Fibular (peroneal) nerve neuropathy
The peroneal nerve (n. Fibularis or n. Peroneus) is a nerve that is mixed in functions (it is also responsible for movement and sensitivity). The peroneal nerve is one of the two main branches of the sciatic nerve and consists mainly of the fibers L4, L5, and S1-spinal nerves.
The motor fibers of the peroneal nerve innervate mainly the extensor muscles of the foot, the extensors of the fingers, and the muscles that rotate the foot outward. Sensory fibers of the peroneal nerve innervate the skin of the outer surface of the lower leg and the dorsum of the foot and toes.
Diagnostics of the neuropathy of the peroneal nerve
When diagnosing a lesion of the peroneal nerve (Fibular (peroneal) nerve neuropathy), it is impossible to extend (dorsal flexion) of the foot and fingers, as well as turn the foot outward. The Achilles reflex (from the tibial nerve) is preserved.
Sensory disorders in neuritis of the peroneal nerve occur on the outer surface of the lower leg and dorsum of the foot. The joint-muscular feeling in the fingers is not disturbed (due to the preservation of sensitivity from the tibial nerve). Pain with neuritis of the peroneal nerve is usually significant or absent, the same applies to trophic disorders.
The foot in the case of neuritis of the peroneal nerve hangs down, slightly turned inward, the fingers are slightly bent. Emaciation of the muscles on the antero-outer surface of the lower leg is noticeable. The patient's gait with neuritis of the peroneal nerve becomes very typical ("peroneal, cockerel", "step"): the patient, in order not to touch the floor with the toe of the hanging foot, raises his leg high and first steps with his toe, then the outer edge of the foot and, finally, the sole.
There are the following basic tests for peroneal neuritis:
- The extension (dorsiflexion) and outward rotation of the foot, as well as extension of the fingers, are impossible
- Unable to stand on heels and walk on heels
Treatment of neuropathy of the peroneal nerve
Treatment for neuritis of the peroneal nerve is selected individually in each case. It includes a set of conservative procedures:
- nerve and muscle stimulation
- vitamins of group "B", "C" and "E"
- antiviral drugs
- homeopathic remedies
- surgical treatment (neurolysis, stitching of the nerve trunk, etc.)
Elimination of paresthesias and pain, restoration of the range of motion in the joints and muscles of the leg and foot with neuritis of the peroneal nerve is accelerated with the use of physiotherapy. We use TENS for neurostimulation of the peroneal nerve.
The TENS procedure also contributes to the simultaneous stimulation of the patient's calf muscles.