The Center for Podiatric Care and Sports Medicine

Why Does It Still Hurt? NYC Podiatrist Discuss Chronic Foot Nerve Pain After a Tendon Injury

Posted by on Friday, April 13th, 2018

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Chronic foot nerve pain after a tendon injury drives a lot of patients through our NYC podiatry clinic doors on Mitchell Place in White Plains and 88th Street in Manhattan. Some people knew they were hurt and never sought care, while others went to a primary care physician or emergency room only to receive inadequate care. There is nothing more rewarding than helping a person who has suffered for a long time with an accurate diagnosis, customized wellness program, state-of-the-art pain-reducing and healing therapies, modern medical procedures (when necessary), and a compassionate approach. Damaged tendons are one of our specialties at The Center for Podiatric Care and Sports Medicine. What we’ve learned during the more than 40 years in the field of podiatry and sports medicine is that you DO NOT have to live with chronic nerve pain forever.

[Image Source: Pexels user Daria Shevtsova]
The trouble with nerve pain after a tendon injury is that it often mimics other injuries. [Image Source: Pexels user Daria Shevtsova]

What Does Nerve Pain Feel Like?

Nerve pain is a very distinct feeling you’re not likely to ever forget, though it may manifest in different ways. Some people report a burning sensation that runs along the axis of the nerve. Others feel tingling like their foot has fallen asleep or even numbness. A third group of patients reports a pinching inside the foot and corresponding weakness in the surrounding area. In some cases, persistent swelling of a nerve “pops” like a rubber band with each step.

A Typical Progression May Go Something Like This…

The trouble with nerve pain after a tendon injury is that it often mimics other injuries. In a typical case, the patient comes in years after a flexor hallucis longus tendon injury at the sesamoid, where the tendon meets up with the little toe bones. This beast of a tendon runs from the calf muscle, through the ankle and arch, to the big toe. Its main purposes are to provide arch support, aid in flexion during the push-off of the gait cycle, and facilitate normal movement in the big toe.

The patient reports seemingly normal healing in the tendon, but the development of a sudden, unrelenting pain in the piriformis muscle, which starts at the lower spine and connects to the femur. The pain can range from mild to severe. This sore spot for nerve pain is common among sciatica sufferers.

If left untreated, the foot can develop a corresponding tension like someone is pulling back on the Achilles tendon with every step forward. The pull-back pain occurs only while walking. It may come and go, much like a compression of the tibial nerve and corresponding tarsal tunnel syndrome.

After a few months of foot pain, another pain can extend up the back of the ankle from the arch and heel to the inner ankle. Patients say it feels like a pulley system sort of yank more than typical nerve pain. This sounds like classic neural tension.

Evaluating Chronic Foot Nerve Pain After a Tendon Injury

In the office, we’ll talk about your symptoms and injury history. We’ll likely have you roll your foot on a tennis ball at the point of pain to see if it triggers tingling along the bottom of the foot similar to the old tendon injury. We’ll look at the abilities of the flexor hallucis longus, flexor digitorum longus, and tibialis posterior tendon. If a re-injury of the tendon does not seem the culprit, we can recommend treatment similar to what you might expect for tarsal tunnel syndrome.

Treatment for Chronic Nerve Pain in the Foot

Here’s what we recommend:

  • Twenty-minute warm soaks, twice daily
  • Custom-fitted orthotics or sole wedges to correct pronation (if necessary)
  • Active ankle range-of-motion exercises
  • Nerve flossing exercises to release entrapped nerves
  • Pregabalin medication to treat severe flares of pain

If you have any questions about nerve pain in the foot, ankle, or lower extremities, contact us at once—no referral necessary.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.