Could your foot pain be caused by a problem in your spine?

A series of spinal nerves from your lower spine travel down your legs and terminate in your feet. When the nerve roots (part of the nerve as it exits the spine) of these spinal nerves are irritated or compressed, foot pain can occur. Foot pain can also occur if a nerve is compressed near your hip, knee, or in your foot.

Nerve root irritation or compression in the lumbar or sacral spine (lower back) may cause sciatica pain to radiate down your leg and into the foot. Specifically, compression of the S1 nerve root, also called classic sciatica, can cause pain along the outer side of your foot.

Nerve roots may be compressed or irritated due to a number of causes. Common examples include:

• Lumbar herniated disc: Leaking of the inner contents of an intervertebral disc
• Lumbar degenerative disc disease: Age-related changes causing narrowing and shrinkage of the disc
• Spondylolisthesis: Slipping of a vertebra over the one below it
• Lumbar spinal stenosis: Narrowing of the bony openings for spinal nerves and/or the spinal cord
  

The inability to lift the front part of your foot or frequent tripping while walking may be due to a condition called foot drop. This condition is typically caused due to compression of the L5 nerve root. Rarely, compression of the L4 and/or S1 nerve roots may also cause foot drop

Foot pain caused by compression of nerves in the hip, knee, or leg

Foot pain can also occur when nerves are compressed or damaged along their path in the hip, knee, or leg. For example:

• Peroneal neuropathy, a condition where the peroneal nerve is compressed or injured near the knee may cause foot pain and foot drop when you try to move your foot.
• Sciatic neuropathy or damage to the sciatic nerve in the pelvic region (hip) may cause foot pain along the top of your foot with some degree of weakness.
  
• Tarsal tunnel syndrome or dysfunction of the tibial nerve within the tarsal tunnel of the inner ankle may cause a sharp, shooting pain in your ankle area and along the sole of your foot.
  
• Sural nerve entrapment can occur in the leg or near the ankle and typically causes shooting pain along the outer side of your ankle and/or foot.
  

Additionally, a corn may develop on the skin around your toes. Corns grow over time as a result of excessive friction and they can compress nearby nerves, causing pain and other symptoms. Another possible cause of nerve pain in your foot is Morton’s neuroma, which is a thickening of the tissue around a nerve in the foot.

How to identify the source of your foot pain

With all the possible causes of nerve pain in the foot, it may be difficult to pinpoint the exact underlying cause. Here are a few useful signs to help you identify the source of your foot pain:

• Foot pain that follows recent trauma to the lower back, hip, knee, or ankle may help indicate the site of nerve damage.
  
• Foot pain due to nerve root compression or sciatica may also be associated with other symptoms, such as pain, numbness, and/or weakness in the buttock, thigh and leg, typically affects one leg at a time.
  
• Foot pain that develops after wearing tight boots or shoes may indicate peroneal or sural nerve compression near the knee or ankle.
  
• Foot pain that develops after a hip injection or hip surgery may indicate sciatic neuropathy.
  

Nerve pain in the foot may also occur due to nerve damage from systemic conditions, such as diabetes or multiple sclerosis.
Twisting, bending, or a direct hit on your ankle and/or foot may injure the foot bones, ankle joint, blood vessels, muscles and/or tendons, causing foot pain.

Schedule a visit with your Chiropractor

It is important to schedule an appointment with your Chiropractor to accurately diagnose the cause of your foot pain. Treatments for foot pain can differ widely and must be directed at resolving the underlying cause; not just masking the symptoms. For example, a lumbar herniated disc may require heat therapy and exercise, while a corn on your toe can often be treated with special shoes and warm water.

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References

1.Alexander CE, Varacallo M. Lumbosacral Radiculopathy. [Updated 2019 Mar 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430837/
2.Wright R, Inbody SB. Radiculopathy and Degenerative Spine Disease. In: Neurology Secrets. Elsevier; 2010:121-130. doi:10.1016/b978-0-323-05712-7.00007-6
3.Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/
4.Liu K, Zhu W, Shi J, et al. Foot drop caused by lumbar degenerative disease: clinical features, prognostic factors of surgical outcome and clinical stage. PLoS One. 2013;8(11):e80375. Published 2013 Nov 5. doi:10.1371/journal.pone.0080375
5.Reife MD, Coulis CM. Peroneal neuropathy misdiagnosed as L5 radiculopathy: a case report. Chiropr Man Therap. 2013;21(1):12. Published 2013 Apr 22. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662609/