Nerve entrapment is a condition where pressure on the nerves causes pain and numbness. Nerve entrapment can be caused by internal pressures such as a nerve being pinched at the joint between two bones or by external pressure such as the top of a shoe rubbing and applying pressure to the top of the foot. Because the nerves on the top of the foot are subject to pressure from shoes and are located on top of some of the most used bones in the body, nerve entrapment foot problems are a fairly common occurrence, and can cause pain top of foot pain. Nerve entrapment foot problems are also referred to as nerve compression syndrome or compression neuropathy.
The pain caused by a nerve entrapment is localized around the area where pressure is being applied to the nerve, or the pain can radiate along the nerve that is being pressed, sometime extending up the ankle or down to the toes, with the pain typically a dull or nagging ache, but can also cause muscle weakness. If the nerve continues to be compressed, eventually the pain may become more severe. Pain on the top of the foot can also be caused by an entrapped nerve in the ankle, with tarsal tunnel syndrome one of the most common nerve problems in the feet.
Numbness and tingling are also common symptoms of nerve entrapment. The more pressure that is applied to the nerve, the worse the numbness and tingling will become. When the nerves on top of the foot have been compressed, running a finger over the nerve will usually cause an intense tingling sensation, similar to an electrical shock. Eventually, an entrapped nerve can lead to loss of strength in the foot or ankle.
Nerve entrapment foot problems are typically caused in one of two ways. Pressure from a shoe may be the cause, or stresses placed on the bones in the foot may cause them to knock together. Pressure from a shoe pushes on the nerve causing it to become irritated. Nerve entrapment caused by shoes is most often seen in people with very high arches where the top of the foot is pressed tightly against the top of the shoe. On the other hand, nerve entrapment caused by pressure from the bones is most often seen in people with very low arches, or flat feet. The foot of someone with very low arches collapses under the weight of a step and the bones of the top of the foot push towards each other, rubbing the nerve and causing irritation.
Treatment for nerve entrapment primarily focuses on easing the pressure on the affected nerve. Once the nerve is no longer being compressed, the symptoms should go away on their own,although it may take several weeks for feeling to return, with the area remaining numb for some time. For nerve compression caused by pressure from a shoe, sometimes just changing to a looser shoe or wearing a size larger can be enough to solve the problem. Placing a piece of foam or moleskin cut into a donut or horseshoe shape over the irritated area is another way to relieve pressure from a shoe. If fallen arches are causing the nerve entrapment, choose shoes with good arch supports or insert over-the-counter or prescription orthotics into your shoes. Be careful not to insert arch supports that push the top of your feet into your shoe or this may aggravate the nerve.
orthoinfo.aaos.org, merckmanuals.com, emedicine.medscape.com
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