(See also Overview of Foot and Ankle Disorders Overview of Foot and Ankle Disorders Most foot problems result from anatomic disorders or abnormal function of articular or extra-articular structures (see figure Bones of the foot). Less commonly, foot problems reflect a systemic... read more .)
Symptoms of medial and lateral plantar nerve entrapment include almost constant pain, with and without weight bearing, which helps to differentiate medial and lateral plantar nerve entrapment from plantar fasciosis Plantar Fasciosis Plantar fasciosis is pain at the site of the attachment of the plantar fascia and the calcaneus (calcaneal enthesopathy), with or without accompanying pain along the medial band of the plantar... read more . The pain of plantar nerve entrapment 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 Plantar Fasciosis Plantar fasciosis is pain at the site of the attachment of the plantar fascia and the calcaneus (calcaneal enthesopathy), with or without accompanying pain along the medial band of the plantar... read more and heel spur pain as well as tarsal tunnel syndrome Tarsal Tunnel Syndrome Tarsal tunnel syndrome is pain along the course of the posterior tibial nerve, usually resulting from nerve compression within the tarsal tunnel. This schematic drawing of the medial aspect... read more . In plantar nerve entrapment, the following are often present:
Other signs of tarsal tunnel syndrome (eg, Tinel sign) are often absent.
Symptoms can be reproduced by palpation over the proximal aspect of the abductor hallucis, the origin of the plantar fascia, or both at the medial tubercle of the calcaneus.
With medial nerve entrapment, there is tenderness of the proximal medial arch beneath the navicular bone, sometimes with pain that radiates to the medial toes.
With lateral plantar nerve entrapment, there is tenderness over the plantar medial heel and abductor hallucis muscle.
Orthoses, immobilization, and physical therapy
Immobilization and foot orthoses to prevent irritating motion and pressure may be helpful in patients with medial and lateral plantar nerve entrapment, 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.