Pain on the top of the foot or in the arch of the foot can be nervous. Although many forms of foot pain arise from the joints and tendons, sometimes the source of foot pain is a nerve that is directly irritated or affected by health conditions that damage the nerve.
When nerves are irritated or damaged, there is a characteristic burning, stabbing, or stabbing pain. The pain usually appears spontaneously, even at rest. Sometimes the area above the affected nerve is tender to the touch. These are some of the common types of nerve problems that cause leg pain.
Morton's neuroma is a benign thickening of a nerve that runs between the third and fourth toes. Typical symptoms include burning or shooting pain in the area between the third and fourth toes, most commonly when walking. Another common symptom is a diffuse feeling of pressure under the toes, as if a sock is wrinkled underneath.
Morton's neuroma is more common in women, possibly due to the fact that they often wear shoes with narrow or high heels.
Common treatments include shoe modification, arch support, and cortisone injections to reduce nerve inflammation.
Also known as pinched nerve , pinched nerve can occur in various areas of the foot. A pinched nerve is often caused by trauma, such as pressure from swelling, excess pressure from tight shoes, or blunt trauma.
A pinched nerve can cause back pain, burning, or tenderness in the upper part of the foot. A pinched nerve in the top of the foot can be caused by excessive pressure on the nerve in tight-fitting shoes.
Tarsal tunnel syndrome
Another common type of nerve entrapment is tarsal canal syndrome. Tarsal canal syndrome occurs when the posterior tibial nerve crawls as it descends below the inner (medial) region of the ankle and enters the foot through an anatomical landmark known as the tarsal tunnel.
Burning, tingling, or stabbing pain can come from the instep (arch) and heel down to the soles. Leg numbness and cramps can also occur, and symptoms may be worse at night during rest or sleep.
Treatment for tarsal canal syndrome usually begins by identifying and treating the cause, which can be anything from a problem with foot function, such as flat feet, or ankle swelling. Cortisone injections and anti-inflammatory medications may be prescribed to treat tarsal tunnel syndrome and other types of nerve entrapment.
Examples of other types of conservative treatment include: padding the shoe where the foot is compressed (often on top of the shoe) or orthotics to correct abnormal structure or function of the foot that causes nerve irritation. If conservative measures fail, surgery may be required to free the nerve.
Diabetic peripheral neuropathy
Chronically elevated blood sugar (glucose) levels associated with diabetes can lead to a form of nerve damage known as peripheral neuropathy. Like other forms of nerve damage, neuropathic pain is characterized by spontaneous burning or shooting pain in the legs. It often occurs at night during sleep.
Pain with neuropathy can come and go over the course of the disease and can be accompanied by a gradual loss of feeling in the feet, beginning in the toes and progressing upward.
It is estimated that one in four people with diabetes will experience a painful neuropathy.
Treatments for diabetic neuropathy include blood sugar control, medications such as antidepressants or anticonvulsants , and vitamin supplements such as B vitamins and alpha lipoic acid .
Other causes of pain in the nerves of the legs
Nerve damage and associated pain symptoms can occur in many other conditions. Here are some examples:
- Physical injury, such as after surgery or an accident.
- Medications such as certain anticancer drugs, antiviral drugs, or antibiotics.
- Reflex sympathetic dystrophy
- Tumors that compress the nerve
- Liver or kidney disease
- Vitamin deficiency
- Herniated disc in the lumbar spine
- Infectious diseases, such as complications from Lyme disease or viral infections.