Nerve blocks are an essential tool in podiatry, offering effective pain management solutions for various foot and ankle conditions. This procedure involves injecting an anesthetic near specific nerves to block pain signals from reaching the brain. Nerve blocks provide targeted relief, allowing patients to experience a more comfortable, pain-free recovery and enabling podiatrists to perform diagnostic and therapeutic procedures more effectively.
Nerve blocks work by injecting a local anesthetic near a nerve, blocking pain signals along that nerve. They are commonly used in anesthesia to provide perioperative pain relief, as well as in other areas of medicine to provide pain relief in certain conditions. For podiatry, nerve blocks can be especially effective in addressing conditions like plantar fasciitis, Morton’s neuroma, tarsal tunnel syndrome, and other forms of foot and ankle pain. In many cases, nerve blocks serve both diagnostic and therapeutic purposes. For instance, if a patient has chronic foot pain, a nerve block can help determine if the pain originates from a specific nerve. If the block relieves the pain, it confirms the nerve’s involvement, guiding future treatment 1,2.
Podiatrists frequently employ several types of nerve blocks, depending on the target area and the underlying condition. A posterior tibial nerve block addresses pain associated with the heel and plantar surface of the foot. It is often used for conditions like plantar fasciitis or heel pain syndromes 3. A sural nerve block targets the sural nerve, which runs along the back of the calf and the lateral side of the foot. It is helpful for pain on the outside of the foot or ankle, often resulting from sprains, fractures, or overuse injuries 4,5. Addressing pain on the inner side of the foot and ankle, the saphenous nerve block is useful for conditions like medial foot pain or injuries that affect the inside of the ankle 6,7. Finally, a digital nerve block is useful for toe pain and is commonly used for conditions like Morton’s neuroma, which affects the nerves between the toes, or for ingrown toenail procedures 8,9.
Nerve blocks have various applications in podiatry, ranging from managing chronic pain to preparing patients for surgery. Nerve blocks can provide prolonged pain relief, often lasting several hours or even days, allowing patients to experience significant pain relief without relying heavily on opioid painkillers, which carry risks of dependency and side effects. In addition, with the targeted pain relief nerve blocks provide, patients often experience faster recovery times, reduced pain-related complications, and an overall improvement in quality of life. Finally, for some foot surgeries or procedures, nerve blocks can eliminate the need for general anesthesia, which can carry higher risks and lead to longer recovery times 10–12.
While nerve blocks are generally safe, they come with some potential risks, such as infection, bleeding, or temporary nerve damage. It is essential for podiatrists to consider these risks and discuss them with patients 12. Overall, nerve blocks are a valuable tool in podiatry, providing effective and targeted pain management for various foot and ankle conditions.
References
1. Nerve Blocks | Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/nerve-blocks.
2. Nerve Block: What It Is, Procedure, Side Effects & Types.
3. Ultrasound Guided Posterior Tibial Nerve Block and Foreign Body Removal | Emory School of Medicine. https://med.emory.edu/departments/emergency-medicine/sections/ultrasound/case-of-the-month/procedures/ultrasound_guided_posterior_tibial_nerve_block.html.
4. D’Souza, R. S. & Johnson, R. L. Sural Nerve Block. Atlas Ultrasound-Guided Reg. Anesth. 221–226 (2023) doi:10.1016/B978-0-323-50951-0.00052-9.
5. Sural Nerve Block – StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK519541/.
6. Saphenous Nerve Block – StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK536967/.
7. Lawson, P. A. & Potter, W. A. Saphenous Nerve Block. Bedside Pain Manag. Interv. 721–730 (2023) doi:10.1007/978-3-031-11188-4_67.
8. Napier, A., Howell, D. M. & Taylor, A. Digital Nerve Block. Adult-Gerontology Acute Care Pract. Guidel. Second Ed. 567–568 (2024).
9. Digital Nerve Block – StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK526111/.
10. Jogie, J. & Jogie, J. A. A Comprehensive Review on the Efficacy of Nerve Blocks in Reducing Postoperative Anesthetic and Analgesic Requirements. Cureus 15, e38552 (2023). DOI: 10.7759/cureus.38552
11. Wiederhold, B. D., Garmon, E. H., Peterson, E., Stevens, J. B. & O’Rourke, M. C. Nerve Block Anesthesia. StatPearls (2023).
12. Nerve Block Anesthesia – StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK431109/.