Have any of these scenarios happened to you?
- You wake up at 2 AM with stabbing pain in your feet?
- You’ve noticed tingling in your toes when you walk, and it stops when you sit down?
- Or maybe you feel a burning sensation on the bottom of your feet when you run, and it’s becoming more than just annoying—it’s painful.
I see patients every day who come in describing symptoms like these, and the first thing I tell them is this: your feet are trying to tell you something. Those stabbing pains, tingling, and burning sensations - they're not just random annoyances. Your nerves are literally sending signals to your brain saying something’s wrong.
Today I want to walk you through the six most common reasons why your feet are sending you these painful sensations. Once you understand what might be going on, you'll be way better equipped to get the help you need.
Diabetic Peripheral Neuropathy
Diabetic peripheral neuropathy is particularly prevalent in diabetics whose blood sugar is not under good control or who’ve had it for a long time. High glucose levels can damage the tiny blood vessels that lead to the nerves. This can result in pain, tingling, burning, or loss of sensation in the feet. While the symptoms can be hard to deal with, the loss of sensation is more dangerous. When you can’t feel a cut or abrasion, you’re more likely to develop a wound that can become infected and be difficult to heal.
Learn how we treat diabetic peripheral neuropathy at our clinic!
Morton's Neuroma
Another common foot condition causing nerve pain is Morton's neuroma. It occurs when a bundle of nerves between your third and fourth toes gets enlarged, resulting in burning, tingling, or the feeling of a rock in your shoe or having a bunched-up sock.
People at risk for this condition are:
- wear pointy and high-heeled shoes,
- athletes
- those with flat feet or other abnormal foot structures are more prone to them.
Morton's neuroma start out mild with occasional pain and sensitivity, but eventually the pain and other symptoms become more constant.
Tarsal Tunnel Syndrome
Third is tarsal tunnel syndrome. Think of it as carpal tunnel's cousin, but for your foot. There's a nerve called the posterior tibial nerve that runs from the inside of your ankle down into your foot, and when it gets squeezed or compressed, you're going to feel it along your inner heel or arch.
Anything that compresses the nerve can cause this condition:
- faulty foot mechanics
- injuries
- swelling
- abnormal growths.
Learn how we treat tarsal tunnel syndrome at the Foot and Ankle Center of Lake City.
Chronic Conditions That Cause Nerve Pain
- Osteoarthritis: When the cartilage in the joints of your feet and ankles starts to break down, it can add pressure on nearby nerves.
- Rheumatoid arthritis: With this condition, your immune system gets confused and starts attacking your joints. The swelling that occurs can also compress the nerves, causing pain.
- Diabetes: Even diabetes, beyond neuropathy, can cause swelling that compresses nerves.
Sciatica
While most people consider this condition a back problem, it can also affect your feet and ankles. That’s because the sciatic nerve is very long and travels from your lower back to your lower extremities. Any time this nerve gets compressed along the way, it can lead to foot or ankle pain. So when we've ruled out everything else and you're still having nerve pain in your feet, I’ll send you to your primary care doc or a specialist who deals with spine issues.
Pinched Nerve or Nerve Entrapment
A couple of examples we already covered, namely Morton’s neuroma and Tarsal Tunnel, but there are other ways nerves can get pinched. One of the simplest?
Tight Shoes
Footwear that squeezes across the ball of your foot or the sides of your toes can irritate nerves over time.
Athletes sometimes do this on purpose:
- rock climbers often wear shoes a size too small to improve grip
- soccer players sometimes wear very snug cleats
- skiers may buckle their boots extra tight for better control.
But that extra snug fit can lead to big problems, including nerve pain and toenail damage.
Injuries
Then there are injuries like the time you dropped a can of soup on your foot, or took a spill during your weekend warrior soccer game. Sometimes those incidents can actually change the structure of your foot just enough to start pinching your nerves. Your foot might look fine on the outside, but inside, things have shifted just enough to cause problems.
Weight
Weight can also play a role. If you're carrying extra pounds, your feet are bearing more pressure than they were designed for. That extra pressure doesn't just affect your joints and muscles; it affects your nerves too.
Baxter's Nerve Entrapment
Finally, there’s a condition called Baxter’s nerve entrapment—it’s when a nerve in the inner heel gets compressed. It can be tricky to diagnose because it often feels just like plantar fasciitis, which is the most common cause of heel pain.
Here's what I want you to take away from all of this: nerve pain in your feet isn't something you should just grit your teeth and live with. I know we live in a world where we're told to push through pain, but nerve pain is different. It's your body's alarm system telling you something needs attention.
The good news is that most of these conditions are very treatable when we catch them early. The longer you wait, the more complicated treatment can become. Some of these issues can be resolved with simple changes like getting properly fitted shoes or modifying your activities. Other conditions might need more involved treatment, but the sooner we start, the better your outcomes are going to be.
