Nerve pain in the foot

There are various nerve disorders that can cause nerve pain in the foot, including: Morton’s neuralgia, tarsal tunnel syndrome, diabetic neuropathy, etc.

Humans take an average of about 5,000-7,000 steps a day, so it is not surprising that foot pain is one of the most common symptoms.
Since the feet are subjected to great stress, it is practically inevitable that tendons, joints and ligaments cause pain.
The nerves are a rare cause of foot pain.
The symptoms can be caused by the direct irritation of a nerve or by diseases that cause nerve damage. When nerves are irritated or injured, stabbing or burning pain occurs.
The pain occurs suddenly and is also present during periods of rest. The supply area of the irritated nerve can be very sensitive to touch.

Nerve disorders that cause foot pain

Morton’s neuralgia: Morton’s neuroma is a benign thickening of the nerve that runs between the third and fourth toes.

A typical symptom is a burning sensation or stabbing pain between the third and fourth toes, which increases when walking, especially on tiptoe.
The complaints are constantly present, 24 hours a day. Another common symptom is a feeling of pressure under the toes, such as a wrinkle-throwing sock or a stone in the shoe.
Morton’s neuroma occurs predominantly in women, possibly because of the tight shoes or high heels they wear.
MRI (magnetic resonance imaging) is a useful examination procedure for Morton’s neuralgia because it shows the exact location and size of the neuroma.
Differential diagnosis is made by excluding metatarsalgia. Treatment includes:

In this disease, physiotherapy treatment with shock wave, Tecar or laser therapy makes little sense because it cannot reduce the formation of new buildings. If the treatment measures do not lead to the desired success, the doctor may recommend surgical intervention to remove Morton’s neuroma, which is performed under local anesthesia.
The patient may start walking again on the day of the operation with a special shoe; between the toes remains only a scar of about 1 cm length above the heads of the metatarsal bones.
Nowadays, a neuroma can also be removed with the help of endoscopic surgical techniques through two small holes instead of a skin incision.
The recovery time is a maximum of two to three days; the foot may be loaded as soon as the effect of the anaesthesia wears off.

2. Nerve irritation or compression: It can occur in different regions of the foot.

Often the compression of a nerve is caused by a strain, the pressure of a bruise (swelling), shoes that are too tight or a bruise.
To find out which nerve is pressed, it is necessary to pay attention to the anatomy of the foot (especially the course of the tibial nerve, sural nerve and plantar nerves). A pinched nerve can cause burning, stabbing pain or a loss of sensitivity in the upper part of the foot.
Nerve damage in the upper foot area can be caused by excessive pressure, such as wearing tight shoes.
Another common cause of nerve compression is posterior or medial tarsal tunnel syndrome.

This is the narrowing of the tibial nerve in the tarsal tunnel at the inner edge of the foot of the sole of the foot.
The symptoms include: burning, tingling or stabbing pain, which can radiate from the foot instep and heel to the sole of the foot. Also possible are numbness and cramps under the foot, which become stronger in the evening at rest and at night.
Treatment of tarsal tunnel syndrome begins with the detection and elimination of the cause of the disorder; there are numerous reasons: from flatfoot to a swollen ankle.

The treatment of medial tarsal tunnel syndrome and other nerve bottleneck syndromes includes cortisone injections and the use of anti-inflammatory drugs (nonsteroidal anti-inflammatory drugs, NSAIDs for short).
Other possible treatment measures: padding of the shoe where the foot is compressed (usually in the upper region of the shoe) or insoles to correct nerve-irritating foot deformities.
If the conservative treatment measures are unsuccessful, the nerve can be surgically exposed.

3. Diabetic neuropathy: A chronically elevated blood sugar level (hyperglycemia) caused by diabetes can trigger peripheral neuropathy, which means damage to the body nerves, except the brain and spinal cord.
As a rule, the lower limbs are affected by diabetic neuropathy, especially the ankle and foot. It is estimated that one in four diabetics suffers from neuropathic pain over time.

As with other nerve damage, the symptoms of diabetic neuropathy are burning or stabbing foot pain.
They often occur at night while sleeping. The pain caused by neuropathy can come and go and be accompanied by a gradual loss of sensitivity in the feet that starts from the toes and progresses towards the instep of the feet.

Treatment for diabetic neuropathy includes controlling blood sugar levels, medications (for example, remedies used to treat depression or epilepsy), vitamin B or alpha-lipoic acid supplements.

4. Other causes of painful neuropathy: There are other conditions that can cause nerve damage and neurological symptoms. Here are some examples:

  • Herniated disc of the lumbar spine, causing compression of the sciatic nerve.
  • Neuropathy of the deep fibula, an end extension of the sciatic nerve that originates from the knee.
    Those affected feel a strong pain on the outside of the knee to the outer toes. With compression of the deep fibula nerve, paralysis of the anterior, outer lower leg muscles can occur, the foot can not be turned outwards, the tip of the foot can not be raised.
  • Physical trauma; they can occur as a result of surgery, a traffic accident or a bruise.
  • Medication; various antitumor and antiviral preparations or antibiotics.
  • Complex, regional pain syndrome (CRPS), also known as: reflex sympathetic dystrophy (SRD), Sudeck’s dystrophy, algodystrophy; this disease occurs after trauma, affects the limbs and produces chronic pain.
  • Tumors that pinch a nerve.
  • Liver or kidney disease
  • Vitamin deficiency
  • Infectious diseases, such as complications of Lyme disease.
  • Virus infections.

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