Peroneal Nerve Compression Neuropathy

What is peroneal nerve compression neuropathy?

The peroneal nerve is one of the main nerves in the lower leg, responsible for sensation on the lateral and posterior surfaces of the lower leg and dorsiflexion of the foot—raising the toes upwards (the ability to stand on the heels). Peroneal nerve compression neuropathy (injury) is the most common condition affecting the lower limb among mononeuropathies, which are disorders affecting a single nerve.

How does peroneal nerve compression neuropathy manifest?

Peroneal mononeuropathy can present with symptoms such as pain, tingling, and sensory disturbances on the outer side of the lower leg. In more severe cases, it can also lead to weakness in foot dorsiflexion (known as “foot drop”—where the patient cannot stand on the heel of the affected foot, causing difficulty walking and frequent stumbling).

In the early stages, nighttime cramps in the lower leg may also occur.

What causes peroneal nerve compression neuropathy?

This condition affects both genders equally. The nerve injury can result from several mechanisms, including direct nerve trauma, nerve stretching, infection, and inflammatory conditions. However, the most common cause is repeated or prolonged nerve compression at the upper outer part of the lower leg:

• The most frequent cause is the habit of sitting with legs crossed (chronic or frequent pressure on the nerve).
• Prolonged forced positions can lead to compression in the nerve area.
• Nerve stretching injuries may occur in dancers.
• A tightly applied plaster cast or high boots may cause external nerve compression.
• Knee joint trauma, including ligament injuries and fibula fractures, may lead to nerve damage.
• Individuals with a thin physique have an increased risk since they have less protective fatty tissue around the nerve.
• Rarely, nerve compression may be caused by bone growth or tumors in the nerve region.

How is peroneal nerve compression neuropathy diagnosed?

Diagnosis is based on patient symptoms, clinical examination, and additional diagnostic tests, including:

• Electromyography (EMG) and nerve conduction studies – used to pinpoint the exact location and severity of the nerve damage.
• Magnetic resonance imaging (MRI) – helps determine whether adjacent tissues, such as a tumor or inflammation, are compressing the nerve.
• Ultrasound – an alternative to MRI that can help assess soft tissue compression on the nerve.

If you or a loved one has confirmed or suspected peroneal neuropathy, consulting a neurosurgeon is necessary.

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