Q:

Anyone doing this? I have a patient with pain/paresthesias in sural nerve distribution. I question compression neuropathy, like meralgia paresthetica, but no obvious cause in her case.

What about performing a sural nerve block under US? My rational is same as a GON or LFCN block. Thoughts?

A:

I’ve done sural nerve and superficial peroneal nerve blocks with varying levels of success. It doesn’t hurt to try.

Temporizing maneuver. What’s the end game?

I agree with trying it though. You may even be able to visualize the location of entrapment with the nerve. I have done ankle blocks with ultrasound for OR cases but it’s generally not worth it. Isolating the sural is easy as you can visualize it as it runs near/along the saphenous vein.

If the end game is to improve functioning and avoid dangerous meds, it is definitively worth a shot… literally and figuratively.

It takes 5 secs to use US so worth it to use if you have an US machine handy.

If responsive to nerve block, maybe next step is pulsed RFA, if perisistent probe, then consider stimwave?

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