Signs & Symptoms

Patients experiencing lower limb nerve compression may report:

Pain

Often sharp, burning, or shooting, localised to specific areas of the foot or lower leg.

Numbness

Loss of sensation in parts of the foot, such as the toes or sole of the foot.

Tingling

A "pins and needles" sensation, usually in the toes or foot.

Weakness

Difficulty in performing movements like toe lifts or pushing off while walking.

Altered sensation

Changes in sensitivity to touch, temperature, or pain. This can also lead to the sensation of having a rock or foreign object in your shoe.

Types of Nerve Compression/Irritation

1. Medial Calcaneal Nerve Compression:

Typically occurs due to conditions like plantar fasciitis. Symptoms include heel pain and discomfort along the arch of the foot.

2. Tarsal Tunnel Syndrome:

Involves compression of the posterior tibial nerve as it passes through the tarsal tunnel, leading to pain, tingling, and numbness in the sole and toes.

3. Compression of the Superficial Peroneal Nerve:

Often related to tight footwear or trauma, causing pain along the outer part of the lower leg and sensory changes on the top of the foot.

4. Neuromas/ Digital Nerve Compression:

Commonly known as Morton’s neuroma, this involves thickening of the nerve tissue between the toes, resulting in sharp pain, tingling, 'rock' in the shoe sensation or numbness.

5. Lateral Plantar Nerve Compression:

This nerve, a branch of the posterior tibial nerve, can be compressed due to excessive pressure or tight footwear, leading to pain and numbness in the lateral aspect of the foot, particularly affecting the fourth and fifth toes.

6. Sural Nerve Compression:

The sural nerve runs along the outer part of the lower leg and into the foot. Compression can occur due to trauma or tight calf muscles, causing pain, tingling, or numbness along the outer edge of the foot and the ankle.

Differentiating from Other Conditions

It’s crucial to distinguish lower limb nerve compression from other neurological issues:

  • Proximal Nerve Compression: This typically affects nerves higher up the leg or spine (like the sciatic nerve), leading to pain and symptoms that may radiate down the leg. Lower limb nerve compression usually affects more localized areas.
  • Neuropathies: Conditions such as Idiopathic or diabetic neuropathy involve widespread nerve damage and often present with more generalised symptoms, including both sensory and motor deficits.

Treatment Options

Effective management strategies include:

  • Offloading: Reducing pressure on the affected nerve through rest and modification of activities.
  • Orthotics: Custom shoe inserts can correct biomechanical issues and alleviate nerve compression.
  • Footwear Recommendations: Encouraging the use of well-fitted, supportive footwear to minimize pressure points.
  • Strengthening Exercises: Focused exercises can improve foot and ankle strength, helping to stabilize the foot and reduce nerve strain.
  • Manual Therapy: Techniques such as dry needling and massage can relieve muscle tension and promote blood flow. Dry needling can specifically target trigger points that contribute to nerve irritation, while massage helps in relaxing tight muscles around the affected nerve.
  • Avoiding Aggravating Activities: Identifying and modifying activities that exacerbate symptoms can help in recovery.
  • Gradual Return to Sport: After symptoms improve, a gradual reintroduction to sports can help prevent recurrence.

Incorporating specific exercises and stretches can help settle some symptoms and promote recovery. Here are a few examples: Early Management Exercises

  1. Calf Stretch:

    Stand facing a wall with one foot forward and the other back. Keep the back leg straight and press the heel into the ground. Hold for 30 seconds, then switch.

  2. Peroneal Stretch:

    Sit on the floor with your knees bent or in a chair with your feet flat on the floor. Roll your foot so the outer edge of the foot comes in contact with the floor. Hold this position for 20-30 seconds.

  3. Foot Rolling:

    Roll the foot over a tennis ball or frozen water bottle to massage the plantar surface and relieve tension.

When to See a Physio or Podiatrist

Patients should consider seeking professional help if they experience:

  • Persistent or worsening pain or symptoms.
  • Recurring foot or ankle complaints. 
  • Significant weakness or changes in foot function.
  • Symptoms that do not improve with self-care measures over a few weeks.
  • Difficulty performing daily activities or sports due to nerve-related issues.

Early intervention can lead to better outcomes, so listen to your body and seek help as needed.

Lower limb nerve compression and irritation can affect your athletic performance and overall well-being, but with early recognition and effective management, you can stay active and achieve your goals. If you’re experiencing symptoms or want to optimize your foot health, don’t hesitate to reach out to our clinic. Together, we can work towards a pain-free and high-performing you!

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