Neuropathy of the peroneal nerve: causes and consequences

The nervous system is a complex complex in the human body. It consists of the brain and spinal cord, as well as numerous branches. The latter provide instantaneous exchange of impulses throughout the body. Violation of the work of one nerve practically does not affect the functioning of the whole network. However, this may lead to a deterioration in the performance of individual parts of the body.

Neuropathy is a disease characterized by non-inflammatory nerve damage. Its development can contribute to degenerative processes, trauma or compression. The main target of the pathological process is usually the lower extremities.

The so-called neuropathy of the legs is divided into the following varieties:

• Pathology of the peroneal nerve;
• Tibial nerve;
• Sensory.

Each of the forms of the disease is of great interest to doctors. Among all peripheral pathologies, the neuropathy of the peroneal nerve takes a special place. It is about her speech and will go further in the article.

Description of the disease

Under the neuropathy of the peroneal nerve is understood a pathological disorder, accompanied by a syndrome of the hanging foot. In specialized literature, you can find another name for this disease - peroneal neuropathy.

Since the peroneal nerve consists of thick fibers with an impressive layer of myelin sheath, it is more susceptible to metabolic disturbances. Most likely, this very moment determines the prevalence of the disease. According to available information, manifestations of pathological process are noted in 60% of patients of traumatology departments, and only in 30% of cases it is associated with primary nerve damage.

Next, consider the anatomical features of the structure described in the article. This is necessary to understand why the neuropathy of the peroneal nerve develops (ICD-10 appropriated the disease code G57.8).

Anatomic Help

The fibular nerve departs from the sciatic at the level of the lower third of the thigh. Its structure is represented by various fibers. At the level of popliteal fossa, these elements are separated into the common peroneal nerve. He spirals around the head of the same name bone. At this point, the nerve lies on the surface and is covered only by the skin, because of which any external factors can exert pressure on it.

Then the peroneal nerve is divided into two branches: superficial and deep. These elements are called by their direction. The superficial branch is responsible for the innervation of the muscular structures, the rotation of the foot and the sensitivity of its rear part. The deep peroneal nerve provides extension of the fingers, as well as a feeling of pain and touch in this area.

Depression of one or another branch is accompanied by a violation of sensitivity in various areas of the foot, the inability to unravel the phalanges. Therefore, the symptoms of neuropathy can vary depending on which department of the structure is damaged. In some cases, knowledge of its anatomical features allows you to determine the extent of the pathological process before calling a doctor.

The main causes of the disease

The development of the pathological process can be caused by a variety of factors. Among them, physicians distinguish the following:

• Nerve compression in any part of it. This is the so-called tunneling neuropathy of the peroneal nerve. It is divided into two groups. The upper syndrome develops against the background of pressure on the structures in the vascular bundle. The disease is most often diagnosed in people whose work is associated with a prolonged stay in an uncomfortable position. These are pickers of berries, parquet layers, seamstresses. The lower tunnel syndrome develops as a result of compression of the deep peroneal nerve in the zone of its exit to the foot. This clinical picture is typical for people who prefer uncomfortable shoes.
• Disturbance of blood supply to the extremities.
• Incorrect position of the legs due to prolonged operation or severe condition of the patient, accompanied by immobilization.
• It enters the nerve fibers with intramuscular injection in the gluteal region.
• Severe infectious diseases.
• Injuries (a fracture of the tibia, dislocations of the foot, damage to the tendons, sprain). As a result of a severe bruise, there is swelling. It leads to compression of the nerve and impairment of the conductivity of the impulses. A distinctive feature of this form of the disease is the defeat of only one limb. Otherwise, it is called posttraumatic neuropathy of the peroneal nerve.
• Oncological lesions with metastasis.
• Toxic pathologies (diabetes, kidney failure).
• Systemic diseases characterized by proliferation of connective tissue (osteoarthritis, gout, rheumatoid arthritis).

All the causes of the development of the pathological process can be classified into five areas: trauma, compression, vascular disorders, infectious and toxic lesions. Regardless of which group of triggers the neuropathy of the peroneal nerve is, the ICD-10 code for this disease is G57.8.

What symptoms are accompanied by ailment?

Clinical manifestations of the disease depend on the degree of neglect of the pathological process and the site of nerve damage. All symptoms can be divided into basic and accompanying. The first group includes a sensitivity disorder in the affected limb. The attendant signs can vary in each particular case. However, most often patients complain about:

• Swelling in the legs;
• Periodic sensation of "goosebumps";
• Spasms and convulsions;
• Discomfort when walking.

A little higher, it was noted that the clinical picture of the disease also depends on the site of nerve damage. For example, the defeat of the common trunk is manifested by a violation of the process of extension of the foot. Because of this, it begins to hang down. The patient is forced to constantly bend his leg in the knee when walking, so as not to catch the foot on the floor. When it is lowered, it first becomes on the fingers, then transfers weight to the lateral plantar margin and only then lowers the heel. This manner of movement is reminiscent of a cock or horse, and therefore has similar names.

Motor disorders are combined with sensory disorders. Patients often note the appearance of pains on the outer surface of the shin, which only increase with squats. Over time, the affected area develops muscle atrophy. Such a sign of the disease is clearly distinguishable, especially when compared to a healthy limb.

What has the neuropathy of the peroneal nerve symptoms in the defeat of the deep branch? In this case, the hanging of the foot is less pronounced. However, sensory and motor disturbances are also present. If the disease is not treated, it is complicated by the atrophy of small muscles.

Neuropathy of the peroneal nerve when the superficial branch is affected is accompanied by a violation of sensitivity and severe pain in the lower part of the shin. During examination, patients often are diagnosed with weakened pronation of the foot.

Methods of diagnosis

Timely detection of the pathological process and elimination of the underlying disease - these two factors are the key to successful therapy. How is neuropathy diagnosed?

First the doctor collects the patient's anamnesis. During this procedure, he studies his disease map and conducts a survey, in order to clarify the information. Then the doctor goes on to the instrumental methods of diagnosis. To assess muscle strength, certain tests are performed, and sensitivity analysis of the skin is carried out using a special needle. In addition, electromyography and electroneurography are used. These procedures allow you to determine the degree of nerve damage. No less informative method of examination is ultrasound, during which the doctor can examine the damaged structures.

Neuropathy of the peroneal nerve always requires differential diagnosis with other disorders that have similar clinical manifestations. Among them are the Charcot-Marie-Toot disease, peroneal muscular atrophy syndrome , and cerebral tumors.

In particularly serious cases, a consultation of narrow specialists is required. For example, a traumatologist. Based on the results of the tests already received, the doctor can prescribe a radiograph of the bones or knee joint.

Neuropathy of the peroneal nerve: ICD

To understand the essence of the doctor's diagnosis, you need to familiarize yourself with a special code system. They are recorded in the International Classification of Diseases (ICD). The system is constructed very simply. First comes the designation of the Latin letter, which defines a group of diseases. Then follows a numerical code indicating a particular ailment. Sometimes you can meet another character. It carries information about the variety of the disease.

Many patients are interested in what the code (MKB) neuropathy of the peroneal nerve has. It should be noted that, as such, there is no sign of the described ailment. The G57 category includes lower extremity mononeuropathies. If we go into the study of pathologies belonging to this class, our disease will not be there. However, it can refer to the code G57.8, which refers to other mononeuropathies of the lower limb.

Knowing what the International Classification of Diseases is, you can get any information on the diagnosis issue. This also applies to a disease such as the neuropathy of the peroneal nerve. ICD-10 gave him the code G57.8.

Principles of therapy

The tactics of treating this pathology are determined by its cause. Sometimes it is enough to replace the plaster bandage, which squeezes the nerve. If the role of provoking factor is uncomfortable shoes, new shoes can also be a solution.

Often patients turn to the doctor with a whole "bouquet" of concomitant diseases. Diabetes mellitus, oncology or kidney failure - these disorders can cause ailment, like the neuropathy of the peroneal nerve. Treatment in this case is reduced to eliminating the primary disease. The remaining measures will be of an indirect nature.

Therapy with medicines

The main drugs that are used in the treatment of neuropathy are the following:

• Non-steroidal anti-inflammatory drugs (Diclofenac, Nimesulide, Xsefokam). They help to reduce puffiness and pain, remove the symptoms of inflammation. NSAIDs are most often prescribed for the diagnosis of "axonal neuropathy of the peroneal nerve".
• Vitamins of group B.
• Antioxidants ("Berlition", "Tiogamma").
• Means for improving the conduction of impulses along the nerve ("Proserin", "Neuromidine").
• Preparations for the restoration of blood circulation in the affected area ("Caviton", "Trental").

Only a few medicines are listed in this list. In each case, the choice of drugs depends on the clinical picture of the disease and the preceding ailments.

Physiotherapeutic procedures

Various physiotherapy measures have proven themselves in the treatment of neuropathy. Typically, patients are recommended the following procedures:

• Magnetotherapy;
• Electrostimulation;
• massage;
• Reflexotherapy;
• Exercise therapy.

The massage with the neuropathy of the peroneal nerve is especially effective. But this procedure at home is unacceptable. Massage should be done by a qualified specialist. Otherwise, you can not only suspend the treatment process, but also damage your health.

The same recommendations are shown for exercise therapy. It is worth mentioning that the first classes should be under the supervision of an experienced coach. Then you can repeat the exercises at home.

Surgical intervention

If conservative therapy for several weeks shows its inefficiency, the doctor decides to conduct the operation. Usually it is prescribed in case of traumatic damage to nerve fibers. Depending on the clinical picture and the general condition of the patient, it is possible to perform decompression of the nerve, neurosis or plastic.

After surgery, a long recovery period is required. At this time, the patient should limit physical activity, engage in exercise therapy. Every day it is necessary to examine the affected limb for cracks and wounds. In case of their detection, the leg should provide complete rest. To this end, use special crutches, and wounds treated with antiseptic means. The doctor gives the other recommendations on an individual basis.

Effects

What outcome does the patient with the diagnosis of "neuropathy of the peroneal nerve" expect? Treatment of the disease largely determines the prognosis for recovery. If the timely start of therapy and follow all the recommendations of a doctor, you can hope for a positive result. The complicated course of the disease and delayed treatment aggravate the situation. In this case, patients often lose their ability to work.

Brief summaries

Neuropathy of the peroneal nerve is a serious disease. It can be based on vascular disorders, intoxication and toxic damage. However, the main cause of the development of the pathological process is still considered injuries of different genesis.

Its main manifestations are associated with impaired motor activity of the limb, and therapeutic tactics are largely determined by the factors that contributed to the development of the disease. The doctor may prescribe medication or physiotherapy. In rare cases, surgical intervention is required.