Common peroneal nerve dysfunction
Common peroneal nerve dysfunction is damage to the peroneal nerve leading to loss of movement or sensation in the foot and leg.
Neuropathy - common peroneal nerve; Peroneal nerve injury; Peroneal nerve palsy
Causes, incidence, and risk factors
The peroneal nerve is a branch of the sciatic nerve, which supplies movement and sensation to the lower leg, foot and toes. Common peroneal nerve dysfunction is a type of peripheral neuropathy
(damage to nerves outside the brain or spinal cord). This condition can affect people of any age.
Dysfunction of a single nerve, such as the common peroneal nerve, is called a mononeuropathy
. Mononeuropathy means the nerve damage occurred in one area. However, certain bodywide conditions may also cause single nerve injuries.
Damage to the nerve destroys the myelin
sheath that covers the axon (branch of the nerve cell). Or it may destroy the whole nerve cell. There is a loss of feeling, muscle control, muscle tone, and eventual loss of muscle mass because the nerves aren't stimulating the muscles.
Common causes of damage to the peroneal nerve include the following:
Common peroneal nerve injury is more common in people:
Charcot-Marie-Tooth disease is an inherited disorder that affects all of the nerves. Perineal nerve dysfunction occurs early in this disorder.
- Decreased sensation
, numbness, or tingling in the top of the foot or the outer part of the upper or lower leg
- Foot that drops (unable to hold the foot straight across)
- "Slapping" gait (walking pattern in which each step makes a slapping noise)
- Toes drag while walking
- Walking problems
of the ankles or feet
Signs and tests
Examination of the legs may show:
or a nerve biopsy
may confirm the disorder, but they are rarely needed.
Tests of nerve activity include:
What other tests are done depend on the suspected cause of nerve dysfunction, and the person's symptoms and how they developed. Tests may include blood tests, x-rays
Treatment aims to improve mobility and independence. Any illness or other cause of the neuropathy should be treated.
Corticosteroids injected into the area may reduce swelling
and pressure on the nerve in some cases.
You may need surgery if:
The disorder does not go away
You have problems with movement
There is evidence that the nerve axon is damaged
Surgery to relieve pressure on the nerve may reduce symptoms if the disorder is caused by pressure on the nerve. Surgery to remove tumors on the nerve may also help.
You may need over-the-counter or prescription pain relievers to control pain. Other medications may be used to reduce pain include gabapentin, carbamazepine, or tricyclic antidepressants such as amitriptyline. Whenever possible, avoid or limit the use of medication to reduce the risk of side effects.
If your pain is severe, a pain specialist can help you explore all options for pain relief.
Physical therapy exercises may help you maintain muscle strength.
Orthopedic devices may improve your ability to walk and prevent contractures
. These may include braces, splints
, orthopedic shoes, or other equipment.
Vocational counseling, occupational therapy, or similar programs may help you maximize your mobility and independence.
The outcome depends on the cause of the problem. Successfully treating the cause may relieve the dysfunction, although it may take several months for the nerve to grow back.
However, if nerve damage is severe, disability may be permanent. The nerve pain
may be very uncomfortable. This disorder does NOT usually shorten a person's expected lifespan.
Calling your health care provider
Call your health care provider if you have symptoms of common peroneal nerve dysfunction.
Avoid putting long-term pressure ono the back or side of the knee. Treat injuries to the leg or knee right away.
If a cast, splint, dressing, or other pressure on the lower leg causes a tight feeling or numbness, call your health care provider.
King JC. Peroneal neuropathy. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal disorders, pain and rehabilitation.. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 66.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by Luc Jasmin, MD, PhD, Departments of Anatomy and Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.