Nerve Entrapments of the Lower Limb

Understanding Nerve Entrapments

Peripheral nerve entrapments occur when a nerve becomes compressed or irritated by surrounding anatomical structures, such as fascia, muscles, or tendons. These conditions can present with a range of sensory and motor symptoms depending on the nerve involved and the location of the compression.

Common symptoms include:

• Localised or radiating pain (often burning or sharp in nature)
• Tingling or "pins and needles"
• Numbness or altered sensation
• Weakness or muscle fatigue in the affected limb
• Symptoms may worsen with specific movements or prolonged activity

Common Lower Limb Nerve Entrapments We Assess and Treat

Tarsal Tunnel Syndrome

Involves compression of the posterior tibial nerve as it passes through the tarsal tunnel near the ankle. Patients may report pain, numbness, or tingling along the sole of the foot and heel.

Sural Nerve Entrapment

A sensory nerve that can be compressed along the outer calf or ankle, leading to pain or altered sensation in the lateral aspect of the foot and lower leg.

Common Peroneal Nerve Entrapment

Often occurs near the fibular head. May present with pain, tingling over the dorsum of the foot, or weakness in ankle dorsiflexion (foot drop).

Piriformis Syndrome

Though not a true spinal radiculopathy, this condition involves compression of the sciatic nerve by the piriformis muscle in the gluteal region, often resulting in pain radiating down the leg.

Saphenous Nerve Entrapment

Compression of this nerve may cause medial knee or lower leg pain, sometimes mistaken for joint pathology.

Diagnostic Imaging: The Role of Ultrasound

High-resolution ultrasound imaging is used as part of our assessment protocol. Ultrasound allows for the visualisation of:

• Swollen or thickened nerves
• Compression points within soft tissue or fascial planes
• Associated pathologies such as tendon inflammation or vascular changes

Ultrasound is non-invasive, real-time, and particularly effective in assessing superficial nerve structures of the lower limb.

Fascial Manipulation® (Stecco Method)

Fascial Manipulation is a manual therapy approach that focuses on the deep fascia—the connective tissue network that supports and integrates muscles, nerves, and vessels. Fascia can become densified or restricted due to injury, postural habits, or overuse, leading to altered tension patterns and potential nerve entrapment.

This method, developed by Luigi Stecco and refined over decades of research, aims to:

• Restore mobility in restricted fascial planes
• Reduce mechanical pressure on peripheral nerves
• Improve neuromuscular coordination and tissue glide
• Address compensatory movement patterns

All treatments are delivered by podiatrists with specialist training in this approach, following a detailed clinical and biomechanical assessment.

When to Seek Assessment

Early diagnosis of nerve entrapments can prevent progression and reduce the risk of chronic symptoms. Referral is appropriate for individuals presenting with:

• Persistent or recurrent sensory changes in the lower limb
• Pain unresponsive to standard musculoskeletal care
• Unclear diagnosis following previous interventions
• A history of overuse, trauma, or biomechanical asymmetry

Contact and Referrals

Our clinic is located in South London and accepts both self-referrals and referrals from healthcare professionals. We welcome patients seeking second opinions or specialist input for complex lower limb pain presentations.

To arrange a consultation or discuss a case, please call us directly or book an appointment online through our booking system.