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Ankle and foot nerve procedures

Persistent ankle and foot pain can be assessed with targeted nerve blocks to identify which nerve is carrying the pain. Radiofrequency treatment may provide a longer-lasting effect.

The ankle and foot are supplied by several nerves with overlapping territories, and pain after injury or surgery here is often attributed to the joint when a nerve is responsible. Careful blocks separate the two.

Diagnostic blocks. Under ultrasound guidance, local anaesthetic is placed around a specific nerve. Substantial relief while the anaesthetic is active identifies that nerve as the carrier. Because territories overlap, more than one block on separate occasions is sometimes needed to build a clear picture.

Common situations. Persistent pain after ankle fracture or fusion. Pain after ligament reconstruction. Entrapment of a nerve by scar tissue or hardware. Neuroma pain in the forefoot. Pain that spread and became disproportionate after a relatively minor injury, which may indicate complex regional pain syndrome and is assessed differently.

Radiofrequency. Radiofrequency treatment of the same target may extend relief. The nerves here are smaller and more variable than in the spine, so results are less predictable and this is discussed frankly before proceeding.

On the day. Ultrasound-guided blocks take 10–20 minutes and rarely require sedation. Radiofrequency takes longer.

Afterwards. Numbness in the nerve's territory is expected. Take care walking until sensation and balance return, and protect the numb area from heat and pressure. Record your pain levels — that is the diagnostic result.

Risks. Whilst pain procedures are generally safe and well tolerated, all procedures carry risks. The specific risks relevant to you and your procedure will be discussed with you, and written information provided, before you decide to proceed.

What else matters. Footwear, orthotics, load management and gait retraining make a substantial difference to foot and ankle pain. Injection is used to clarify the problem and enable that work, not to replace it.