What it is
Nerve pain in the foot has several distinct causes: Morton's neuroma, a thickening of the nerve between the toes; tarsal tunnel syndrome, where the nerve is compressed at the inside of the ankle; and peripheral neuropathy, most commonly related to diabetes.
Each presents differently and each is treated differently, which is why an accurate diagnosis matters more here than almost anywhere else in the foot. Burning that is worse at night points somewhere quite different from a sharp electric jolt between the third and fourth toes.
Symptoms we look for
- Burning or electric pain rather than a dull ache
- Numbness, tingling or pins and needles
- The feeling of standing on a pebble or bunched sock
- Symptoms that worsen at night or in tight shoes
How we treat it
- Diagnostic testing to localize the affected nerve
- Metatarsal padding and orthotic offloading
- Injection therapy, including alcohol sclerosing for neuromas
- Medication management for neuropathic pain
- Surgical decompression or neuroma excision
When to see a podiatrist
Come in promptly if you have numbness, if burning pain is disturbing your sleep, or if you are diabetic and notice any change in sensation. Nerve damage responds far better to early treatment.
Common questions
Is nerve pain in the foot always diabetes?
No. Neuromas, nerve entrapment, spinal causes and vitamin deficiencies all produce foot nerve pain. Diabetes is common but far from the only cause.
Will the numbness come back?
If the nerve is compressed rather than degenerated, sensation often improves substantially after decompression. Long-standing neuropathy is harder to reverse, which is why timing matters.