Peroneal Neuropathy
The peroneal nerve branches from the sciatic nerve and runs along the outer part of the lower leg. It plays a critical role in controlling the muscles that lift the foot and toes, and it provides sensation to the lower leg and foot. Peroneal neuropathy occurs when the peroneal nerve becomes compressed, injured, or inflamed. The condition can lead to weakness, difficulty with movement, numbness or tingling, or pain; foot drop can also occur, particularly in the lower leg, foot, or toes).
Even with physical therapy, peroneal neuropathy can significantly impact ambulation and daily activities. Advancements in nonsurgical medicine, however, offer innovative solutions for relief and recovery.
What causes Peroneal Neuropathy?
Identifying the root causes of a patient’s condition is essential for effective treatment and relief. Several factors can contribute to peroneal neuropathy, including:
- Prolonged pressure on the peroneal nerve, often from crossing legs, wearing tight casts, or sitting in certain positions
- Fractures, dislocations, or blunt force injuries around the knee
- Excessive movement of the fibula during ambulation that creates friction on the nerve (secondary to generalized hypermobility or a localized issue with overstretched ligaments)
- Overuse from sports or physical activities
- Diabetes, nerve disorders, or vascular conditions that impact nerve health
- Nerve damage following surgeries near the knee or lower leg
- Scar tissue compressing the nerve following surgical decompression of the peroneal nerve at the fibular head
Symptoms of Peroneal Neuropathy
Although they may vary in severity, common symptoms include:
- Weakness in the foot or ankle, leading to a “foot drop” gait
- Tingling, numbness, or burning sensations in the lower leg or top of the foot
- Sharp or aching pain along the outer knee or leg
- Difficulty lifting the foot or toes, especially while walking
- Muscle atrophy in the shin or foot over time if untreated
Seeking timely professional care is vital to prevent further complications as these symptoms can significantly impact daily activities and overall well-being.
Diagnosing Peroneal Neuropathy
Diagnosing typically begins with a thorough medical evaluation which includes the following steps:
- Taking a complete patient history to understand symptoms, lifestyle, and any previous injuries
- Conducting a thorough physical examination to assess strength, sensation, lumbar involvement, knee function
- Conducting a thorough neurological exam of the lower extremities
- Nerve conduction studies (NCS) and electromyography (EMG) to assess nerve and muscle activity and pinpoint the location and extent of nerve damage
- The potential use of advanced imaging techniques such as MRI to rule-out potentially contributing nerve compression or structural issues in the lumbar spine
- Dynamic musculoskeletal ultrasound to determine if the peroneal nerve is rubbing or moving excessively during active knee flexion and extension
- this test can also reveal enlargement of the nerve, scarring, or fluid surrounding the nerve
Determining the origins of a patient’s peroneal neuropathy is a necessary part of the diagnostic process, allowing us to tailor preventive and therapeutic strategies to meet each individual’s needs.
Nonsurgical Treatment for Peroneal Neuropathy
The Orthohealing Center offers the advanced, nonsurgical treatments below to target the root causes of peroneal neuropathy and promote natural healing.
- Platelet lysate or alpha 2 macroglobulin (A2M): these processes use the patient’s own growth factors and proteins to reduce inflammation and stimulate tissue repair
- MFAT: the stroma fibers and mesenchymal stem cells present in fat are used to support the health and reduce symptoms associated with damaged tissue and nerve
- Shockwave therapy: a powerful tool designed to break-up scar tissue, this noninvasive technology is used to stimulate circulation
- Nerve hydrodissection therapy: a minimally invasive technique that uses fluid to separate and relieve compressed nerves
By customizing innovative treatment plans to each patient’s unique needs, we aim to restore function, alleviate pain, and enhance quality of life, without the risks associated with surgery.
