Nerve Pain In Foot: Causes, Symptoms & Diagnosis (2024)

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Written By: Chloe WilsonBSc(Hons) Physiotherapy
Reviewed By:FPE Medical Review Board

Nerve Pain In Foot: Causes, Symptoms & Diagnosis (1)

Nerve pain in the foot is a common problem. There may be burning foot pain, tinging, numbness or weakness. Symptoms may be confined to the foot however they often affect the leg too.

Nerve pain in the foot is typically caused by damage to the nerve somewhere along its path from the spine down to the foot.

This is usually either from an injury to the back, leg or foot, an underlying medical condition or a side effect of medication.

Nerves are responsible for carrying messages telling muscles how and when to work, providing information on different sensations such as hot and cold and controlling various bodily functions.

Damage anywhere along the course of a nerve affects its ability to carry these messages and can cause nerve pain in foot, also be known as a foot neuropathy or neuropathic pain.

Nerve pain in foot can stem from two places

  • The Spine: Damage to the lower back is a common cause of nerve pain in the foot. This tends to cause back, buttock and leg nerve pain as well as foot pain and weakness.
  • The Nerve: a peripheral foot neuropathy is caused by damage along the course of the nerve somewhere down the leg or in the foot itself. In this case symptoms tend to be localized to the foot and possibly lower leg.

Here, we will look at how nerves work, the most common causes of foot and leg nerve pain, how they present and how to know when nerve pain in foot is a medical emergency.

How Do Nerves Work?

Nerve Pain In Foot: Causes, Symptoms & Diagnosis (2)

Our nervous system is made up of two systems, the central nervous system (brain and spinal cord) and the peripheral nervous system (nerves).

The peripheral nerves take messages to and from the brain and spinal cord which interpret the messages and send a responding signal back down to the starting point.

There are three types of nerves in our bodies:

  • Sensory Nerves: These receive information on different sensations such as hot/cold, sharp/dull, light/heavy pressure
  • Motor Nerves: These control how the muscles work telling them when, how long and how strongly they should contract and relax
  • Autonomic Nerves: these control things like bladder and bowel function, heart rate and digestion

Damage to the nerves causes them to behave abnormally. They may stop sending messages altogether e.g. causing numbness or weakness, or fire erratically, sending excessive or incorrect signals e.g. causing pain or pins and needles.

Foot Neuropathy from Spinal Problems

Nerve pain in the foot often comes from a problem in the back, rather than in the foot itself. At the base of the spine, five nerves (L4, 5, S1, 2 &3) exit the spine and join together to form the sciatic nerve, the largest nerve in the body. The sciatic nerve travels down through the buttock and the back of the leg, branching out as it spreads further down through the leg and into the foot.

If the sciatic nerve is squashed anywhere along its path, it interrupts the signals travelling up and down the nerves to the spinal cord resulting in pain, weakness, tingling or numbness anywhere in the leg and down in to the foot.

The two most common problems in the lower back that can damage the sciatic nerve and thus cause nerve pain in foot are:

Herniated Disc aka Slipped Disc

Nerve Pain In Foot: Causes, Symptoms & Diagnosis (3)

Between most of the vertebrae in our back there are discs that provide cushioning and allow pain-free, flexible movement.

If discs get squashed too much, some of the material from the middle of the disc (the nucleus) gets pushed out of the back of the disc, irritating and/or squashing the nerve root.

Think of it like a jam donut, where the donut represents the disc, and the jam represents the nucleus. When you squeeze a donut, the jam leaks out the back, sticking to whatever it touches.

The most common symptoms of nerve pain in the foot from a herniated disc are:

  • Pain: in the lower back which may spread down through the buttock, back of the leg and sometimes the foot. The pain tends to be sharp or burning rather than dull
  • Altered Sensation: the pain may progress to pins and needles or numbness with or without associated weakness e.g. inability to lift the foot and toes up
  • Unilateral Symptoms: Usually only affects one leg rather than both

In most cases, nerve pain in foot from spinal problems settles down within a few weeks with a combination of rest, exercises and medication. However, in a few cases, it can be a medical emergency – see below.

Spinal Stenosis

Nerve Pain In Foot: Causes, Symptoms & Diagnosis (4)

Spinal stenosis is another possible cause of nerve pain in foot. It develops due to narrowing of the gaps in the spine where the spinal cord and nerves run.

The most common symptoms of spinal stenosis in the lower back are burning foot pain and cramp, typically in both legs.

Spinal stenosis symptoms tend to ease when you sit down or bend forward, so people with stenosis often find it easier walking uphill than on the flat or downhill as you naturally bend forwards slightly.

Spinal stenosis can be caused by:

  • Wear and Tear: As this can cause the production of bone spurs, small outgrowths of bone which stick out
  • Tumours: Abnormal growths in the spinal cord
  • Spinal Injuries: Injuries to the spine such as a fracture can cause inflammation or bone displacement

Nerve pain in the foot from spinal stenosis is usually linked with aging, most commonly affecting people over the age of 50. In severe cases, surgery may be indicated.

Peripheral Neuropathy

Peripheral neuropathy is a problem with the nerves that carry messages to and from the spinal cord and brain. It most commonly causes problems in the extremities i.e. hands and feet. Peripheral neuropathy can come on:

Suddenly: usually due to a traumatic event (known as acute onset) or
Gradually: tends to get progressively worse and is slow to improve (known as a chronic condition).

If one nerve is affected it is known as mononeuropathy, if more than one nerve is affected it is referred to as polyneuropathy.

The damage from peripheral neuropathy can cause:

  • Pain: Sharp, stabbing, electric shock or burning foot pain, often worse at night
  • Weakness: difficulty moving the foot normally such as a foot drop (difficulty lifting the foot up)
  • Altered Sensation: tingling, pins and needles and/or numbness, hypersensitivity. It can sometime feel like you are wearing a sock when you are actually barefoot.
  • Altered Balance & Co-ordination: you may feel unsteady on your feet

Symptoms of peripheral neuropathy usually affect both feet, rather than just one and may come and go or gradually progress.

There are a number of different causes of nerve pain in foot from peripheral neuropathy.

Nerve Pain In Foot: Causes, Symptoms & Diagnosis (5)

Medical Conditions
Diabetes is the most common cause of peripheral neuropathy. Diabetic nerve pain in foot results from changes in blood sugar levels which affects the metabolism of the nerves glucose levels.

Anyone suffering from diabetes should take extra care of their feet and report any incidences of burning foot pain or foot neuropathy as they are at high risk of severe foot problems.

Charcot Marie Tooth Diseasecan also cause peripheral neuropathy. CMTD is a condition where damage to parts of the nerve fibre slows down transmission of signals, resulting in weakness and loss of sensation.

Injuries
This may be from a one-off incident or from sustained or repetitive compression. A typical example of this is Tarsal Tunnel Syndrome which causes burning foot pain

Infections
Such as Lyme Disease, shingles or leprosy

Medications
Peripheral neuropathy can be a side effect of some medications e.g. chemotherapy drugs

Alcoholism
Long term excessive alcohol intake can damage the peripheral nerves

In approximately 30% of cases of peripheral neuropathy, the cause is idiopathic – of unknown origin.

When Is Nerve Pain in Foot Serious?

Any incidence of nerve pain in foot should be assessed by your doctor. If you experience any of the following symptoms, you should see your doctor immediately as these symptoms constitute a medical emergency:

  • Bladder or Bowel Dysfunction: inability to control function
  • Saddle Anaesthesia: numbness in your saddle region between your legs
  • Weakness: e.g. foot drop where you are unable to pick up your foot properly causing you to stumble or trip frequently when walking

These are usually linked with a problem in the spine rather than a peripheral foot neuropathy.

If none of these causes of nerve pain in foot is sounding quite like your problem, visit the burning foot pain section for help working out what is causing your problem or the common foot conditions section.

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Page Last Updated: 2019-06-07
Next Review Due: 2021-06-07

References

Treating Diabetic Neuropathy: Present Strategies and Emerging Solutions. Saad Javed, Uazman Alam & Rayaz A. Malik. Journal of the Society For Biomedical Diabetes Research. 2015

Risk Factors for the Need of Surgical Treatment of a First Recurrent Lumbar Disc Herniation. R Yurac, J Zamorano, F Lira, D Valiente, V Ballesteros, A Urzúa. European Spine Journal. 2016

Nerve Pain In Foot: Causes, Symptoms & Diagnosis (2024)

FAQs

How do I know if my foot pain is nerve pain? ›

Symptoms of foot and ankle neuropathy and nerve entrapment depend on the cause, but the most common symptoms include:
  1. Numbness.
  2. Sharp or burning pain.
  3. Tingling sensations or feeling that your foot has fallen “asleep”
  4. Weakness in your foot, toes or ankle.

What triggers nerve pain in feet? ›

Nerve pain in the foot tends to result from a compressed nerve or diabetes. A range of health issues may be at play, and they tend to cause similar symptoms. For this reason, receiving a diagnosis is key. It is especially important to contact a doctor if the pain is worsening or home care techniques cannot ease it.

How do you diagnose nerve damage in foot? ›

Electromyography (EMG) records electrical activity in your muscles to detect nerve damage. A thin needle (electrode) is inserted into the muscle to measure electrical activity as you contract the muscle.

What can be done for nerve pain in the foot? ›

Medications—A variety of prescription medications can be used to alleviate neuropathy symptoms. Surgery—In more severe situations, surgery may be necessary to release swollen and compressed nerves. MLS Laser Therapy—This non-invasive therapy is the latest technology in neuropathy pain treatment.

How is nerve pain diagnosed? ›

How is nerve pain diagnosed?
  1. blood tests to check your general health and look for underlying conditions.
  2. nerve conduction studies which measure how quickly your nerves carry electrical signals.
  3. a CT scan or an MRI scan to look for anything that could be pressing on a nerve.

What is the most common symptom of nerve damage? ›

The signs of nerve damage include the following:
  • Numbness or tingling in the hands and feet.
  • Feeling like you're wearing a tight glove or sock.
  • Muscle weakness, especially in your arms or legs.
  • Regularly dropping objects that you're holding.
  • Sharp pains in your hands, arms, legs, or feet.

What disease causes nerve pain? ›

Peripheral neuropathy is nerve damage caused by a number of different conditions. Health conditions that can cause peripheral neuropathy include: Autoimmune diseases. These include Sjogren's syndrome, lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and vasculitis.

What is the best medicine for neuropathy in the feet? ›

The most effective treatment was nortriptyline. Of the study subjects taking this medication, 25% reported their discomfort improved by at least 50%. The least effective treatment was pregabalin: only 15% of study subjects reported that much improvement. Side effects were common with all of the treatments.

What is the best tablet for nerve pain? ›

The main medicines recommended for neuropathic pain include: amitriptyline – also used for treatment of headaches and depression. duloxetine – also used for treatment of bladder problems and depression. pregabalin and gabapentin – also used to treat epilepsy, headaches or anxiety.

Can a blood test detect nerve damage? ›

A variety of blood tests may be performed to determine the cause of nerve damage. These tests may look for high blood glucose levels, diabetes onset, vitamin deficiencies, etc.

What test shows nerve damage? ›

A nerve conduction velocity (NCV) test — also called a nerve conduction study (NCS) — measures how fast an electrical impulse moves through your nerve. NCV can identify nerve damage. During the test, your nerve is stimulated, usually with electrode patches attached to your skin.

Does MRI show nerve damage? ›

Nerve damage can usually be diagnosed based on a neurological examination and can be correlated by MRI scan findings. The MRI scan images are obtained with a magnetic field and radio waves. No harmful ionizing radiation is used.

What kind of doctor treats nerve pain in foot? ›

Everyone with symptoms of peripheral neuropathy of the feet should see a podiatrist. Podiatrists are doctors who are specially trained to preserve the health of the feet.

What home remedy can I use for foot nerve pain? ›

Soaking Feet in Cold Water

Cold applications calm your nerve endings and make the area numb. This aids in soothing soreness and inflammation. Cold or ice is ideal when the pain is achy and hot. Once the pain subsides, heat application will improve blood circulation and support the healing of the injury, if present.

What vitamins help with nerve damage? ›

B Vitamins

Vitamins B-1, B-6, and B-12 have been found to be especially beneficial for treating neuropathy. Vitamin B-1, also known as thiamine, helps to reduce pain and inflammation and vitamin B-6 preserves the covering on nerve endings.

Can nerve pain be cured? ›

While nerve pain can't always be cured, it can be treated -- and there are a lot of good options available. If you're struggling with nerve pain caused by diabetes, cancer, HIV or another condition, here are some answers.

What is nerve damage in the feet? ›

Peripheral neuropathy is nerve damage disorder that typically causes pain in your hands and feet. Other common symptoms of this disorder include: muscle weakness. numbness. tingling.

How do neurologists treat nerve pain? ›

Multimodal therapy (including medicines, physical therapy, psychological counseling and sometimes surgery) is usually required to treat neuropathic pain. Medicines commonly prescribed for neuropathic pain include anti-seizure drugs such as: Gabapentin (Neurontin®).

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