feeling in your legs can often be accompanied by:

Some reasons for a burning feeling in your legs aren’t as obvious and need a doctor’s diagnosis. These conditions include:

Meralgia paresthetica

Meralgia paresthetica occurs when the nerve that provides sensation to the skin on your thigh is compressed. It’s also referred to as Bernhardt-Roth syndrome.

The condition often presents as a burning pain on the surface of your outer thigh. The outer thigh may also tingle or feel numb.

Venous reflux

Venous reflux occurs when the veins in the leg aren’t properly circulating blood to the heart. It’s also referred to as venous insufficiency.

If a leg vein fails, the blood can back up, pool, and leak into the leg tissue. This leads to a hot or burning sensation often accompanied by discoloration and itching.

Peripheral neuropathy

Peripheral neuropathy is a loss of function of the nerves that relay signals from the body to the spinal cord and brain. It’s often associated with:

Multiple sclerosis (MS)

Symptoms of MS include sensory disturbances that can lead to burning pain as well as numbness and tingling in the legs. These symptoms are often the result of faulty nerve signals due to MS lesions in the spinal cord and brain.

Treatment of burning legs depends on the underlying cause.

Meralgia paresthetica

Most people can expect a full recovery from meralgia paresthetica in four to six weeks. First-line treatments can include the following:

  • Drugs like aspirin, acetaminophen (Tylenol), naproxen (Aleve), or ibuprofen (Advil) can relieve pain.
  • Lose weight if you’re overweight.
  • Wear loose-fitting clothing.
  • Physical therapy can build leg strength.

If your pain is severe or symptoms continue for more than eight weeks, your doctor might recommend the following to reduce pain:

  • corticosteroid injections
  • tricyclic antidepressants
  • antiseizure medications, such as gabapentin (Neurontin), phenytoin (Dilantin), or pregabalin (Lyrica)

Surgery to decompress the nerve might be recommended if you’re pain is very severe and persistent, but this is rare.

Venous reflux

Your doctor may recommend the following when venous reflux is diagnosed early:

  • Compression stockings put pressure on your legs to help move blood.
  • Get moving. Avoid standing or sitting for long periods to reduce pressure on your legs. Exercise also helps pump blood.
  • Blood thinners can prevent the formation of blood clots.

If the condition has progressed, your doctor might recommend a procedure to close a problem vein. Doing so forces blood to flow through healthier veins. These procedures include:

  • Sclerotherapy. Your doctor injects a scarring solution to close the affected vein.
  • Endovenous thermal ablation. A laser or high-frequency radio waves are focused on the problem vein and closes it.
  • Ligation. Your doctor cuts and ties off the affected vein.

Peripheral neuropathy

Treatments for peripheral neuropathy can include:

  • Pain relief. Over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs, can ease mild symptoms. Stronger painkillers might be prescribed for more severe symptoms.
  • Antiseizure medications. Developed to treat epilepsy, antiseizure medications such as gabapentin (Neurontin) and pregabalin (Lyrica) may relieve nerve pain.
  • Topical treatments. Capsaicin cream may relieve your symptoms if you’re looking for a natural option.
  • Lidocaine patches. These patches are applied to your skin and may offer pain relief.

If your case of peripheral neuropathy is more serious, your doctor may recommend the following treatments:

  • Transcutaneous electrical nerve stimulation. Electrodes are placed on the skin to deliver a gentle electric current to relieve symptoms.
  • Physical therapy. Exercises can strengthen muscles and improve movements.
  • Plasma exchange. A machine removes the plasma from your blood as well as antibodies that are attacking your immune system. The affected plasma is treated or replaced with a substitute and then returned to your body.

Multiple sclerosis

There’s no cure for MS yet, but treatment can manage symptoms in most cases. Treatment focuses on slowing MS progression and minimizing recovery time following flare-ups. Medications to treat MS include:

Call 911 or your local emergency services if a burning sensation in your leg suddenly appears and is accompanied by:

These can be signs that you’re experiencing a stroke. It’s vital to seek immediate medical attention for a good outcome and quicker recovery.