Your complaints are:
- Numbness, tingling or chronic pain in the heel, arch, ball of foot and/or toes.
- The complaints worsen during the day, at work, and may keep you up at night.
- There may be cramping of your arch or curling of your toes.
What causes your complaints? At the inside of your ankle, a nerve divides into branches and travels from the leg into the foot through a series of narrow tunnels. This nerve is called the Tibial Nerve, and it branches into the medial and lateral plantar nerves, and the calcaneal nerve. The main branch of the Tibial Nerve is the approximate thickness of a pen. When the ankle moves, the nerve gets irritated, it swells and becomes compressed within the narrow tunnels. When the nerve gets compressed, blood flow to the nerve decreases, and the nerve sends a message of numbness and tingling, or a buzzing sensation to the heel, arch and/or toes.
Treatment without surgery: If you are diabetic, strict control of your blood sugar is extremely important. You should see your medical doctor if your sugar is not maintained under control. If you are not diabetic but have numb feet, you should be checked for diabetes. In some situations, orthotics may be needed to help support your feet and keep them from flattening too much (pronation) or rolling to the outside part of your foot (supination). It may be also necessary to modify your daily walking or exercising activities.
When should I have surgery?
- When your feet, toes or heel are painful or numb most of the day.
- When there is pain associated with the numbness.
- When your foot or feet disturb your sleep every night.
- When you have trouble feeling the floor, or gas/brake pedals of your car.
- When you have the sensation of sand or a wadded sock in your shoe.
- When you begin to lose your balance.
- When conservative treatments have not relieved your symptoms.
- When neurosensory testing with the Pressure Specified Sensory Device (PSSD) ™ demonstrates that sensory nerves to your big toe or heel are degenerating.