I have lower my head and confess that I used to be confused about the peroneal nerve: today’s mesh problem. Okay, I thought it affected the perineum. You know what they say about making assumptions, right? Makes an ass out of “u” and “me.” Okay, here’s the truth: the pudendal nerve serves the perineum and the peroneal nerve served the lower, outer leg and foot but, that’s not completely true any more. In 1998 scientists decided to change the name of the nerve to the fibular nerve and thought that should clear things up, right? Well, no. The scientists didn’t count on all the old doctors who were forgetting the new name and still calling it the peroneal nerve. For today’s blog, I’ll call it the fibular nerve.
Isn’t that what this blog is all about? Taking a close look at confusing and contradictory things that the medical profession says and sorting them out a bit so you can know what to do next?
Your common fibular nerve is a division of your sciatic nerve which travels near the outside of your biceps muscle to the outer side of your knee and then branches to the side of you lower leg before entering your toes. The nerve gives off branches along its way. The nerve can be injured at any level during surgery, or due to trauma or stretching.
In most cases, fibular nerve neuropathy, or fibular neuropathy, causes weakness in your ankle, trouble when you try to lift up your toes (dorsiflexion) as well as “foot drop.” Fibular nerve problems can create changes in sensation and movement to the outside surface of your foot and ankle as well as your outer three toes. One woman with fibular sensory changes said she felt like there was a blanket over the bottom of her leg all the time.
Fibular neuropathy is often misdiagnosed as sciatica, other nerve problems or systemic diseases. The most common injury causing fibular neuropathy is trauma, stretching, or compression at the top of your fibula (lower leg bone).
Diagnosing fibular nerve damage includes carefully listening to your description of your symptoms, discussion of your past medical problems, and physical and neurological exams. Xray and MRI help narrow down the diagnosis but the most reliable diagnostic tool is the electromyogram because specific techniques can be used to determine how much recovery can be predicted for your particular injury.
Although there are many causes of Foot Drop, fibular nerve injury is the most frequent. Footdrop is not itself a disease, but a symptom. Walking is a challenge with footdrop because you can’t control your ankle and you may develop a high-stepping gait in order to compensate. Some causes of footdrop are compression from a disc herniation, trauma to the sciatic nerve, bone fractures, crush-type injures, lacerations, among many others.
• Decreased sensation, numbness, or tingling in the top of your foot or the outer part of your upper or lower leg
• Foot that drops (unable to hold your foot up)
• “Slapping” gait (walking pattern in which each step makes a slapping noise)
• Toes drag while walking
• Walking problems
• Weakness of the ankles or feet
Treatment is determined by the cause of the fibular neuropathy. It is is due to compression, relief of the compression may involve surgery. Strengthening exercises can help improve function, stretching to maintain your ability to move your ankle in all directions can limit contractures. Orthotics, including a lateral wedge shoe insert can help. More complex surgeries include neurolysis, nerve repair and nerve and tendon transfers.
Peggy Day is working on a book to combine all these stories. This is an excerpt from Pelvis in Flames: Your Pelvic Mesh Owner’s Guide. Your input is welcome to help make Pelvis in Flames the book you need to read.
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