How To Diagnose And Treat Sural Nerve Problems

Last updated: 04-05-2021

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How To Diagnose And Treat Sural Nerve Problems

Your sural nerve is a sensory nerve that runs down the back of your leg, behind the lateral side of your ankle and along the outside of your foot. It helps to provide sensory information for the outside of your foot and the 4th and 5th toes, and this is the same area where you’ll notice symptoms if a problem begins to develop. We noticed that a lot of people were ending up on our site after performing a Google search related to the sural nerve, so we wanted to provide a little more information about how problems with the nerve are diagnosed and treated.
Diagnosing A Sural Nerve Problem

Sural nerve problems can be a little tricky to diagnose because they aren’t something that show up well on standard imaging exams. For example, x-rays aren’t going to be able to pinpoint a nerve issue. Even an MRI isn’t a great option because the sural nerve is so tiny. An MRI can help to rule out other potential problems, but it’s not a doctor’s best tool for diagnosing a sural nerve issue.

Instead, the most common way to diagnose a sural nerve issue is through a physical examination performed by an orthopedic surgeon who knows what to look for. The surgeon will manipulate the area and see if pressure sensations in specific spots trigger an “electric-like” sensation. This sensation isn’t painful, it’s more like when you hit your funny bone in your elbow. The surgeon will also look for signs of swelling or tenderness on the outside of your foot and ankle. It’s old-fashioned, but it’s effective.
Treating A Sural Nerve Issue

Treating a sural nerve issue involves targeting the underlying cause of the nerve problem. For example, you’re not going to make much headway in treatment if you’re only trying to absolve the symptoms. If your sural nerve issues are being caused by lateral ankle instability and chronic ankle sprains, your best bet will be to stabilize the lateral ankle ligaments and prevent excessive movement in the area that is contributing to nerve irritation. Targeting the symptoms instead of the root cause can lead to frustration, so it’s important that your orthopedic specialist identifies what’s contributing to this nerve irritation.

Some forms of treatment based on the most common underlying causes of sural nerve impingement include:

Desensitization – Direct tissue massage and stretching exercises can help to desensitize the nerve and free it from compressing scar tissue in the area. These massage and stretching exercises become more effective and less uncomfortable the longer you pursue them.

Changing Shoes – You may be surprised to learn how much pressure your shoes can put on the outside of your feet. If your shoes are too tight or putting pressure in the wrong places, nerve problems can develop. Switching to a roomier, more comfortable option can help to provide relief.

Physical Therapy – Physical therapy to strengthen lateral ankle ligaments and prevent chronic ankle sprains can help to calm sural nerve irritation.

Corticosteroid Injections – Pain-relieving medications can help to break up problematic scar tissue in the area that may be affecting the nerve.

Medications – Certain medications can help curb inflammation that could be compressing the nerve.

Surgery – Finally, a decompression operation can help free the sural nerve, but surgery is generally avoided if it can be.

If you are dealing with nerve pain, numbness or sensation issues in your ankle and foot, reach out to Dr. Silverman to learn how he can help you find relief from sural nerve problems. For more information, contact his office today at (952) 224-8500.


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