J Korean Orthop Assoc.  2017 Aug;52(4):305-309. 10.4055/jkoa.2017.52.4.305.

Neurogenic Pain Disorder in the Foot and Ankle: Peripheral Neuropathy

• Kim HJ
• Park YH
• Kim SH

• KMID: 2387788
• DOI: http://doi.org/10.4055/jkoa.2017.52.4.305

Abstract

Most common peripheral neuropathy around foot and ankle is diabetic neuropathy, but there are another cause of peripheral neuropathy, such as rheumatoid arthritis, metabolic disease, genetic disease, toxic material, and so on. The main symptom of peripheral neuropathy is pain. The disturbance of sensory and balancing, weakness of muscle, deformity of foot and neuropathic arthropathy are also the symptoms of the peripheral neuropathy. History taking is most important to identify the cause of peripheral neuropathy. Neurological exam have to include the pin prick test, vibration test, 10 g-monofilamant test and ankle reflex test. Simple radiography is essential to observe the deformities or neuropathic arthropathy at foot and ankle. The presence of peripheral neuropathy, involvement and severity can be identified from nerve conduction study. The study of occlusive arteritis is essential for diabetic neuropathy. The medical treatment of associated disease is important but the pain of peripheral neuropathy should be controlled simultaneously. Medicine include the antidepressants, anticonvulsants, opioids and topical agents. The surgical treatment of peripheral neuropathy include lengthening of Achilles tendon, correction of deformity, the total contact cast and arthrodesis. Surgical decompression of specific nerve might helpful in pain control of peripheral neuropathy.

Keyword

ankle; foot; peripheral neuropathies; diagnosis; treatment

MeSH Terms

Achilles Tendon
Analgesics, Opioid
Ankle*
Anticonvulsants
Antidepressive Agents
Arteritis
Arthritis, Rheumatoid
Arthrodesis
Congenital Abnormalities
Decompression, Surgical
Diabetic Neuropathies
Diagnosis
Foot*
Metabolic Diseases
Neural Conduction
Peripheral Nervous System Diseases*
Radiography
Reflex
Somatoform Disorders*
Vibration
Analgesics, Opioid
Anticonvulsants
Antidepressive Agents

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