Common peroneal nerve dysfunction is damage to the peroneal nerve leading to loss of movement or sensation in the foot and leg.
Causes
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 implies there is a local cause of the nerve damage, although certain bodywide conditions may also cause isolated nerve injuries.
Damage to the nerve destroys the covering of the nerve cells (the myelinmyelin sheath) or causes degeneration of the entire nerve cell. There is a loss of sensation, muscle control, muscle tone, and eventual loss of muscle mass because of lack of nervous stimulation to the muscles.
Common causes of damage to the peroneal nerve include the following:
•Trauma or injury to the knee
•Persistent use of Cold Therapy Machines or other forms of Cold Therapy on the knee area
•Fracture of the fibula (a bone of the lower leg)
•Use of a tight plaster cast (or other long-term constriction) of the lower leg
•Pressure to the knee from positions during deep sleep or coma
•Injury during knee surgery.
People who are extremely thin or emaciated (for example, from anorexia nervosa) have a higher-than-normal risk of common peroneal nerve injury. Conditions such as diabetic neuropathy or polyarteritis nodosa, as well as exposure to certain toxins, can also cause damage to the common peroneal nerve.
Symptoms
•Decreased sensation, numbness or tingling in the top of the foot or the outer part of the upper or lower leg
•Weakness of the ankles or feet
•Walking abnormalities
•”Slapping” gait (walking pattern in which each step taken makes a slapping noise)
•Foot drop (unable to hold foot horizontal)
•Toes drag while walking
Exams and Tests
Examination of the legs may show a loss of muscle control over the legs (usually the lower legs) and feet. The foot or leg muscles may atrophy (lose mass). There is difficulty with dorsiflexion (lifting up the foot and toes) and with eversion (toe-out movements).
Muscle biopsy or a nerve biopsy may confirm the disorder, but they are rarely necessary.
Tests of nerve activity include:
•EMG (electromyography, a test of electrical activity in muscles)
•Nerve conduction tests
•MRI to look for compressive lesion along nerve
Other tests are determined by the suspected cause of the nerve dysfunction, based on the person’s history, symptoms, and pattern of symptom development. They may include various blood tests, x-rays, scans, or other tests and procedures.
Treatment
Treatment is aimed at maximizing mobility and independence. Any illness or other source of inflammation that is causing the neuropathy should be treated.
If there is no history of trauma to the area, the condition developed suddenly with minimal sensation changes and no difficulty in movement, and there is no test evidence of nerve axon degeneration, then a conservative treatment plan will probably be recommended.
Corticosteroids injected into the area may reduce swelling and pressure on the nerve in some cases.
Surgery may be required if the disorder is persistent or symptoms are worsening, if there is difficulty with movement, or if there is evidence on testing that the nerve axon is degenerating. Surgical decompression of the area may reduce symptoms if the disorder is caused by pressure on the nerve. Surgical removal of tumors or other conditions that press on the nerve may be of benefit.
Over-the-counter or prescription analgesics may be needed to control pain. Other medications may be used to reduce the stabbing pains that some people experience, including gabapentin, carbamazepine, or tricyclic antidepressants such as amitriptyline. Whenever possible, medication use should be avoided or minimized to reduce the risk of side effects.
If pain is severe, a pain specialist should be consulted so that all options for pain treatment are explored.
Physical therapy exercises may be appropriate for some people to maintain muscle strength.
Orthopedic assistance may maximize the ability to walk and prevents contractures. This may include use of braces, splints, orthopedic shoes, or other equipment.
Vocational counseling, occupational therapy, or similar intervention may be recommended to help maximize mobility and independence.
Outlook (Prognosis)
The outcome depends on the underlying cause. Successful treatment of the underlying cause may resolve the dysfunction, although it may take several months for the nerve to grow back. If nerve damage is severe, disability may be permanent. The nerve pain may be quite uncomfortable.
Possible Complications
•Decreased ability to walk
•Permanent decrease in sensation in the legs or feet
•Permanent weakness or paralysis in the legs or feet
•Side effects of medication
When to Contact a Medical Professional
Call your health care provider if you have symptoms that indicate common peroneal nerve dysfunction.
Prevention
Avoid prolonged use of Cold Therapy machines or devices which cool the knee area. Use of Cold Therapy devices should be limited to periods of less than 30 minutes at a time. Avoid prolonged pressure to the back or side of the knee. Injuries to the leg or knee should be treated promptly.
If a cast, splint, dressing, or other possible constriction of the lower leg causes a tight feeling or numbness, notify your health care provider.
Alternative Names
Neuropathy – common peroneal nerve; Peroneal nerve injury; Peroneal nerve palsy
Cold Therapy Attorney
Cold therapy lawsuits are being filed by lawyers representing victims injured by these defective products. Cold therapy lawsuits claim that the cold therapy machines were defective in their design by not having adequate safety mechanisms to prevent injury. Cold machine lawsuits also claim these devices fail to adequately warn consumers of the risks involved with extended or prolonged use of their product.
Poorly designed cold therapy machines can cause permanent nerve damage, skin & tissue damage (frost bite) and numerious other serious side effects. Seek immediate medical attention if you are suffering an emergency situation.
If you or someone you know has been severely injured as a result of cold therapy, ice machines, recirculating ice coolers, crynotherapy or other forms of cold treatment, talk to a Cold Therapy Attorney at the Willis Law Firm in Houston for legal advice about a potential cold therapy – cryotherapy lawsuit. Please fill out the Free Case Evaluation at the right or call us toll-free at 1-800-883-9858.
