Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Regional Anesthesia: Transforming Foot Surgery Recovery

The experience of foot and ankle surgery has changed dramatically with the widespread adoption of regional nerve blocks — techniques that use local anesthetic to block nerve sensation specifically in the foot and ankle without requiring general anesthesia. For patients, regional blocks mean waking from surgery with little or no pain, reduced narcotic requirements, and better early recovery. At Balance Foot and Ankle in Howell and Bloomfield Township, Michigan, we coordinate closely with anesthesiology for regional anesthetic planning in patients undergoing foot and ankle surgery to optimize their postoperative comfort.

Types of Nerve Blocks Used for Foot Surgery

Popliteal sciatic nerve block: performed behind the knee (popliteal fossa) where the sciatic nerve is accessible before it divides into the tibial and common peroneal branches. This single injection (guided by ultrasound for precision) blocks sensation to almost the entire foot and ankle for 12-18 hours. This is the most commonly used block for foot and ankle surgery and provides the most complete postoperative analgesia. Ankle block: injection of local anesthetic around the five nerves that supply the foot at the ankle level (sural, superficial peroneal, deep peroneal, saphenous, and posterior tibial nerves) — provides complete foot anesthesia below the ankle. Used for procedures confined to the foot when the leg above the ankle doesn’t need to be blocked.

What the Block Experience Is Like

Regional blocks are typically performed in a pre-operative block suite 30-60 minutes before surgery. The anesthesiologist places an IV for sedation, and a small amount of sedation is given to make the block placement comfortable — patients are relaxed but awake. Using ultrasound guidance, a needle is positioned precisely near the target nerve, and local anesthetic is injected around the nerve. The foot and ankle feel progressively numb and heavy over 15-30 minutes — a sensation patients often describe as “the leg falling asleep.” Surgery is then performed without pain. After surgery, patients wake without pain in the operative foot — the block can last 12-24 hours depending on the anesthetic used.

After the Block Wears Off

The period when the block wears off — typically 12-18 hours after surgery — is when postoperative pain is usually at its worst. Adequate oral pain medication taken proactively before the block begins to fade (rather than waiting until pain develops) significantly smooths this transition. The surgeon and anesthesiologist will provide specific instructions for when to take oral pain medications relative to expected block duration. For extended analgesia: some centers place a perineural catheter (a small tube that delivers local anesthetic continuously for 48-72 hours) for expected high-pain procedures like calcaneal fracture repair or complex hindfoot reconstruction. Contact Balance Foot and Ankle at (810) 206-1402 for a surgical consultation that includes discussion of your regional anesthetic options and postoperative pain management plan.

Foot or Ankle Pain? We Can Help.

Balance Foot & Ankle — Howell & Bloomfield Township, MI

📅 Book Online
📞 (810) 206-1402

What to Expect from Nerve Blocks for Foot Surgery

Nerve blocks are a safe and effective way to manage pain during and after foot and ankle surgery. At Balance Foot & Ankle, Dr. Tom Biernacki uses nerve block techniques to provide targeted pain control, reduce the need for opioid medications, and accelerate your post-surgical recovery.

Learn About Our Surgical Treatment Options | Book Your Appointment | Call (810) 206-1402

Clinical References

1. Hadzic A, Arliss J, Kerimoglu B, et al. A comparison of infraclavicular nerve block versus general anesthesia for hand and wrist day-case surgeries. Anesthesiology. 2004;101(1):127-132.
2. Singelyn FJ, Gouverneur JM, Gribomont BF. Popliteal sciatic nerve block aided by a nerve stimulator: a reliable technique for foot and ankle surgery. Reg Anesth. 1991;16(5):278-281.
3. Ilfeld BM. Continuous peripheral nerve blocks: an update of the published evidence and comparison with novel, alternative analgesic modalities. Anesth Analg. 2017;124(1):308-335.

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.