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Soleal Sling Syndrome: A Narrative Review
Laura Hilbig-Vlatten1, Jennifer N Grauberger2, Toni F Engmann1
1Division of Orthoplastic and Reconstructive Microsurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Journal of the Peripheral Nervous System : JPNS
|May 20, 2025
Summary
Soleal sling syndrome, a rare neuropathy, causes calf pain and foot numbness due to tibial nerve compression. Surgical decompression offers definitive treatment for this underrecognized condition.
Area of Science:
- Neurology
- Orthopedic Surgery
- Anatomy
Background:
- Soleal sling syndrome is an uncommon cause of lower extremity neuropathy.
- It results from proximal tibial nerve compression under the soleus muscle's fibromuscular arch.
- Symptoms include plantar numbness, calf pain, and potential toe flexor weakness.
Purpose of the Study:
- To review the clinical presentation, diagnostic methods, and treatment of soleal sling syndrome.
- To emphasize its importance in differential diagnosis for calf pain and plantar foot neurosensory changes.
Main Methods:
- A comprehensive literature review of the PubMed database up to August 30, 2022.
- Gathering clinical, anatomical, and radiographic findings related to soleal sling syndrome.
Main Results:
- Key features include calf pain, tenderness, and plantar foot sensory changes.
- Diagnosis relies on clinical examination (e.g., positive Tinel's sign), with variable imaging utility.
- Radiological imaging can exclude other causes but is inconsistent for idiopathic soleal sling syndrome.
Conclusions:
- Soleal sling syndrome is underrecognized and can mimic other conditions.
- Surgical nerve decompression is the definitive treatment for tibial nerve compression in this syndrome.
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