Treating Sural Nerve and Lower Leg Pain

Last updated: 11-16-2020

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Treating Sural Nerve and Lower Leg Pain

Your sural nerve has a somewhat complex arrangement in your lower body, and if it becomes damaged, it can lead to painful sensations in your feet and lower leg. In today’s blog, we take a closer look at the sural nerve and how we work to treat sural nerve issues in our patients.
Sural Nerve Anatomy

On a basic level, you have two sural nerves – the medial sural cutaneous nerve and the lateral sural cutaneous nerve – and these nerves eventually connect via your peroneal nerve to make your sural nerve. It runs down the back of your calf, behind the outside edge of your ankle and along the outside edge of your foot. It is a purely sensory nerve that supplies sensation to your lower leg, your lateral heel, your ankle and your fourth and fifth toes.

Problems with the nerve can develop for a variety of reasons, the most common being acute trauma or irritation of the nerve. Most patients describe their pain as a burning sensation located on the outside of their foot or ankle, but it can also involve symptoms of hypersensitivity or numbness, which may be amplified when the area is touched or compressed. The most common reason for sural nerve damage to occur is a result of an ankle sprain, but some patients experience the condition as a result of damage during a surgical operation or due to scar tissue formation that entraps the nerve.
Treating Sural Nerve Issues

Treating sural nerve issues begins with a professional diagnosis by a foot specialist. This way your specialist can help to determine where the nerve irritation is located and how to best treat it. They begin by listening to your symptoms, reviewing your medical history and by conducting some physical tests to see which actions cause symptoms or provide relief. X-rays aren’t usually relied on for sural nerve issues, and MRIs also aren’t the best option because of the small size of the nerve. Instead, ultrasound is often used to detect issues with the nerve if physical exams don’t yield a conclusive diagnosis.

If you’ve been diagnosed with sural nerve damage or irritation, your foot specialist will attempt to resolve symptoms with conservative care techniques. Most cases resolve over time with the help of non-operative methods including but not limited to:

Direct massage desensitization
Medications
Corticosteroid injections
Anti-inflammatory medications
Changing footwear to avoid direct pressure over the damaged nerve

In rare cases, the nerve may need to be freed from a compressed location with the assistance of a minimally invasive surgery. The nerve is easy to access, so the procedure can be performed under local anesthesia using minimally invasive techniques. This too has high success rates, but most surgeons will opt for non-operative methods before moving to a surgical procedure.

If you believe you’re dealing with sural nerve impingement or want to get to the bottom of your foot or heel discomfort, reach out to Dr. Silverman and the experienced team at Silverman Ankle & Foot today.


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