Neuropathic Pain in the Foot

damaged,When experiencing burning pain in the foot, tingling toes, or pain that shoots down your leg, there may be an irritated or compressed nerve in your foot. Nerve pain does not feel like normal muscle aches or joint pain. People may describe nerve pain as “pins and needles," electrical, shooting, stabbing, or constant. Early recognition of the cause of nerve irritation or compression is key because once nerves are damaged they do not always heal with time. Clinicians can conduct an examination to determine if symptoms are caused by something localized to your foot, from other health problems that can cause nerve damage, or due to structural issues of the foot.

Types of Foot Pain 

Recognizing Symptoms Caused by Nerve Compression or Damage

Most people can recognize nerve-related pain because it feels different from other foot conditions. Patients often complain of burning feet, tingling toes, numbness, or feeling “pins and needles” in their toes or the bottom of their foot.

These symptoms may develop slowly and get worse at night or after standing for long periods of time. Realizing when your symptoms are present and activities that cause them to flare can help clinicians narrow down which nerve is involved based on the location.

Burning, Tingling, and Numbness in the Foot

If you have burning feet at night or numbness in your toes, this may be one of the first signs that you have a nerve problem in your foot. Tiny nerve fibers send information about sensation to your brain. Tingling, burning feet may begin as just a feeling that you have in your toes.

Some patients even notice patches of skin on their feet that “feel” different or numb compared to other areas of their foot. Symptoms may progress to involve the entire sole of the foot or radiate towards the ankle.

Shooting or Electrical Pain

One specific type of nerve pain that many people may experience is shooting pain down the foot. When nerves become compressed, they may send sharp, jabbing pains that feel like lightning bolts shooting through the foot.

These pains can occur with walking, prolonged standing, or wearing shoes that crowd or compress the nerves in your feet. Clinicians can determine which nerve is involved with compressive symptoms if you can track where the pain travels across your foot or toes.

Morton’s Neuroma

Morton’s neuroma is a very common cause of nerve pain in the toes. It occurs when excess tissue forms around a nerve that runs between your toes. This most frequently occurs between the third and fourth toes.

Patients with this condition often describe feeling like they are stepping on a small rock or pebble when walking. Alternatively, they may even feel sudden bursts of electrical pain with stepping. Many people find relief just by wearing shoes with a wider toe box. Orthotics, injections, and other therapies can help decrease your symptoms before considering surgery.

Tarsal Tunnel Syndrome

Another common nerve condition that causes pain in the foot is called tarsal tunnel syndrome. When the posterior tibial nerve becomes compressed as it passes through the inside of the ankle, it can lead to burning pain, numbness, or tingling that extends into the heel or sole of the foot.

For some people, these symptoms may also become worse when lying down at night or after standing at a job for long periods of time. Pinpointing where the pain begins and what nerves control those areas of your foot can help providers determine if you have this condition.

Peripheral Neuropathy

Peripheral neuropathy is a condition that affects nerves all over the body but usually starts in the feet. Diabetes is the most common cause of peripheral neuropathy, but there are other causes, such as vitamin deficiencies, alcohol consumption, medications, kidney failure, and autoimmune disorders.

If you have neuropathy, your pain may be present in both feet in a “symmetrical” pattern.

Vitamin Deficiencies

Other causes of nerve pain can be from vitamin deficiencies. One example is a vitamin B12 deficiency, which can cause numbness, weakness, and loss of balance in your feet and legs.

Blood work can determine if you have this deficiency, and taking supplements or changing your diet can reverse these symptoms.

Mechanical Causes of Nerve Pain in the Foot

There are certain structural deformities that change the normal anatomy of the foot. Examples of this are bunions, hammertoes, high arches, or flat feet.

Any condition that alters the normal position of bones and soft tissue can put added pressure on nearby nerves. Orthotics and shoes can often help cushion your feet and restore the normal pressure placed on nerves when standing or walking.

Diagnostic Testing for Foot Pain

The first step in diagnosing your foot pain is a thorough clinical examination. Providers look at how you walk, your foot strength, balance, and where you feel tingling or numbness.

Additional testing such as ultrasound or MRI can be used to look for structural abnormalities. Other tests that look at how your nerves are functioning include nerve conduction studies and electromyography.

Treating Neuropathic Pain in Your Foot

Conservative therapy is always tried first when treating painful neuropathy in the foot. Custom orthotics and supportive shoes can help cushion your feet and decrease pressure on irritated nerves.

There are even medications that specifically target nerve pain. Anticonvulsants and antidepressants can help decrease overactive nerve signals. If patients fail conservative therapy, some injections and procedures can be used to reduce swelling around nerves.

Lastly, if there is severe nerve compression that does not improve with injections or physical therapy, surgery can be used to physically decompress the nerve.

Visit our Foot Pain Clinic

If you have any of these symptoms, make sure to visit your doctor to have them examined. At

Wasatch Foot & Ankle we understand nerve pain can be difficult to live with. We work closely with all of our patients to evaluate their specific symptoms and provide individualized treatment to get you healthy again.

Frequently Asked Questions

Q1: What is causing burning in my foot?

A: Nerve pain is often caused by irritation or damage to nerves. This can be due to problems in your foot like peripheral neuropathy, Morton’s neuroma, tarsal tunnel syndrome, or other foot deformities that place pressure on nerves.

Q2: How can I tell if my foot pain is caused by a nerve?

A: Most people know when they have nerve pain. It can feel like tingling, burning, numbness, or a sharp electric type of pain. Oftentimes, night pain that wakes you up from sleeping or pain with activity can be related to nerves.

Q3: Will nerve pain in my foot go away?

A: Some causes of nerve pain may improve with rest and taking pressure off of the affected area. If you injure a nerve, it may take time for the pain to completely resolve. If your nerve pain is chronic and gets worse over time, you should make sure to see your doctor.

Q4: What tests are done to diagnose foot pain?

A: There are a variety of tests that help providers diagnose the cause of your foot pain. Foot and ankle x-rays are often the first test that is done. Other tests, such as MRI or ultrasounds, can be obtained to look at the bones and soft tissues of the foot. Finally, doctors can perform testing that looks at how your nerves are functioning.

Q5: When should I see a doctor for foot pain?

A: You should make an appointment with your doctor if you have a sudden onset of foot pain that does not improve with rest or boot/stability shoes. If you have weakness, nerve pain that causes numbness, or your ability to walk is affected, you should make sure to get that checked.