Have you ever experienced tingling, burning, numbness, weakness, or nerve pain in your feet or legs? If so, it might be caused by one of the following conditions: Morton’s neuroma, tarsal tunnel syndrome, neuropathy, or radiculopathy. Each of these conditions can lead to nerve pain and discomfort in your lower extremities, but they have distinct causes and treatment options. Let’s dive into each one to better understand the differences and how they can be treated.
Morton’s Neuroma
A neuroma is the thickening of nerve tissue, often resulting in nerve pain. In podiatry, Morton’s neuroma refers to a common condition where this nerve thickening occurs between the third and fourth toes in the ball of the foot. However, it can also develop between other toes. The pain associated with Morton’s neuroma can manifest as tingling, burning, or numbness in the affected area and toes.
Typically, the thickening of the nerve tissue is caused by compression from the metatarsal bones in the foot, which are located near the area where the nerve passes. This compression can be triggered by factors such as tight shoes, high-heeled shoes, or foot structure.
Patients often describe the sensation as if they are walking on a pebble, even though no visible object is present inside the shoe or on the foot.
Treatment for Morton’s neuroma includes:
- Wearing shoes with a wider toe box
- Avoiding shoes with a heel lift
- Taking anti-inflammatory medications
- Using custom orthotics
In more severe cases, treatment options may include:
- Corticosteroid injections
- Surgical removal of the neuroma
Tarsal Tunnel Syndrome
The tarsal tunnel is a small passageway inside the ankle through which tendons, blood vessels, and a nerve pass. This anatomical feature is similar to the carpal tunnel in the wrist. When the nerve in this tunnel becomes compressed or irritated—due to inflammation, veins, or muscles within the canal—it results in tarsal tunnel syndrome.
Symptoms of tarsal tunnel syndrome can include heel pain, nerve pain, tingling, burning, and numbness in the foot or ankle.
Treatment for tarsal tunnel syndrome typically involves:
- Supportive shoe gear
- Custom orthotics
- Anti-inflammatory medications (oral or topical)
- Corticosteroid injections
- Surgical decompression of the nerve, if necessary
Neuropathy
Neuropathy refers to damage or dysfunction of one or more nerves, often peripheral nerves. The symptoms of neuropathy can include nerve pain, numbness, tingling, burning sensations, and weakness. Peripheral neuropathy, a common form of this condition, is frequently diagnosed in patients experiencing these symptoms in their feet.
There are many potential causes of peripheral neuropathy, including:
- Diabetes
- Alcohol use
- Vitamin B deficiency
- Medications (such as chemotherapy drugs)
- HIV
- Lumbar radiculopathy
Treatment for neuropathy starts with identifying its underlying cause. Once the cause is determined, the condition can be managed with appropriate medications (topical or oral), supportive shoe gear, and custom orthotics. Additionally, regular checkups with a podiatrist are important for monitoring the condition, as it may be a long-term issue for some patients. If the neuropathy is linked to a systemic condition, a podiatrist may refer the patient to a primary care physician for further management.
Radiculopathy
Radiculopathy, often referred to as a “pinched nerve,” occurs when a nerve root branching from the spinal cord becomes compressed. Although radiculopathy can affect any part of the spine, it is most commonly seen in the lumbar (lower back) region. The nerve that is compressed may cause nerve pain, tingling, or burning sensations in the lower back or legs. Symptoms can extend to the feet as well, causing discomfort further down the body.
Treatment for radiculopathy involves managing the symptoms in the lower extremities, such as using supportive shoes and orthotics, along with anti-inflammatory medications. However, it is also important for patients to see a spine specialist, such as an orthopedic spine doctor, for evaluation and treatment of the root cause of the nerve compression.
When to See a Podiatrist
If you are experiencing any of the following symptoms in your feet or calves—tingling, burning, numbness, weakness, or nerve pain—it’s important to consult with a podiatrist. Podiatrists are trained to diagnose and treat conditions that affect the lower extremities. Early diagnosis and appropriate treatment can help alleviate discomfort and prevent further complications.