Certain cases of plantar fascitis may not only be due to the plantar fascia scarring and swelling, but may also be due to a nerve pinched in the ankle region. Calcaneal nerve entrapment is due to a branch of the tarsal tunnel nerves being trapped or scarred in the arch. With regular plantar fascia care, this problem may not resolve. Dr. Wilkes performs neurosensory testing to check for nerve compression and ultrasound testing to check for plantar fascia problems prior to surgical care and for diagnosis of problems.
Conservative care will often include cortisone injection about the nerve and physical therapy with possible bracing for a period of time. Custom insoles/orthotics are often used to relieve the pain along the problematic nerve. All aspects of conservative care are attempted prior to surgical care consideration. Cryotherapy is sometimes used as treatment to make the nerve pain symptoms improve without surgery.
The surgical release of the nerve is commonly necessary if pain continues. The surgical procedure is done in an outpatient setting with fairly rapid recovery.
|Picture showing calcaneal nerve branch.||Picture showing medial and lateral plantar nerve tunnels prior to release.|