Understanding Nerve Pain in the Feet
Foot pain isn’t always caused by muscles or joints—it can also stem from nerve issues. Nerve pain can originate anywhere along the nerve pathway before reaching your feet, including the spine or pelvis. In fact, a single nerve cell can extend all the way from the spinal cord to the feet.
Nerves are especially vulnerable where they pass around bony structures or through connective tissue tunnels. Over time, prolonged nerve pain can lead to tissue damage at the target area (Butler D, The Sensitive Nervous System).
The Role of Nerves in Pain Perception
Nerves transmit sensations, including pain, to the brain. Pain, while unpleasant, serves an important function: it protects us from injury. For example, when stepping on something sharp, pain signals alert the brain to avoid further harm. However, in cases of nerve pain, the signal either does not turn off or activates at inappropriate times.
Nerve pain can be persistent and debilitating, often described as shooting, stabbing, or burning sensations. Over time, it may also cause numbness or tingling (pins and needles). This type of pain can significantly impact daily life, work, and mobility. Studies indicate that individuals with nerve pain experience higher rates of sleep disturbances, anxiety, and depression.
How Do Nerves Work?
Nerves are long cells with insulating segments that allow electrical signals to jump from one gap to another, enabling rapid transmission. However, these gaps also make nerves vulnerable to external pressures and conditions.
Causes of Nerve Pain
Nerve pain can be triggered by various factors, including:
- Pressure on the nerve (from swelling, tight muscles, or footwear)
- Heat and chemical changes (inflammation or bleeding)
- Hormonal influences (affected by nutrition and stress)
- Stress from footwear, including narrow shoes, high heels, and specialised sports or work shoes, can compress or irritate nerves.
Nerves That May Cause Foot Pain
All the nerves affecting foot pain originate from the spine:
- Tibial nerve and its branches (shown below): Can cause pain in the sole of the foot or inner heel, often misdiagnosed as plantar fasciitis.
- Saphenous nerve: This may result in pain along the arch or inner ankle.
- Peroneal nerve and its branches: Affects the outside of the foot and sometimes between the first and second toe.
- S1 nerve (from the pelvic sacroiliac joint): Can contribute to heel pain, a commonly overlooked source of plantar heel pain.
Treatment for Nerve Pain
To relieve nerve pain, we focus on reducing the contributing factors. Effective techniques include:
- Reducing Inflammation: Using gentle movement, massage, dry needling, laser therapy, and ice.
- Relieving Pressure: Addressing tight muscles, swelling, or minor compressions (even as little as 10mmHg pressure can irritate a nerve).
- Enhancing Nerve Glide: Promoting smooth nerve movement through muscles and joints.
- Managing Stress: Using relaxation techniques such as yoga therapy and meditation to regulate hormonal effects on nerves.
- Enhancing foot stability and alignment
How Physiotherapy Can Help
At Physio Body and Sole in Milsons Point, North Sydney, we specialize in treating nerve pain using a combination of these methods.
Summary
Symptoms of nerve pain in the feet include:
- Burning, shooting, or stabbing pain
- Aching (potentially linked to inflammation)
- Tingling (pins and needles) or numbness
Common conditions linked to nerve irritation include:
- Heel pain
- Arch pain
- Pain in or between the toes
- Pain along the outside border or top of the foot
- Muscle cramps
Early intervention is key to resolving nerve pain efficiently. Physiotherapy approaches include:
- Reducing inflammation
- Nerve glides to improve mobility
- Strengthening and stretching exercises to restore alignment and muscle balance
- Specific release of nerve entrapments using gentle touch (a therapist must be trained in this technique)
- Laser therapy or dry needling to relieve trigger points in muscles, and localised nerve irritation
- Footwear guidance for optimal comfort and support
By addressing nerve pain early, you can prevent long-term discomfort and regain mobility and quality of life. If you’re struggling with foot pain, consult a physiotherapist trained in these techniques to identify and treat the underlying cause effectively.
A-J at Physio Body and Sole has been treating peripheral nerve pain, and feet for over 20 years.
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