Foot Pain Due to A Nerve Entrapment
Heel and foot pain conditions are among the most common and frustrating problems we see in our clinic.
While most foot conditions such as plantar fasciitis or metatarsalgia are related to biomechanical problems in the foot itself or up the leg it is not uncommon for foot pain to be caused by entrapment or irritation of the nerves that supply the foot.
These nerve entrapments are often overlooked in the diagnosis and treatment of foot pain, and need to be treated differently. Fortunately most of these syndromes can be resolved with the right treatment approach.
So in this article I will briefly the topic of nerve entrapments as a source of foot pain.
Basic Anatomy – The Nerves of the Foot
As the sciatic nerve travels down past the back of the knee it branches into the two major branches of the lower leg, the tibial nerve and the peroneal nerve.
The tibial nerve runs down the back of the calf and continues to the bottom of the foot and toes (fyi, as it passes into the foot it becomes the plantar nerve). The peroneal nerve wraps around the outside of the knee and travels down the front of the leg to the top of the foot.
As these nerves travel down the leg they pass underneath, between, and through the various muscles and ligaments of the lower leg and foot. Under normal circumstances as the knee and ankle bend these nerves should move and slide against these surrounding muscles.
However if the muscles become tight or restricted with scar tissue adhesions it can cause the a nerve to become stuck to the surrounding structures. Not only can this compress the nerve but it will also prevent the normal and necessary sliding of the nerve with movements.
Both of these situations can damage the nerve and compromise blood flow, leading to symptoms such as pain, tightness, or burning along along the path of the affected nerve.
With irritation to the tibial nerve symptoms will be felt in the bottom of the heel and/or foot. These symptoms are commonly misdiagnosed as generalized foot pain or plantar fasciitis.
When the peroneal nerve is involved the symptoms will be into the shin and/or the top of the foot, mimicking conditions such as shin splints or extensor tendinopathy.
The tibial nerve supplies the bottom of the foot. It can become entrapped as it passes under the muscles of the foot and ankle leading to foot pain.
The peroneal nerve supplies the shin and top of the foot. It can become entrapped as it passes under the muscles of the shin and ankle.
Treatment of Foot Pain Due to A Nerve Entrapment
Fortunately, most cases of foot pain due to nerve entrapment do respond well to the right type of conservative treatment.
We have found the best way to treat these nerve entrapment syndromes is with a combination of Active Release Technques (or ART for short), along with specific home exercises to facilitate healing and to restore the normal sliding of the nerves along the foot and lower leg.
I have discussed Active Release Techniques in depth in other articles and other areas of our website, but for the sake of being inclusive I will provide a brief description here as well.
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What is ART
Active Release is a hands-on treatment method to address problems in the soft tissues of the body, including the muscles, ligaments, fascia, and nerves.
What makes ART different from other treatments is that it is specifically designed to identify and treat scar tissue adhesions that build up and compromise muscles and nerve health.
By locating and treating the soft-tissue adhesions with ART it allows the doctor to to 1) break-up restrictive scar tissue adhesions, and 2) restore normal movement and sliding of the muscles and nerves.
When performing an ART treatment for a nerve entrapment affecting the foot the doctor will first position the leg to shorten the involved nerve then apply a very specific pressure with their hands on the muscles beside the nerve where it is getting trapped.
The doctor will then move the leg to lengthen the nerve while holding a pressure on the muscle to prevent the muscle from being pulled along. Essentially we are working to free the nerve from the muscle.
The nerve flossing exercises I mentioned above employ the same concept but are done at home and without the added pressure by the doctor.
ART takes a long time to master and after years of practice ART docs are able to develop a very acute sense of touch and feel. This not only helps us to know exactly which muscles or ligaments are entrapping the nerve, but also helps improve treatment results by allowing us to be very specific with treatment.
This is something that cannot be done with other treatment methods or with stretching or exercises which target the foot muscles or nerves in a more generalized fashion.
How Long Does It Take to Resolve Foot Pain Due To Nerve Entrapment?
One of the best things about ART is how quickly results are felt. In our experience the majority of nerve entrapment cases respond very well to ART treatment, especially when combined with the appropriate home exercises.
Although each case is unique and there are several factors that will determine the length of time it will require to fully resolve a condition, we usually find a significant improvement can be gained in just 3-4 treatments.
Get Relief From Foot Pain Due To A Nerve Entrapment
To learn more, or to book an initial appointment to see if ART may be able to help with your foot pain simply call our office at (905) 685-7227.
For general questions you can either call our office or send us an email at [email protected] – one of our ART certified doctors will be happy to answer any questions you may have.
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