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Writer's pictureDavid Barber

How Your Back Can Cause Foot Pain: Understanding the Connection

It might seem surprising, but issues in your back can sometimes cause discomfort in your feet—even when your back doesn’t feel sore. This happens because the nerves in your back are connected to different parts of your body, including your feet. When these nerves become irritated or compressed, they can send signals to your feet that create unusual sensations, like numbness, tingling, or pain. Understanding how this connection works can help you identify the source of your discomfort and explore treatment options.


Nerves of the Back
Artist Depiction of Back Nerves

Nerve Connections Between the Back and Feet

The nerves in your lower back extend down through your legs and into your feet. One key nerve involved is the posterior tibial nerve, which is responsible for foot sensation. When something in your back—like a herniated disc or pinched nerve—affects these nerve pathways, it can cause discomfort in your feet even if your back feels fine. It’s similar to a polluted river: if the problem is upstream (in your back), it affects everything downstream (your legs and feet).


Common Symptoms of Nerve Issues

If you have nerve-related foot pain originating from your back, you might notice some of the following symptoms:

  • Numbness: A feeling as if there’s a mask over your foot, making it hard to feel anything.

  • Tingling: A pins-and-needles sensation that can range from slightly irritating to severe.

  • Electric or Radiating Pain: Sharp, electric-like pain that travels from your back down into your legs and feet.

  • Tightness or Stiffness: Difficulty moving your toes or feet due to a tight or stiff feeling.

  • Decreased Sensation: Often linked to neuropathy, where nerve signals aren’t properly transmitted, resulting in numbness.

  • Severe Pain: Amplified pain (Ex: Allodynia) signals from the nerves, causing extreme pain even with light touch or no clear cause.

Causes of Back-Related Foot Pain

Several issues with the back can result in nerve-related pain that travels down to the feet:

  • Herniated Disc: A slipped or bulging disc in your lower spine compresses nearby nerves.

  • Spinal Stenosis: A narrowing of the spinal canal that puts pressure on the nerves.

  • Trauma: Injuries to the back can cause nerve irritation or damage.

  • Scoliosis: A spinal curvature that affects how nerves run through your body.

  • Heredity: Some people are genetically more prone to nerve and back issues.

While these are common causes, it's important to note that this is just a small sampling of the many possible factors. Other conditions, such as hip arthritis or inflammatory disorders, can mimic nerve pain. A proper evaluation is essential to accurately determine the source of the pain.


Varicose Veins and Nerve Pain

Varicose veins, which can sometimes press on nearby nerves, are an often-overlooked cause of nerve pain in the legs and feet. If varicose veins are contributing to your nerve discomfort, wearing compression stockings can help reduce pressure and improve circulation, potentially easing nerve pain.

How to Tell if It’s Nerve Pain or Musculoskeletal Pain

It’s important to differentiate between nerve pain and musculoskeletal pain. One key indicator is the timing and nature of the pain:

  • Nerve Pain: Nerve pain tends to be more noticeable at night. During the day, your feet are busy with activity, and other sensations can mask the nerve pain. At night, when you’re resting, the nerve pain becomes more prominent. This can feel like burning, tingling, or electric-like discomfort in your feet. If the pain is worse or continues after you’ve been off your feet, it’s more likely related to a nerve issue.

  • Musculoskeletal Pain: Musculoskeletal pain usually improves with rest. It’s more likely to occur during the day when your muscles, tendons, and joints are in use. This type of pain, which can be caused by conditions like plantar fasciitis, arthritis, or tendonitis, tends to subside by the time you go to bed.

If your pain worsens at night, it’s a sign that nerve involvement may be part of the issue. It’s also possible to experience both nerve and musculoskeletal pain simultaneously, and they can even influence each other.


Complex Cases: When It’s Both Nerve and Musculoskeletal Pain

In some situations, nerve pain and musculoskeletal pain can coexist. You might have a musculoskeletal issue that’s made worse by nerve involvement, or a nerve issue that increases your musculoskeletal discomfort. The balance of nerve and musculoskeletal pain can be 50/50, or one type may dominate. Because these conditions can interact in complex ways, a thorough evaluation of both your nerves and musculoskeletal system is necessary, especially if you’re considering surgery.


Seeking Professional Help

If you’re experiencing foot pain without an obvious cause, it’s important to consult with a medical professional. Depending on your symptoms, a variety of specialists can help:

  • Podiatrists: Experts in foot and ankle care who can assess whether your foot pain is related to nerve or structural issues.

  • Orthopedic Specialists: They focus on issues with your spine and back, helping determine if nerve involvement is causing your foot pain.

  • Pain Management Doctors: These professionals specialize in treating chronic pain, including nerve-related conditions.

  • Neurologists: Experts in the nervous system who can perform tests like nerve conduction studies to diagnose and treat nerve problems in your back and feet.

  • Physical Therapists: Specialists in rehabilitation who can design exercise programs to strengthen your muscles and relieve pressure on nerves.


Treatment Options

The good news is that there are a variety of treatment options available for nerve-related foot pain:

  • Medications: Nerve pain can often be managed with medications such as gabapentin, Lyrica, or Cymbalta, which are designed to target nerve issues.

  • Orthotics: Using over-the-counter or custom orthotics can help relieve pressure on your feet and better align your body, which can alleviate some nerve pain.

  • Surgical Intervention: In more severe cases, surgical options may be considered to address the underlying back issue, such as removing a herniated disc or relieving pressure on a pinched nerve.

  • Physical Therapy: These professionals can create tailored exercise programs to help alleviate nerve pain and improve mobility. Strengthening the muscles around the back and improving posture can relieve pressure on irritated nerves and reduce symptoms in the feet.

  • Yoga: Incorporating yoga into your routine can help improve flexibility, posture, and core strength, which may relieve some of the pressure on your back and nerves. Yoga's focus on stretching and mindfulness can help with both musculoskeletal and nerve-related pain, making it a helpful tool in managing discomfort.

These treatments can be used alone or in combination depending on the severity of your condition and the recommendations of your healthcare provider.


The Importance of Early Intervention

Ignoring nerve pain, whether in your back or feet, can lead to long-term damage. Nerves that remain irritated for extended periods can suffer permanent injury, making treatment more difficult. Seeking early medical attention is crucial to prevent further complications and to improve your quality of life.


Summary

Your feet are deeply connected to the rest of your body, including your back. Unexplained foot pain could be a sign of an issue originating in your spine. Just like pollution upstream can affect everything downstream, problems in your back can have far-reaching effects. By getting the right diagnosis and treatment, you can resolve the issue and improve your mobility and comfort.



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