Nerve Entrapment Post Trauma/Surgery
Nerve entrapment often causing symptoms like numbness, aching, tingling, or burning pain, is a recognized and known complication that can arise during the normal healing process following surgery or trauma in the foot and ankle. As tissues repair, scar tissue forms and can compress the delicate nerves in the area of the injury. While not desirable, this condition of nerve compression is a well- understood possible outcome of the body’s healing response to injury or surgery.
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Understanding Nerve Entrapment after Trauma or Foot and Ankle Surgery
Nerve entrapments can occur during the healing process following foot and ankle trauma or surgery. Common causes include:
- Scar Tissue Formation
- After any significant trauma or surgery, the body naturally creates scar tissue as a normal part of healing.
- This thick fibrous tissue can form around the nerve and cause compression of the nerve, causing it to “stick” to the surrounding tissue.
- Loss of Gliding: When the nerves become “stuck” they are unable to move freely when the surrounding joints move. This inability of the nerve to move and glide causes irritation and pain.
- Swelling and Edema
- Swelling following an injury can increase pressure in narrow spaces, compressing the nerve
- Changes in Local Anatomy
- Trauma can cause changes in the shape of the bone where the nerve rests and narrowing of the spaces where the nerves naturally glide through.
- The necessary changes to bone made during surgical procedures can place the nerve in an area where it can be more vulnerable to pressure.
Foot/Ankle Trauma and Associated Nerve Entrapments
Calcaneal Fracture
Associated Nerve Entrapment
Tarsal Tunnel Syndrome (Posterior Tibial Nerve)
Baxter Neuropathy (First Branch of the Lateral Plantar Nerve)
Common Symptoms
Pain, tingling and numbness along the bottom and inside of the foot and toes. Chronic heel pain that travels along the outside of the foot.
Mechanism/Cause
Swelling and bleeding from the heel bone reduces space or causes direct compression on the nerve in the tarsal tunnel.
Location of Nerve Symptoms
Ankle Fracture
Associated Nerve Entrapment
Tarsal Tunnel Syndrome (Posterior Tibial Nerve)
Superficial Peroneal Nerve
Common Symptoms
Pain, burning, pins and needles on the bottom of the foot .
Numbness and tingling on the top of the foot
Mechanism/Cause
Nerve stretches or bruises during the injury, scar tissue or bone fragments from the fracture put pressure on the nerves.
Location of Nerve Symptoms
,
Navicular Bone (Tarsal Bone) Fracture
Associated Nerve Entrapment
Deep Peroneal (Fibular) Nerve
Common Symptoms
Pain and numbness across the top of foot, numbness in the space between the first and second toes.
Mechanism/Cause
Swelling, bleeding, and scarring near the fracture put pressure on the nerve.
Location of Nerve Symptoms
5th Metatarsal Fracture /Jones Fracture
Associated Nerve Injury
Sural Nerve
Common Symptoms
Numbness, tingling and burning along the outer aspect of the foot, pain with pressure when sleeping.
Mechanism/Cause
Stretching of the nerve during the injury, scarring , direct trauma to nerve or surrounding soft. tissue
Location of Nerve Symptoms
Lesser Metatarsal Fracture/ Stress Fracture
Associated Nerve Injury
Plantar Digital Nerve
Morton’s Neuroma (between 3rd and 4th digits)
Common Symptons
Sharp burning pain in the ball of the foot, numbness in the toes, feeling that socks are balled up in the shoe.
Mechanism/Cause
Changes in weight distribution when walking due to shifting of the bone, scarring and pressure from bone callus as the bone heals.
Location of Nerve Symptoms
Talar Fracture (Talus Bone)
Associated Nerve Injury
Tibia Nerve/ Tarsal Tunnel
Common Symptoms
Pain, numbness and tingling along the inside of the ankle and bottom of the foot.
Mechanism/Cause
High energy trauma cases stretching and swelling around the tibial nerve in the tarsal tunnel
Location of Nerve Symptoms
Chronic Ankle Sprains
Associated Nerve Entrapments
Common Peroneal Nerve
Superficial Peroneal Nerve
Sural Nerve
Common Symptoms
Numbness or tingling on the top of the foot and lower leg, weakness or instability to the ankle, partial foot drop, pain along the outer aspect of lower leg, ankle and foot.
Mechanism/Cause
Stretching injury to the nerve caused by the inward rolling of the ankle
Location of Nerve Symptoms
Foot and Ankle Surgery: Associated Nerve Entrapments
Flat Foot Reconstruction
Description of Procedure
Surgery to rebuild the arch using cuts in the bone and often tendon adjustments to correct a fallen arch.
Nerve at Risk of Entrapment
Posterior Tibial Nerve (Tarsal Tunnel Syndrome)
Common Symptoms
Aching pain, numbness, and tingling on the inside of the ankle and bottom of the foot.
Location of Nerve Symptoms
Ankle Arthroscopy
Description of Procedure
A minimally invasive procedure using small cameras and instruments to diagnose and treat problems inside of the ankle joint.
Nerve at Risk of Entrapment
Sural Nerve
Superficial Peroneal Nerve
Common Symptoms
Pins and needles or numbness on the top of the foot, often near the small cuts made for the camera.
Location of Nerve Symptoms
Midfoot Fusion
Description of Procedure
Surgery to permanently join two or more bones in the middle ofthe foot (fusion) to stop motion at the joint. Thisis done to relieve severe arthritis pina or correct a significan structural deformity.
Nerve at Risk of Entrapment
Deep Peroneal Nerve
Superficial Peroneal Nerve
Common Symptoms
Pain, aching and numbness on the top of the foot.
Location of Nerve Symptoms
Achilles Tendon Repair
Description of Procedure
A torn or ruptured tendon at the back of the heel is repaired and sutured.
Nerve at Risk of Entrapment
Sural Nerve
Medial Calcaneal Nerve Branch
Lateral Calcaneal Nerve Branch
Common Symptoms
Pain, burning or numbness along the incision line and back of the heel bone.
Location of Nerve Symptoms
Haglund's Resection/Removal of Posterior Calcaneal Bone Spur
Description of Procedure
Prominent bone and spur at the back of the heel is removed where the Achilles tendon attaches to the bone.
Nerve at Risk of Entrapment
Sural Nerve
Medial Calcaneal Nerve Branch
Lateral Calcaneal Nerve Branch
Common Symptoms
Pain, numbness or hypersensitivity at the back of the heel.
Location of Nerve Symptoms
Lapidus Bunionectomy
Description of Procedure
The bunion is corrected by releasing soft tissue at the great toe joint, rotating the long metatarsal bone and fusing this bone at the midfoot (first metatarsal cuneiform joint).
Nerve at Risk of Entrapment
Deep Peroneal Nerve
Branches of the Superficial Peroneal Nerve
Common Symptoms
Numbness or persistent ache on the top of the foot , between the first and second toes and surrounding the great toe.
Location of Nerve Symptoms
Tailor Bunion Correction
Description of Procedure
Surgery to fix a bunion deformity on the little toe side of the foot by cutting the 5th metatarsal and shifting the bone into a new position.
Nerve at Risk of Entrapment
Lateral Dorsal Cutaneous Branch of the Sural Nerve
Common Symptoms
Numbness, burning, or sensitivity on the top and side of the foot.
Location of Nerve Symptoms
Expertise in Foot, Ankle and Nerve Surgery
Dr Moore is an experienced podiatric surgeon with 30 years of trusted expertise in foot and ankle surgery. In addition to treating common foot and ankle problems, she specialized in treating nerve entrapments. With her unique expertise, Dr Moore can identify chronic aching pain that persists longer than expected after an injury or surgery. This perspective is key to determining if a nerve entrapment is the underlying cause. If a nerve entrapment is confirmed, Dr Moore offers a range of treatment options aimed at resolving the issue and restoring comfort.
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Nerve Entrapment Post Trauma/Surgery
Treatment options include physical therapy, regenerative medicine, injections and advanced podiatric procedures.
Moving Forward Together
At Janus Lower Extremity Pain Center, we recognize the frustration of living with chronic pain after an injury or surgery. We are here to guide you on a path to less pain and better mobility.
Lower Extremity Advanced Procedures for Nerve Pain
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