LOWER EXTREMITY NERVE PAIN Frequently Asked Questions

Lower extremity nerve pain, or weakness associated with nerve dysfunction, is experienced by people of all ages and demographic backgrounds. It most often occurs in middle age or later. It can also be the result of injury that happened earlier in life. Many times it is related to an underlying metabolic disease such as diabetes, thyroid conditions, or others.

There are a number of causes of lower leg and foot nerve pain. Often, these common problems go undiagnosed or misdiagnosed because symptoms can be so varied, and because the onset of symptoms is sometimes very slow.


Neuropathy is nerve damage that generally results from a systemic disease. Diabetes, thyroid problems, lupus, rheumatoid arthritis, Sjorgren’s syndrome, and celiac disease are just some of diseases that can contribute to nerve damage. The most common form of neuropathy is diabetic peripheral neuropathy; up to 30% of the cases of peripheral neuropathy are caused by this disease.

Tarsal Tunnel Syndrome: AKA Nerve Entrapment

At the inside of your ankle, a nerve divides into branches and crosses from the leg into the foot through a series of tunnels. This main nerve is called the tibial nerve, and it branches out to the medial and lateral plantar, and the calcaneal nerves. Sometimes, when the ankle moves the nerve gets pressed. When the nerve gets pressed, blood flow to the nerve decreases, and the nerve sends a message of numbness and tingling, or buzzing of the foot/toes. This is very common in patients with diabetes because elevated blood sugar can make the nerve swell. If the nerve gets too big, it gets pinched going through its tunnel, causing symptoms to be felt on the bottom of the foot.


Compression of the sensory nerve between the metatarsals is a very common condition of the foot. The symptoms most people complain about are burning, numbness, cramping, and ball of foot pain. Interdigital neuroma can occur between any of the toes. With an interdigital neuroma, the burning, numbness, and cramping are often felt on the top of the foot.

At Next Step Foot & Ankle Clinic we are very exited about the many treatment options for nerve pain and that we have the very latest technologies available in our offices.

What sets us apart is a multi-pronged approach in treating nerve pain that helps heal the nerve. We hope you consider Next Step Foot and Ankle Clinic as your next step for healthy feet. 

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Looking for a Nerve Pain Expert but don’t live in San Antonio?

Dr. Silvester received his nerve training from the Association of Extremity Nerve Surgeons. To find a nerve pain expert in your local area, with at least 2 years of experience and has completed specialty training from the Association of Extremity Nerve Surgeons…click the logo below to use the Find A Doctor tool.


Dr. Silvester and Dr. Larsen specialize in many advanced minimally and non-invasive treatments, and if necessary, advanced minimally invasive and traditional surgical techniques with patient proven success stories.

Some of those are used to treat your nerve pain, such as:

  • Nerve Decompression

Nerve Decompression Surgery

When other non-operative treatments fail and compression of the nerve is playing a role in the nerve dysfunction, surgery may be the best option. Sometimes nerve disease is like sleeping on your elbow wrong. You wake up and your hand is numb or tingling. The nerve is just always being compressed.

Nerve decompression surgery allows the surgeon to open the tight area through which the nerves pass by dividing the anatomical structures that encase the nerve. Surgical procedures can be performed in the comfort of our Olympia Surgery Center.

Dr. Silvester and Dr. Larsen have additional certifications in nerve surgery. He has undergone specialized training in the treatment of painful nerve conditions. The organization called The Association of Extremity Nerve Surgeons (AENS) provides advanced training in the medical, physiological, and surgical treatment of nerve conditions. Through this organization and other ongoing medical education, Dr. Silvester chose to specialize in the treatment of these difficult and perplexing conditions. Dr. Silvester achieved adequate surgical experience and demonstrated proficiency in the procedure, and is now a Fellow of the Association of Extremity Nerve Surgeons.

success story

This patient said GOODBYE to nerve pain!

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Our patient shares her experience with her treatment at Next Step for Nerve Entrapment.


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