Small sensory nerves around the ankle and foot can become a source of persistent pain, often after injury or surgery. Targeting these nerves aims to reduce your pain, though individual results vary. There are several treatment options, used only as far as needed:

• Local anaesthetic: numbs the nerve immediately, helping confirm it as a source of your pain.
• Pulsed radiofrequency (pulsed RF): short bursts of energy that calm the nerve without destroying it, aiming for relief lasting weeks to months.

This procedure may help if you have:

• Persistent ankle or foot pain in a specific nerve distribution
• Pain following prior injury, surgery, or scarring in the area
• Not had lasting relief from physiotherapy, footwear changes, or medication

It isn't possible to guarantee how any individual will respond. As a general guide:

• Local anaesthetic: works within minutes and wears off after a few hours.
• Pulsed RF: effect usually begins after a couple of weeks and may last for a few months.

This procedure is generally considered safe when performed under X-ray guidance, though as with any medical procedure benefit cannot be guaranteed and complications rarely occur. Pulsed RF modulates the nerve rather than destroying it.

Common, minor effects:

• Temporary soreness or bruising at the injection site
• Brief flare of your usual pain before it settles

Rare, more serious risks:

• Infection or bleeding at the injection site
• Nerve injury, which may rarely be permanent
• Allergic reaction to the local anaesthetic or contrast dye
• Serious sedation or anaesthetic complications, very rarely including stroke or death
• No improvement in pain, or relief that doesn't last

• Tell us about any blood-thinning medication (e.g. warfarin, Xarelto, Plavix) well in advance — special arrangements may be needed and you may be asked to pause these under guidance
• Tell us if you are, or might be, pregnant — this procedure uses X-ray guidance
• Tell us about any allergies, including to contrast dye, local anaesthetics, or reactions to previous injections or anaesthesia
• You will usually be asked to fast for 6 hours beforehand if sedation is planned
• Bring a list of your current medications
• Arrange for someone to drive you home afterwards

• The skin over the treatment area is cleaned with antiseptic
• Local anaesthetic numbs the skin before the main needle is placed
• Live X-ray (fluoroscopy) guides the needle precisely to each target
• The procedure usually takes 15-30 minutes

• You will be monitored briefly in recovery before going home
• Some soreness at the injection sites is common for 1-3 days — simple pain relief (e.g. paracetamol) usually helps
• You may remove the small dressing after 24 hours, keeping the area clean and dry
• Avoid strenuous activity or heavy lifting for 24-48 hours
• If you were sedated, avoid driving, operating machinery, or making important legal or financial decisions for 24 hours
• Continue your regular medications unless specifically advised otherwise

Contact your GP, Total Pain Clinic, or your nearest Emergency Department if you notice:

• Increasing redness, warmth, swelling, or discharge at the injection site
• Fever or feeling generally unwell
• Worsening numbness or weakness in the foot
• Severe pain not settling with simple pain relief

A review appointment is usually arranged 2-4 weeks after your procedure to discuss how you responded and plan next steps — please call Total Pain Clinic reception to schedule this if it hasn't already been arranged. Please ask your doctor any questions before you proceed; you will be asked to sign a consent form if you agree to go ahead.