Chronic heel pain due to the entrapment of the first branch of the lateral plantar nerve: analysis of surgical treatment

This is a case series study that was conducted to report the outcome of surgical release of the first branch of the lateral plantar nerve in patients with chronic heel pain. Thirty-one patients with chronic heel pain underwent release of the first branch of the lateral plantar nerve. The setting was a public university hospital and a public university-affiliated hospital in the north of Jordan. Six patients were lost to follow-up. The average age of the remaining 25 patients was 43.8 years. The average duration of symptoms prior to surgery was 15 months. Radiography showed spur in 14 cases. All patients had conservative treatment for a minimum of 6 months before surgery, and all had one or two local cortisone injection. The average length for recovery was 3 months. All patients, except for 2, reported fair to excellent results. Level of post-operative satisfaction between fair and excellent was reported by 75% at 3 months, 96% at 6 months and 80% at 3–11 years (average 8 years). The diagnosis of entrapment of the first branch of the lateral plantar nerve can be clinical and could be confirmed by nerve block. Heel spurs should be removed when in very close proximity relation to the first branch of the lateral plantar nerve.