Nerve Entrapments

Nerve entrapments are very commonly misdiagnosed and often can be challenging to diagnose given the possibility of pathologies with overlapping symptoms.

One may experience symptoms in different parts of the ankle, the bottom of the foot, the heel, and/or the ball of the foot. Symptoms may be isolated to one area or radiate to other parts of your foot.

Nerve Entrapment Causes:

• When too much pressure is placed on a nerve
• A traumatic injury to your foot from a fall, car accident, or playing sports
  • An injury can cause the soft tissue in the foot to become inflamed and swollen, which can place additional pressure on nearby nerves
• Repetitive motions
  • Over time, this can lead to swelling of the surrounding tissue, which may affect the nerves
• Shoewear/orthotics
  • Improperly fitting shoes or orthotics can put too much pressure on certain parts of the foot
    • Most common example is high-heeled shoes or shoes that are too tight in the toe box
• Abnormally flat or high arches
  • Placing too much stress on different parts of the foot/ankle
• Abnormal structures in foot
  • Bone spurs/arthritis
    • Rheumatoid Arthritis (RA):
      • RA is an autoimmune condition that causes your immune system to mistakenly attacks your joints. This can lead to swelling that may pinch surrounding nerves
    • Osteoarthritis (OA):
      • When the cartilage around your joints breaks down
    • Bone Spurs:
      • When extra bone forms
  • Ganglion cysts
    • Fluid-filled cysts can form around the joints
  • Varicose veins
    • Enlarged veins
• Obesity or being overweight
  • Too much stress in foot/ankle
• Diabetes
  • the metabolic changes can lead to swelling

Possible Nerve Entrapments:

• Tarsal Tunnel Syndrome: is a condition in which the posterior tibial nerve becomes compressed
  • Symptoms include:
    • Diffuse pain on the inside part of ankle or the bottom of foot
    • Symptoms aggravated with activity and better with rest
    • Often will experience symptoms at night
    • Can having burning, numbness, tingling, electric shock, or shooting pain
• Baxter’s Neuropathy: is a condition in which the lateral plantar nerve is compressed
  • Symptoms:
    • Pain in heel or the bottom of foot.
    • Often confused or misdiagnosed at plantar fasciitis
    • Pain with weight bearing and non-weight bearing
    • Pain that increases the longer one is weight bearing
• “Jogger’s Foot”: is a condition where the medial plantar nerve is compressed.
  • Symptoms:
    • Symptoms located at inside bottom part of foot
    • Often exercise induced
    • Pain with weight bearing and non-weight bearing
    • Pain can go into inside part of ankle and/or first, second, and third toes
• Morton’s Neuroma: is a condition in which an interdigital nerve is being compressed
  • Occurs in the ball of the foot, most commonly between the bones of the third and fourth toes
  • More common for women to get Morton’s neuroma because they wear shoes that have a more narrow toe box, especially high heels
  • Symptoms:
    • The pain is often described as feeling like you have a pebble in your shoe under the ball of your foot
    • Pain, burning, stinging and/or numbness of toes
• Superficial Peroneal Nerve Entrapment:
  • Symptoms:
    • Pain, numbness, tingling, and/or burning on the outside part of leg and/or top of foot
    • Symptoms increase with activity and are better with rest
    • Can have pain at night
    • Pain with crossing legs
    • Pain when wearing tight fitting socks or pants
    • Injury to the nerve can occur after surgery due to the location of portal hole surgeons use and prolonged traction during surgeries.
• Deep Peroneal Nerve Entrapment:
  • Symptoms:
    • Vague pain, burning, and/or cramping at top of foot and sometimes in webspace of first toe
    • Often have pain during rest or when sleeping
    • Some people have weakness in muscles that lift foot up when tapping foot
    • Symptoms worse with tight shoes or boots
• Sural Nerve Entrapment:
  • Symptoms:
    • Pain, burning, numbness, and/or tingling along the outside border of ankle, heel, and foot
    • Most common causes:
    • Post surgery
    • Bony overgrowth
    • Soft tissue scarring
    • Instability

Source:

Pomeroy, Gregory, et al. “Entrapment Neuropathy About the Foot and Ankle.” Journal of the American Academy of Orthopaedic Surgeons, vol. 23, no. 1, 2015, pp. 58–66., doi:10.5435/jaaos-23-01-58.

Nerve Entrapments Physical Therapy Specialists in the Twin Cities

If you are experiencing any symptoms of Nerve Entrapments please contact us today to set up your appointment with a Minnesota physical therapist. We have physical therapy clinics located in Minneapolis and Edina.