There are several painful areas in the ankle. There can be various causes, but today I will explain about pain due to nerves. It's called tarsal tunnel syndrome. The main symptoms are when the ankle is like this, the outward movement is slightly weakened, there is a decrease in sensation on the top of the foot and toes, the symptoms worsen when walking, running, or squatting, and when pressure is applied during wearing tight shoes, the symptoms occur. If the diagnosis is delayed and not treated properly, nerve damage can occur, leading to numbness or other issues. Therefore, it is important to receive a prompt diagnosis and treatment. I will also explain how to perform a self-examination at home. If the front of the ankle, the top of the foot, or the front or outer side of the shin hurts, when examined, if this is detected, you should suspect it and visit the hospital.

If you tap the middle or lower third of your shin like this, it can hurt there. Specifically, the area between the middle part of the knee and ankle, divided into three parts from the middle to the bottom, around the lower third point, where a nerve comes out. By tapping around with your hand, you can find a tingling area. If pressing here causes pain or tingling, it could be suspected as tibial nerve entrapment syndrome. Another thing is, if you stretch your foot out and then rotate it while extended, and it hurts at that moment, you could be ignoring plantar fasciitis. Next, if pressing on the fourth toe causes pain, it's because the nerve passes through that area towards the fourth toe. When you hold the foot like this and pull the toe a bit more while stretching, some people feel pain due to the nerve stretching downward.

They might think, Oh, this is bothering me from above, and this is pressing on the outside of the peach bone with their hand, pushing it down while turning it. I will show this in more detail in the video. If it hurts when I do this test, there may be some suspicion, so it is recommended to visit a hospital. At the hospital, various tests such as X-rays, MRI, and ultrasound are conducted to check for nerve problems, whether there are any nerve entrapments, varicose veins, fractures, or other muscle or fascia issues. In cases of nerve problems, nerve conduction tests can be performed for confirmation. Sometimes, diagnostic injections are also administered. After conducting several tests, if it seems like there is an issue with the median nerve, then confirmation is necessary. The easiest way is to apply a local anesthetic to that area, just a small amount where the nerve passes.

When the pain disappears, then it can be diagnosed as the initial entrapment neuropathy. After receiving this diagnosis, treatment must be done because if the diagnosis and treatment are delayed, permanent nerve damage can occur. Therefore, early diagnosis and treatment are crucial. Once diagnosed, what kind of treatment is done? It's not all surgery, but initially, injection therapy is done. Injection therapy, manual therapy, steroid injections can reduce swelling in the trapped area and reduce inflammation. Nerve prolotherapy or nerve entrapment management examination uses low-concentration dextrose to expand the fascia around the nerve. This is entrapment neuropathy, right? It means something is compressed, and the injection is to widen the space and relieve the compression. That's how you can think of it.

In the case of steroid injections, they cannot be administered frequently due to side effects. However, nerve prolotherapy or nerve entrapment injection treatments have minimal side effects, so you can undergo treatment multiple times without worry. Manual therapy relaxes the tense parts of the nerves and muscles, but it can be done at home as self-rehabilitation therapy. If conservative treatments like injection therapy or manual therapy have been done for three months without improvement and the pain persists, surgical treatment may be considered. Although not common, surgery can lead to dramatic improvement, so it is necessary to undergo treatment. I will explain self-rehabilitation methods and diagnostic techniques later. One self-diagnostic method is to first examine the leg, focusing on the halfway point of the thigh area, about one-third from the bottom.

I get nervous in between the fingers when I touch them. You can feel the bones in the front, and if you go sideways along the front bone, there is a sunken area. Try tapping the area where the metatarsal bone enters with your hand. If you feel a tingling sensation and an electric shock down to the top of your foot, you may have a suspicion. Another one is the coccyx bone. Press the front like this, then pull your foot forward and rotate it inward against the pressure. When you pull it forward again and rotate it inward, it causes pain. Still, you may have a suspicion. Another one is to grab and pull the fourth toe while pulling the foot. If it hurts or tingles, you may suspect Baxter's neuropathy. If you have been diagnosed in this way, you can try self-manual therapy. As mentioned earlier, the nerve.

During muscle contraction, nerves can get caught between the muscles. Releasing them is simply a matter of loosening this area. So, the way to do it is the simplest way, just by massaging. When you massage, do it in one direction, mainly from bottom to top. Grab and massage like this, not pressing too hard, just enough to slightly compress the skin from the bottom. Of course, applying massage cream or lotion can make it smoother. Press and pull slowly, maintaining a speed of about 1cm per second, don't press too hard, just grab and slowly move from here to here for about 30 seconds. This is one method, and another is to use a tool like this. You can purchase massage bars like this at health stores. If you press too hard, it can bruise, so gently massage up to this point.

As you do it, you may feel a sense of tension at the exact point where the nerve is caught. You only need to do this about three times. When you do this, you can feel the symptoms improving as the muscles relax. Another thing is, when you tapped earlier and felt a tingling sensation, that's where the nerve is caught. Grab that exact spot, lift your foot in at first, pull, twist, press, pull, twist, do this about 10 times. Even if you do this twice a day, you can see good effects. If it's difficult to press and twist here, you can use a tool like this, apply lotion, and swipe it from bottom to top. You can see the effects of muscle and nerve relaxation. Today, I talked about tarsal tunnel syndrome for those with pain in the front of the ankle, pain on the instep, and pain on the outside of the calf. That's it for today's video help.

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