Numbness Above the Inner Ankle: Possible Nerve Compression?

Numbness above the medial ankle?

Hello, Dr.
Gao: Last Thursday, I noticed that the skin about 10 centimeters above my inner ankle to my calf feels numb to the touch, but I do not experience any discomfort (pain or tingling).
I only feel the numbness when I touch it.
I did Pilates that day, but I did not feel any discomfort during the exercise.
Could this be due to some kind of compression in that area?

Niming, 30~39 year old female. Ask Date: 2015/07/20

Dr. Gao Chunde reply Neurology

There is a branch of the saphenous nerve, which is a sensory nerve that branches off from the femoral nerve beneath the adductor magnus muscle on the inner thigh.
Therefore, in addition to numbness or tingling and pain, there should be no weakness symptoms.
If there is weakness when going up and down stairs, it is likely not related to this nerve, but rather an issue with the higher-level femoral nerve or lumbar nerve.
The saphenous nerve may be compressed by muscles or fascia near the inner thigh or the medial aspect of the knee, leading to distal numbness.
You can palpate the area nearby to check for tender points or radiating pain down to the medial aspect of the calf.
Generally, once the compression point is identified, local massage or heat application, while avoiding further activities that may cause compression, can help the nerve function gradually recover on its own.
If you wish to confirm the diagnosis in detail, you may also visit a neurology clinic for further examination.

Reply Date: 2015/07/20

More Info

Numbness above the inner ankle can indeed be indicative of nerve compression, particularly involving the nerves that innervate the lower leg and foot. The area you described, specifically the inner ankle and extending up to the calf, is primarily supplied by the tibial nerve and its branches. Compression or irritation of this nerve can lead to sensory changes, including numbness, tingling, or a loss of sensation in the affected area.

There are several potential causes for nerve compression in this region. One common cause is a condition known as tarsal tunnel syndrome, where the tibial nerve is compressed as it passes through the tarsal tunnel, located behind the inner ankle. This can occur due to swelling, inflammation, or structural abnormalities in the surrounding tissues. Other possible causes of nerve compression include:
1. Injury or Trauma: A direct injury to the ankle or lower leg can lead to swelling or hematoma formation, which may compress the nerve.

2. Repetitive Strain: Activities that involve repetitive motions or prolonged pressure on the ankle can lead to inflammation and subsequent nerve compression.

3. Anatomical Variations: Some individuals may have anatomical variations, such as a prominent bone or abnormal soft tissue structures, that predispose them to nerve compression.

4. Systemic Conditions: Conditions such as diabetes can lead to peripheral neuropathy, which may present as numbness or altered sensation in the extremities.

Given that you mentioned experiencing this numbness after engaging in Pilates, it is possible that certain movements or positions may have placed stress on the ankle or lower leg, leading to temporary nerve compression. However, since you did not experience any discomfort during the exercise, it may indicate that the numbness is not directly related to the activity but could be a result of other factors.

It is important to monitor the symptoms closely. If the numbness persists, worsens, or is accompanied by other symptoms such as pain, weakness, or changes in mobility, it would be advisable to seek medical evaluation. A healthcare professional, such as a neurologist or an orthopedic specialist, can conduct a thorough examination, which may include physical assessments and imaging studies, to determine the underlying cause of the numbness.

In the meantime, consider the following self-care measures:
- Rest: Avoid activities that may exacerbate the symptoms.

- Ice: Applying ice to the area can help reduce any inflammation if present.

- Elevation: Keeping the leg elevated may help alleviate any swelling.

- Gentle Stretching: Engaging in gentle stretching exercises for the calf and ankle may help relieve tension.

In summary, while numbness above the inner ankle could suggest nerve compression, it is essential to evaluate the symptoms in the context of your overall health and activity level. If the numbness continues or is concerning, a professional evaluation will provide clarity and guide appropriate treatment options.

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