ANKLE AND FOOT PAIN


 

ANKLE & FOOT PAIN

Common causes of pain in the ankle and foot are POSTERIOR AND ANTERIOR TARSAL TUNNEL SYNDROME, MORTON’S NEUROMA, OSTEOARTHRITIS, TENDON problems, LIGAMENT SPRAINS and PLANTAR FASCITIS.

POSTERIOR TARSAL TUNNEL is entrapment of the Posterior Tibial Nerve, which can cause pain, tingling, numbness into the bottom of the foot and sometimes the heel. ANTERIOR TARSAL TUNNEL is entrapment of the Deep Peroneal Nerve (sometimes called the Anterior Tibial Nerve), which can cause pain, tingling, numbness into the dorsum(top) of the foot and to the first two toes.  MORTON’S NEUROMA is a common problem causing forefoot pain. This an entrapment of the PLANTAR NERVES between the metatarsal heads.  People often describe taking their shoes off will relieve their pain.  There are 3 other nerves  going to the ankle/foot that may need to be assessed: i)the Superficial Peroneal nerve can cause anterolateral ankle pain. ii) the Sural nerve can cause lateral foot pain. iii) the Saphenous nerve can cause medial ankle pain. All of these nerves can be considered for steroid injections or Peripheral Nerve Stimulation (see PNS section).  May also consider Radiofrequency Ablation (see RFA section) of the Sural and Superficial Peroneal Nerves as well as the Morton’s Neuroma and the Calcaneal nerve(branch of the Posterior Tibial Nerve).

Osteoarthritis in ankle/foot is not uncommon due to the significant pressure these joints take on bearing the pressure of our body weight.   There are too  many joints to mention, but all are candidates for steroid or PRP injections. 

Common TENDON problems are: On the lateral ankle you can see subluxation of the peroneal tendons over the lateral malleolus. On the lateral foot you can see irritation of the same peroneal tendons at the peroneal tubercle. It is not uncommon to have irritation of the anterior tibialis tendon with running or simply crossing one foot over the other.  Of course, posteriorly there can be inflammation of the achilles tendon.  These problems will usually respond to steroid injections. If partial tears of theses tendon, PRP may be considered.   If no benefit, you may need to consider seeing a foot surgeon.  

Of course, the ankle is commonly sprained, which is actually tears or microtears of the supporting ligament across the many joints of the ankle. Another common ligament problem is Plantar Fascitis.  All these ligament problems may respond to steroid or PRP injections.

ALL of the above procedures are done by our specially trained providers with ultrasound guidance.