What is a pinched nerve in the foot?
There are a number of potential locations in the foot and ankle where nerves can become entrapped or pinched. In some situations it's truly a pinched nerve and others, the nerve becomes irritated and can develop scar tissue around it. That is the case with a Morton's neuroma. Often times there is enough irritation to the nerve in this area that the nerve sheath becomes thicker and all the more prone to irritation and compression.
A Morton's neuroma involves branches of the plantar nerves between the third and fourth metatarsals in the forefoot area. Tarsal tunnel syndrome is similar to carpal tunnel syndrome and involved the posterior tibial nerve where the ankle meets the foot. This is on the inside or medial aspect. This is also directly adjacent to the primary artery and veins to the bottom of the foot. It also is part of the compartment that has the long flexor tendons to the toes and inside of the midfoot. Tarsal tunnel syndrome can be aggravated by other problems such as physical space-occupying conditions like a ganglion cyst or other soft tissue enlargements or growths. The top of the midfoot near the base of the second and third metatarsal is a common area to have nerve compression and a pinched nerve.
People with a high arch foot are more prone to these problems especially if they get into a tight fitting shoe or ski boot or similar device that could put non-forgiving pressure on the top of the midfoot. In this particular location there is not much subcutaneous tissue or fat pad to help the nerves in this location have adequate room. Instead there is very little subcutaneous layer and the nerve can get pin down directly against the top of the foot and press against the second metatarsal or second cuneiform midfoot bones. So these would be the 3 most common pinched nerves in the foot and ankle. In each case there can be nervelike symptoms from compression on the nerve in this area. These may be alleviated by changing shoes. But in some cases as time goes on they become hypersensitive and damaged with potential for permanent nerve damage and chronic pain. Each of these conditions involves specific examination and testing to help confirm diagnosis. They also had their own unique treatments. If you have any of these symptoms and are concerned and would like to come in to see either Dr. Nelson or myself. Please let us know.
