The peroneal is one of the major nerves in your leg, and the most common injury symptom is weakness when raising your toes. Treating it depends on the underlying cause, but it can include physiotherapy or surgery.
The common peroneal nerve (also called the common fibular nerve) is one of the two major nerves in your lower leg. This nerve and its branches provide sensation to the tops of your feet and the fronts and sides of your legs. It also allows you to point your toes upward and control muscles in the outer and front parts of your legs.
Read on to learn more about peroneal nerve injuries including causes, risk factors, and treatment options.
A large nerve that originates in your lower spine called the sciatic nerve is responsible for much of the sensation and ability to move muscles in your lower body. Your sciatic nerve has two branches:
- the tibial nerve, the larger branch that runs down the back of your leg and ends in your foot
- the common peroneal nerve, which runs down the back and outer edge of your lower leg, branching off into the superficial peroneal nerve and deep peroneal nerves
A peroneal nerve injury is damage to your common peroneal nerve or its branches. The common peroneal nerve is most vulnerable where it wraps around the top of your fibula. Your fibula is the smaller of the two bones in your lower leg.
Other symptoms of a peroneal nerve injury can include:
- numbness, tingling, or loss of sensation in the top of your foot or outer part of your lower leg
- changes to the way you walk, such as dragging your toes or walking with a higher-than-normal step
- tripping more often than usual due to foot drop
- weakness in foot eversion (rotating your sole outward)
- flopping or slapping sounds when walking
Your common peroneal nerve can be damaged through:
- knee dislocation, with common peroneal nerve injury reported in up to
- direct impact, slicing, or penetration of the nerve
- fracture of your lower leg bones, with common peroneal injury occurring in
1% to 2%of cases
- knee replacement surgery or lateral meniscus repair
- Compression from:
- casts or splint
- habitual leg crossing
- prolonged bed rest
- awkward positioning during surgery
- Complications of conditions such as:
- motor neuron conditions
- anorexia nervosa, from loss of fat under the skin
Peroneal nerve injury during pregnancy
Nerves in your lower body can be damaged during labor from compression or stretching, especially during the pushing phase of childbirth. Nerve injury typically resolves within 6 months, but in rare cases can be permanent.
Peroneal nerve damage can occur when your feet are in stirrups with your knees flexed for prolonged periods. It may also happen when your knees rest against a hard surface such as a bed rail or from squeezing the area around your knee with your hand.
Doctors, physiotherapists, and other healthcare professionals begin the diagnostic process by performing a physical exam and examining your medical history. They may order imaging tests to help find the source of your symptoms such as:
- computed tomography (CT) scans
- magnetic resonance imaging (MRI) or magnetic resonance neurography
They may also order tests to evaluate your nerve function such as:
- Nerve conduction studies: These studies measure how fast electricity moves through your nerves.
- Electromyography: Electromyography measures the electrical activity of your muscles when you’re moving and resting.
Peroneal knee injury after a total knee replacement
Peroneal nerve injury is a potential risk of knee replacement surgery. In a 2020
Your physical therapy program may include:
- strengthening exercises
- mobilization exercises
- manual manipulation
- balancing exercises
- ankle bracing
- ankle taping
You may require surgery if you
- no signs of improvement within
- a rapidly deteriorating lesion
- an open wound with a severed nerve
A physical therapist or other healthcare professional can give you specific exercises to help you recover. The exercises they prescribe depends on the cause of your injury.
For example, they may have you perform exercises using resistance bands where you point your toes upwards against resistance if you have foot drop.
The recovery time for peroneal nerve injury depends on the underlying cause and severity of the injury.
In a 2020
Your common peroneal nerve can get injured due to a sudden injury, from chronic compression, or as a complication of another health condition. The most common symptom is a weakness when raising your toes.
Treatment for peroneal nerve injury depends on the underlying cause. Many people experience symptom relief with physiotherapy. More severe cases may require surgery.