Medial and lateral plantar nerve entrapment is symptomatic compression of the medial and/or lateral branches of the posterior tibial nerve at the medial heel and proximal arch. Diagnosis is clinical. Treatment involves orthotics and immobilization.
Symptoms include almost constant pain, with and without weight bearing, which helps to differentiate medial and lateral plantar nerve entrapment from plantar fasciosis. The pain is often chronic, intractable, and aggravated by high-impact activities such as running. However, simple standing is often difficult. Burning, numbness, and paresthesias are usually absent.
Medial and lateral plantar nerve entrapment may be confused with plantar fasciosis and heel spur pain as well as tarsal tunnel syndrome. In plantar nerve entrapment, the following are often present:
Immobilization and foot orthoses to prevent irritating motion and pressure may be helpful, as may physical therapy and cryotherapy. If these treatments are ineffective, injection with a sclerosing agent that contains alcohol or careful surgical decompression of the nerve may help relieve pain.
Last full review/revision December 2012 by Kendrick Alan Whitney, DPM
Content last modified January 2013