Syndrome of the infringement of the fourth plantar nerve ( metatarsalgia ) occurs due to infringement of the nerve trunk, which is formed from the inner and outer plantar nerves – the terminal branches of the tibial nerve. The fourth plantar nerve is thicker than others, more fixed under the deep transverse ligament between the heads of III and IV metatarsal bones. When a nerve is pinched under a thickened ligament against a background of constant pain and paresthesia, intolerable shooting pains appear in the area of the heads of these bones, the attacks of which last for 1-15 minutes. The pain intensifies when standing and walking. The zone of the heads of III and IV metatarsal bones is painful, hyperalgesia (less often hypalgesia ) of the skin of the inner surfaces of the III and IV fingers is often noted .
Tarsal canal syndrome
This osteofibrotic calcaneal canal of Richet is located below and behind the inner ankle. In it, along with the vessels, the tibial nerve passes. Patients experience burning or aching pains in the area of the sole and fingers, sometimes in the posterior parts of the lower leg, as well as paresthesia in the zone of innervation of the plantar branches of the nerve; Hypesthesia can also be detected here. Pain and paresthesia intensify at night, sometimes when walking, when striking along the canal zone, as well as with pronation and extension of the foot.
Peroneal nerve syndrome
Syndrome of the peroneal nerve under the tendon of the biceps femoris occurs in people who have been squatting for a long time or sitting on a low seat in a similar position – in collectors of berries, aviators, etc. It is characterized by a progressive dysfunction of this nerve (drooping foot, the patient cannot walk on the heels). This nerve is often infringed below the head of the fibula under the initial part of the long fibula. There is muscle hypotrophy, paresthesia, pain, hypalgesia along the outer edge of the lower leg.
Syndrome of infringement of the lateral cutaneous nerve of the thigh
Syndrome of infringement of the lateral cutaneous nerve of the thigh under the pupartic ligament ( paresthetic meningy of Bernhardt- Roth) is very common, especially in older people, more often in men. Its appearance is due to fibrotic growths pupartovoy ligament both due to age-related changes, or under the influence of mechanical factors. In a predominant number of cases, the onset of meralgia is difficult to relate to a specific cause. In limited areas of the thigh (on its lateral surface) paresthesias appear: sensations of creeping goosebumps, tingling, tension, numbness. Soon the pains join, gradually intensifying. Initially, these sensations arise periodically, especially with prolonged walking, standing. If the patient does not manage to stop, paresthesias disappear, giving way to burning pains. Attacks become more and more prolonged, and then often and constant. In many patients, the course is characterized by an alternation of periods of obstruction and remissions. Over time, persistent hypalgesia forms , especially with regard to the temperature and tactile sensitivity of the skin of the lateral thigh. Less commonly observed trophic disorders (thinning of the skin), a decrease in sweating. In the area of the nerve passage under the pupartic ligament, pain on palpation is often determined.