Painful-feet Syndrome among Prisoners of War

Flight Lieutenant Peach’s observations on Burning Feet Syndrome in Far Eastern Prisoners of War 1942–45

“…Large numbers of BFS patients were found also found by Cruickshank in Singapore 12 and Page in Hong Kong and the Philippines. 6 Others reported a much lower prevalence: in 551 cases of dietary associated scrotal dermatitis seen in Changi camp in Singapore, Frankland, noted only six cases with painful feet. 13 In 1943 he relocated to a camp at Blakang Mati (an island off Singapore, now called Sentosa), and in personal communication (September 2015) he recalls few cases of burning feet or scrotal dermatitis, perhaps attributable to FEPOW being allowed to grow their own vegetables.…”

“…5 Usually occurring 3-5 months after capture, and often following a debilitating bout of infection such as dysentery or malaria, 4 the condition usually started with a dull ache in the feet, specifically over the metatarsal region, and progressed to a 'severe burning sensation' and hyperaesthesia. 6 This was followed by a more severe, but intermittent, 'sharp' or 'shooting' type pain, 'like toothache' 12 which radiated into the heels and sometimes up the shins. 4 The pains were always distal and symmetrical in distribution and a small minority of cases (6.4%) reported tingling or numbness in their hands.…”

“…10 Patients were described as sitting in a squatting position, gripping their toes and massaging their feet 'for hours on end.' 4,6 During the day, some men reported being comparatively free from pain. 7 Relief was sought by some through immersing the feet in buckets of water, whilst others reported that walking helped.…”

“…4 There are multiple accounts describing how patients would often be found 'shifting their position from one foot to the other' when standing, 'usually wincing with pain as each foot touches the ground'. 6 Simpson described how the hyperaesthesia was 'superficial in some cases, but usually deep muscle tenderness'. With progression, the hyperaesthesia 'tended to be replaced by hypoaesthesia', often with a patchy distribution of the two.…”

“…The focus of this historical review is 'Burning Feet Syndrome' (BFS), which afflicted between 10 and 33% of prisoners. 3 Although retrospective accounts of BFS were published by surviving FEPOW medical officers in the immediate post-war period, [4][5][6][7] these were largely based on the authors' post-captivity recollections as no contemporaneous medical records of individual cases were thought to have survived. This situation changed in 2007 when the late Nowell Peach was interviewed as part of the Liverpool School of Tropical Medicine FEPOW oral history study.…”