Radiofrequency ablation in has been reported in the literature as a treatment option for chronic midfoot pain typically secondary to arthritis. We present a patient who is a United States Marine who was stationed overseas in 2024 when he had a fall from height resulting in the following injuries: L5 compression fracture, second through fourth metatarsal shaft, calcaneus, navicular and medial cuneiform fractures.

The patient was transferred back to the United States for further management. His fractures were non operative and he underwent conservative management. His pain improved over time but 12 months after his injury he was unable to run 3 miles in less than 28 minutes which is required for the USMC Physical Fitness Test. The inability to meet this standard would result in him being separated from the military which the patient did not want. 

When the patient presented in 2025 for management of his chronic pain he had maximized his conservative options like rehab, medications, and orthotics. He underwent a corticosteroid injection of the deep peroneal nerve in the distal tibia which resulted in a greater than 50% improvement in his pain. He was then able to run 3 miles in less than 28 minutes for the first time after his injury. The reduction in his pain lasted for months. 5 months after the steroid injection he went on to have pulsed Radiofrequency ablation of the nerve which has provided him with sustained pain relief. 

The innervation of the midfoot comes from articular branches of the deep peroneal nerve and and the plantar nerves. Arthrodesis is the traditional surgical procedure performed when nonoperative management fails but is a technically demanding procedure that requires prolonged postoperative immobilization and is not uncommonly complicated by nonunion or deep infection. Deep peroneal nerve neurectomy has also been proposed as a surgical alternative to manage this chronic pain. 

To our knowledge this is the first report of radiofrequency ablation of the deep peroneal nerve to manage chronic foot pain. 

As the case report is devoid of patient identifiable information, it is exempt from IRB review requirements as per Defense Health Agency.

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