Burning pain on top of foot arch

Many forms of foot pain start with joints and tendons. The former enable movement and the latter connect muscles to bone.

But if you feel pain on the top of your foot, or through your arch, a nerve might be to blame. You might feel burning, shooting, or stabbing pain when a nerve in your foot is irritated or damaged.

These sensations can occur while you're moving or while you're at rest. Sometimes, even the area closest to the nerve will be sensitive to the touch.

This article will discuss the most common nerve-related causes of foot pain and how to recognize them. It also addresses some other common causes.

Morton's Neuroma

Morton's neuroma involves a thickening of the nerve that runs between the third and fourth toes. Typical symptoms include a burning or shooting pain in this area, most often while walking.

Another common symptom is a vague feeling of pressure beneath the toes, as if a sock was bunched up underneath them.

Common treatments include shoe modifications, arch supports, and cortisone injections to decrease swelling. Typical shoe modifications include lifts and rocker soles, which provides cushion where it's needed.

Morton's neuroma occurs more frequently in women. A possible explanation is that many women wear high-heeled shoes.

Pinched Nerve

A pinched nerve, known as nerve entrapment, can occur in various regions of the foot. Trauma—from swelling, blunt impact, or even a tight shoe—is the most likely cause.

A pinched nerve can feel like shooting or burning pain. Or the surrounding area on top of the foot may feel sensitive.

Pinched nerves in the feet are treated much like Morton's neuromas. Rest, wearing roomier shoes, and anti-inflammatory medications may also help.

Nerve Problems Hurt

Nerve problems often make their presence known; you may feel burning or shooting pain.

Tarsal Tunnel Syndrome

Another common type of nerve entrapment is tarsal tunnel syndrome. It includes "anything that produces compression on the posterior tibial nerve," the American College of Foot and Ankle Surgeons (ACFAS) says.

The tibial nerve is located near the heel. And the burning, tingling, or shooting sensations often radiate from the instep (arch).

Other symptoms include numbness and foot cramps. Both can worsen while the foot is at rest, such as when you're sitting or sleeping.

Twin Conditions

There's a good reason that tarsal tunnel syndrome sounds like carpal tunnel syndrome, which affects the wrist. Both conditions involve a nerve being squeezed in a tight space, the ACFAS says.

Sometimes, placing padding in a shoe (where the foot is being compressed) can relieve foot pain. Other times, more elaborate orthotics are necessary. Orthotics are prescription medical devices that you place inside your shoes.

Tarsal tunnel syndrome often recedes with cortisone shots or other anti-inflammatory treatments. As a worst-case scenario, surgery may be necessary to release the nerve.

Diabetic Peripheral Neuropathy

The long-term high blood sugar (glucose) associated with diabetes can lead to a form of nerve damage. This is known as peripheral neuropathy.

Like other forms of nerve damage, neuropathy pain feels like burning or shooting pain. And it often appears overnight.

The pain of neuropathy may come and go. It may also be marked by a gradual loss of feeling in the feet. Often, it begins in the toes and moves up the foot.

It's estimated that one in four people with diabetes will experience painful neuropathy.

Treatments for diabetic neuropathy include blood sugar control, medications like antidepressants, or anti-seizure drugs. Vitamin B and the dietary supplement alpha lipoic acid may also help.

Other Causes of Foot Nerve Pain

Other conditions can spawn nerve damage and the ensuing pain. Some examples include:

• Physical trauma, such as after surgery or an accident
• Certain cancer drugs, antiviral drugs, or antibiotics
• Complex regional pain syndrome
• Tumors that compress a nerve
• Liver or kidney disease
• Vitamin deficiencies
• A herniated disc in the lumbar spine
• Infectious diseases, such as complications from Lyme disease, or viral infections

You should call your doctor if:

• The pain worsens over several days.
• A numb, tingling or burning feeling gets worse over several days.
• Your foot begins to swell.
• You have trouble walking or holding up your weight.

Summary

Four common nerve problems can cause foot pain: Morton's neuroma, tarsal tunnel syndrome, diabetic peripheral neuropathy, and a pinched nerve.

You'll probably know when trouble strikes. Nerve problems often trigger burning or shooting pain. And the sensation can be so intense that it can rouse you from a deep sleep.

See your doctor if the pain and related symptoms get worse, or if you have trouble standing or walking.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Gougoulias N, Lampridis V, Sakellariou A. Morton's interdigital neuroma: instructional review. EFORT Open Rev. 2019;4(1):14-24. doi:10.1302/2058-5241.4.180025

2. Chari B, McNally E. Nerve entrapment in ankle and foot: ultrasound imaging. Semin Musculoskelet Radiol. 2018;22(3):354-363. doi:10.1055/s-0038-1648252

3. American College of Foot and Ankle Surgeons. Tarsal tunnel syndrome.

4. Cleveland Clinic. High blood sugar is toxic to your nerves - here’s how to avoid it.

5. Cohen K, Shinkazh N, Frank J, Israel I, Fellner C. Pharmacological treatment of diabetic peripheral neuropathy. P T. 2015;40(6):372-88. 

6. Staff NP, Windebank AJ. Peripheral neuropathy due to vitamin deficiency, toxins, and medications. Continuum (Minneap Minn). 2014;20(5 Peripheral Nervous System Disorders):1293-306. doi:10.1212/01.CON.0000455880.06675.5a

7. University of Utah Health. Foot injuries: when to see a doctor.

Additional Reading

• Hovaguimian A, Gibbons CH. Clinical approach to the treatment of painful diabetic neuropathy. Therapeutic Advances in Endocrinology and Metabolism. 2011;2(1):27-38

• National Institute of Neurological Disorders and Stroke. Peripheral neuropathy fact sheet. NIH.

By Catherine Moyer, DPM
Catherine Moyer, DPM, is a podiatrist experienced in the diagnosis, treatment, and prevention of disorders of the foot and ankle.

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