Back Clinic Nerve Injury Team. Nerves are fragile and can be damaged by pressure, stretching, or cutting. Injury to a nerve can stop signals to and from the brain, causing muscles not to work properly and losing feeling in the injured area. The nervous system manages a great majority of the body’s functions, from regulating an individual’s breathing to controlling their muscles as well as sensing heat and cold. But, when trauma from an injury or an underlying condition causes nerve injury, an individual’s quality of life may be greatly affected. Dr. Alex Jimenez explains various concepts through his collection of archives revolving around the types of injuries and condition which can cause nerve complications as well as discuss the different form of treatments and solutions to ease nerve pain and restore the individual’s quality of life.
The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
The central nervous system is responsible for sending neuron signals to all the organs and muscles in the body, allowing for mobility and proper functioning. These signals are constantly exchanged between the organs, muscles, and brain, informing of their activities. However, environmental factors and traumatic injuries can impact the nerve roots, disrupting the flow of signals and leading to musculoskeletal disorders. This can result in misalignments in the body and chronic pain if left untreated. Today’s article will inform us about peripheral neuropathy, a nerve injury correlated with back pain, and how spinal decompression can relieve this condition. We work with certified medical providers who use our patients’ valuable information to provide non-surgical treatments, including spinal decompression, to relieve pain-like symptoms associated with peripheral neuropathy. We encourage patients to ask essential questions and seek education about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer
What Is Peripheral Neuropathy?
Peripheral neuropathy refers to a range of conditions that affect the nerve roots and can cause chronic symptoms throughout the body, as research studies revealed. The nerve cells in our body transmit messages between the brain and other body parts. When these cells are damaged, it can disrupt communication between the central nervous system, leading to muscle and organ problems. Studies have linked peripheral neuropathy to pain and other symptoms, which can have a negative impact on daily activities, quality of life, and mental and physical well-being. Additionally, peripheral neuropathy may increase the risk of falls.
How Peripheral Neuropathy Correlates With Back Pain
Have you recently felt a tingling or sharp sensation when you stepped or experienced constant lower back pain? These symptoms could be related to peripheral neuropathy, which can cause back pain. “The Ultimate Spinal Decompression,” a book by Dr. Perry Bard, D.C. and Dr. Eric Kaplan, D.C., FIAMA, explains that peripheral neuropathy is nerve damage that affects the legs, causing numbness, pain, tingling, and oversensitivity to touch in the toes and feet. This can cause the muscles in the lower back to shift weight away from the painful areas, leading to low back pain. Research studies have revealed that chronic low back pain can involve both nociceptive and neuropathic pain mechanisms. Nociceptive pain is a response to tissue injury that activates the muscles. In contrast, neuropathic pain affects nerve roots branching from the spine and lower limbs, often resulting from damaged spinal discs. Fortunately, there are ways to manage peripheral neuropathy and its associated back pain.
Peripheral Neuropathy Relief & Treatment- Video
Peripheral neuropathy is a nerve injury that affects people differently and can cause sensory symptoms in the upper and lower body. Those with peripheral neuropathy may experience constant pain in their extremities, which can lead to compensation in other muscles and spinal misalignment. This can result in chronic musculoskeletal conditions. Studies show that peripheral neuropathy, especially in cases of low back pain, can cause a malfunction in the brain’s pain modulatory system, leading to overlapping risks and dysfunction. However, various treatments are available to restore the body and reduce neuropathic pain, including chiropractic care and spinal decompression. The video above explains more information on how these treatments can help alleviate neuropathic pain and release the body from subluxation.
Peripheral neuropathy can cause a lot of pain, and many people consider surgery to treat it. However, this can be expensive, so some people opt for non-surgical treatments like spinal decompression and chiropractic care. Studies have shown that spinal decompression can be very helpful in relieving nerve entrapment and improving low back pain symptoms. It’s a safe and gentle treatment that uses traction to help the spine return to its position and allow fluids and nutrients to flow back in. Combining spinal decompression with other therapies can also help reduce peripheral neuropathy symptoms, improving people’s quality of life and helping them become more mindful of their bodies.
Conclusion
Peripheral neuropathy is a condition that results from nerve injuries and can affect both the upper and lower parts of the body. This disorder can cause sensory symptoms that may lead to musculoskeletal conditions, spinal misalignment, and disability. Pain and discomfort are common experiences for those with this condition, which can negatively impact their daily lives. Fortunately, spinal decompression can help alleviate the effects of peripheral neuropathy by gently stretching the spine, releasing entrapped nerves, and correcting subluxation. These treatments are safe, non-invasive, and can be incorporated into an individual’s health and wellness plan.
A pinched, compressed, overly stretched, twisted, and entangled nerve can happen throughout the body. The most common locations are the neck, shoulder, upper back, upper chest, arm, elbow, hand, wrist, low back, legs, and feet. This disrupts the nerve’s ability to function properly. Each nerve stimulates muscles and detects sensations in specific areas of the skin or internal organs so they work properly. Common symptoms are tingling, numbness, pain, weakness, and musculoskeletal problems. The average pinched nerve duration can last a few days to as long as 4 to 6 weeks or, in some cases, longer, in which case individuals should see a doctor or neurologist. Injury Medical Chiropractic and Functional Medicine Clinic can relieve, release, and restore nerve health.
Pinched Nerve
A pinched nerve is caused by pressure from surrounding tissues that place added stress on it. Muscles, bones, cartilage, and tendons can all press, pull, or entangle a nerve. This can result in a loss of function, which can then lead to symptoms including:
Tingling
Numbness
Muscle weakness
Various types of pain – sharp, electrical, throbbing, aching, and radiating/spreading out to other areas.
Burning sensation
A pinched nerve can become serious, cause chronic pain conditions and lead to permanent nerve damage.
More severe cases may require surgery.
Pinched Nerve Duration
Pinched nerve duration depends on the injury, which can happen suddenly or gradually. A temporary case with an acute cause, such as injury or poor posture, can last several days. Cases related to chronic conditions, like arthritis, may last longer. Treatment, as well as recovery, also vary based on the location of the injury and what’s causing the pressure.
Body Locations
Neck
A pinched nerve in the neck can cause tingling sensations and pain, which can travel to the shoulders and arms. This type can be caused by:
Sleeping position
Repetitive movements
Injuries
The pain will usually ease within several days unless a chronic health condition is the cause of the pinching.
Lower back
A pinched nerve in the lower back is often brought on by herniated discs that compress nerve roots.
It may also be caused by arthritis or injuries.
Individuals may feel a sharp pain in the lower back, as well as in the buttocks and back of the leg.
Sciatica may be a symptom.
Lower back pain may be acute, lasting only a few days.
If the injury doesn’t resolve, it may cause chronic back pain that can last 12 weeks or more.
Leg
The legs can develop pinched nerves from herniated discs or injuries.
If left untreated can lead to peripheral neuropathy.
This can develop over several weeks or years.
Hip
A pinched nerve in the hip can last a few days if related to an injury. If the pain lasts longer than a few days, consult a doctor. Possible causes of chronic hip pain may include:
Obesity
Bone spurs
Arthritis
Shoulder
Shoulder pain brought on by a pinched nerve usually starts in the upper spine and is caused by:
Injury
Tendinitis
Arthritis
To tell if the pain symptoms are from a pinched nerve and not a muscle strain, the pain tends to occur in one shoulder, and there is a sharpness to the aches.
Left untreated, arthritis or tendinitis can lead to chronic pain that can come and go for several weeks, months, or years.
Wrist
Repetitive overuse is commonly linked to pinched nerves in the wrist.
Pinched nerves can lead to carpal tunnel syndrome – pain and numbness extending through the arm, hand, and fingers.
Pain lasting over two months could indicate other underlying conditions, like arthritis.
Chiropractic Relief
Chiropractic adjustments identify the impacted nerve/s and use various therapies to remove the compression, relieving symptoms and the injury or issue. A personalized treatment plan can include the following:
Cornwall, R, and T E Radomisli. “Nerve injury in traumatic dislocation of the hip.” Clinical orthopedics and related research, 377 (2000): 84-91. doi:10.1097/00003086-200008000-00012
Dmytriv, Mariya, et al. “PT or cervical collar for cervical radiculopathy?.” The Journal of family practice vol. 59,5 (2010): 269-72.
Hochman, Mary G, and Jeffrey L Zilberfarb. “Nerves in a pinch: imaging of nerve compression syndromes.” Radiologic clinics of North America vol. 42,1 (2004): 221-45. doi:10.1016/S0033-8389(03)00162-3
Lopez-Ben, Robert. “Imaging of nerve entrapment in the foot and ankle.” Foot and ankle clinics vol. 16,2 (2011): 213-24. doi:10.1016/j.fcl.2011.04.001
Needham, C W. “Pinched nerves and signature signs.” Connecticut Medicine vol. 57,1 (1993): 3-7.
Siccoli, Alessandro, et al. “Tandem Disc Herniation of the Lumbar and Cervical Spine: Case Series and Review of the Epidemiological, Pathophysiological and Genetic Literature.” Cureus vol. 11,2 e4081. 16 Feb. 2019, doi:10.7759/cureus.4081
The nervous system communicates with the entire body and reacts to internal and external changes using electrical and chemical impulses to send and receive messages. Messages travel/synapse from one neuron to another using specialized chemicals known as neurotransmitters. Paresthesia refers to sensations of numbness, tingling, prickling, skin crawling, itching, or burning, usually in the arms, hands, legs, and/or feet, but can affect other areas of the body. Chiropractic care, massage therapy, decompression therapy, and functional medicine can relieve tissue and nerve compression, improve flexibility, range of motion, and mobility, and strengthen the muscles surrounding the affected nerve to maintain optimal health and prevent worsening or further injury.
Paresthesia
The sensation comes on without warning and is usually painless and described as tingling or numbness. There are different causes of paresthesia, including:
Some individuals have chronic or long-term paresthesia, which can be a sign of a more serious nerve injury or condition. Added physical stress can cause surrounding tissues to irritate or entangle the nerve leading to building pressure. This pressure causes paresthesia in the area interrupting circulation and function. A pinched nerve can happen anywhere in the body, like the neck, shoulder, wrist, back, and face.
A herniated disc in the lower spine can cause back pain and paresthesia in the leg or foot on the affected side.
Carpal tunnel syndrome is a pinched nerve in the wrist that causes numbness and tingling in the hand and fingers.
Pinched nerve symptoms can be intermittent or constant.
Usually, a temporary sensation is caused when pressure is placed on the affected nerve.
Once that pressure is relieved, the discomfort goes away.
Individuals with an Increased Risk
Overuse Injury
Individuals with jobs or hobbies requiring repetitive motions are at a higher risk for nerve compression, paresthesia, or injury.
Anyone can get a pinched nerve, and most individuals will experience paresthesia at some point.
Weight and water gain can cause swelling and increase pressure on nerves.
Thyroid Disease
This puts individuals at risk for carpal tunnel syndrome.
Rheumatoid arthritis
This causes inflammation, which can also compress nerves in the joints.
Diagnosis
To diagnose paresthesis, a doctor will look at the individual’s medical history and ask questions about the symptoms. They will perform a physical examination and, depending on the findings, may recommend tests that can include:
Nerve Conduction Study
This measures how fast nerve impulses travel in the muscles.
Electromyography – EMG
To look at the electrical activity of how nerves and muscles interact.
Magnetic Resonance Imaging – MRI
This looks at the different areas of the body in high definition.
Ultrasound
Used to produce images, this can be applied to the smaller areas to look for nerve compression or damage.
Chiropractic
Treatment options depend on the cause of the paresthesia. Body misalignments can cause nerve interference that can lead to health problems such as migraines, or can disrupt nerve communication and block proper circulation. Chiropractic care focuses on treating the nervous system and is a safe and effective method for treating nerve problems that cause discomfort and sensations. After a thorough examination of problem areas, massage, decompression, and chiropractic adjustments will:
Bova, Joseph, and Adam Sergent. “Chiropractic management of a 24-year-old woman with idiopathic, intermittent right-sided hemiparesthesia.” Journal of chiropractic medicine vol. 13,4 (2014): 282-6. doi:10.1016/j.jcm.2014.08.002
Christensen, Kim D, and Kirsten Buswell. “Chiropractic outcomes for managing radiculopathy in a hospital setting: a retrospective review of 162 patients.” Journal of chiropractic medicine vol. 7,3 (2008): 115-25. doi:10.1016/j.jcm.2008.05.001
Freihofer, H P Jr. “Parästhesien” [Paresthesia]. Schweizerische Monatsschrift fur Zahnheilkunde = Revue mensuelle suisse d’odonto-stomatologie vol. 89,2 (1979): 124-5.
Karne, Sampada Swapneel, and Nilima Sudhakar Bhalerao. “Carpal Tunnel Syndrome in Hypothyroidism.” Journal of Clinical and diagnostic research: JCDR vol. 10,2 (2016): OC36-8. doi:10.7860/JCDR/2016/16464.7316
It’s not unusual for runners to experience tingling, pins and needles, and numbness in their feet while running. Running foot numbness is a relatively common problem for runners and can be easily remedied. Numbness will present in one part of the foot or just the toes. Sometimes it can spread throughout the whole foot. Different causes, most of which are not serious, can be easily dealt with. Serious causes can be treated with chiropractic, massage, decompression therapy, and functional medicine.
Running Foot Numbness
Reasons, why the feet experience numbing sensations when running, include:
Improper footwear.
Laces that are tied too tightly.
Foot strike pattern.
Foot structure.
Training schedule.
Muscle tightness.
Compressed nerve.
Medical conditions like neuromas or peripheral neuropathy.
Footwear
A common cause of running foot numbness is having overly tight shoes that place added pressure on nerves.
If this could be the reason, the remedy is to get new shoes.
Try to find a store that specializes in running shoes and ask for help.
Footwear professionals look at the size of the foot, the shape, and running gait.
For example, individuals with a wide foot may need a style with a wider/larger toebox or the front of the shoe that houses the forefoot.
Get a pair that’s one-half to a full size larger than a regular everyday shoe size.
This is because when running, the feet swell, especially in hot and humid weather.
Going up a half or whole size will also accommodate thicker socks for individuals that run in cold weather.
Sometimes numbness can result from biomechanical issues that can be corrected with the proper shoe.
Tight Laces
Sometimes it’s not the shoes but the laces that are too tight.
Pulling a little tighter to get a firm fit around the ankle is common, but this can entrap nerves on top of the foot at the ankle/anterior tarsal tunnel, similar to the carpal tunnel in the wrist.
This can be problematic for individuals with high arches.
Loosening the laces are recommended.
However, runners may feel insecure with looser laces.
Experimenting with different lacing techniques is recommended to find one that keeps the shoes comfortable without creating undue pressure over the top of the foot.
Using padding under the tongue of the shoe can help.
Foot Fall Pattern
Sometimes running form can put pressure on nerves that, lead to numbness.
Overstriding– Landing heel first with the foot ahead of the body’s center of gravity places the feet on the ground for too long.
Correcting this issue can be achieved by shortening the stride and focusing on landing on the midsole.
This way, the feet will land directly under the body.
Running like stepping on hot coals is recommended, keeping the movements light and quick.
Correcting overstriding saves energy and lowers the risk of shin splints.
A sports chiropractor, physical therapist, or running coach can help fine-tune form for specific guidance.
Foot Structure
The anatomy of the feet, specifically the arches, can contribute to running foot numbness.
Flat feet mean the entire bottom of each foot is in contact with the floor when barefoot.
Overly flexible feet are more likely to experience nerve compression.
This can be corrected with shoe orthotic inserts.
Over-the-counter orthotics may work, but custom orthotics are another option if they don’t.
Muscle Tightness
Stiff, inflexible muscles can lead to anatomical conditions that generate nerve pressure.
Warm-up exercises before running will get the muscles loose and ready.
Stretching is very important before and after running.
Individuals prone to muscle tightness should include flexibility exercises.
Yoga can improve flexibility and body alignment.
Foam rollers and other massage tools will work out kinks in areas where tightness forms and affects nerves, like the quadriceps, calves, hamstrings, and I.T. band.
Regular sports massage and chiropractic can help keep the body pliable.
Sciatic Nerve Issues
A compressed nerve causes a decrease in the sensation to the areas the nerve supplies.
Foot numbness, especially around the heel or the sole, can be caused by sciatic nerve compression.
The pain from sciatica might originate in the back but can end up causing numbness in the feet and/or toes.
Poor posture, tight piriformis muscles, or other back injuries can also cause sciatica.
A chiropractor or physical therapist can prescribe decompression therapy, MET stretches, and rehabilitative exercises.
Prevention
Most of the time, running foot numbness can be treated by adjusting footwear or technique. Here are a few tips for injury prevention:
Evaluate Shoes
First, make sure the shoelaces are not overly tight.
If the shoes are uncomfortable when running, look for another set and get a custom fitting.
Running Form
Avoid overstriding by focusing on landing on the midsole instead of the heel.
This will take the pressure off of the feet.
Foot Orthotics
Individuals with flat feet, high arches, or overly flexible feet should consider orthotics.
Avoid Overtraining
Work rest days into the training schedule and gradually build up to avoid overuse injuries.
Stretch to prevent muscle imbalances, keep muscles loose, and improve the range of motion.
Chiropractic and Physical Therapy
If symptoms don’t improve, see a doctor, podiatrist, or chiropractor so they can rule out conditions and develop a personalized treatment plan.
Benefits of Custom Foot Orthotics
References
Aldridge, Tracy. “Diagnosing heel pain in adults.” American family physician vol. 70,2 (2004): 332-8.
Atik, Aziz, and Selahattin Ozyurek. “Flexible flatfoot.” Northern Clinics of Istanbul vol. 1,1 57-64. 3 Aug. 2014, doi:10.14744/nci.2014.29292
Jackson, D L, and B L Haglund. “Tarsal tunnel syndrome in runners.” Sports medicine (Auckland, N.Z.) vol. 13,2 (1992): 146-9. doi:10.2165/00007256-199213020-00010
Souza, Richard B. “An Evidence-Based Videotaped Running Biomechanics Analysis.” Physical Medicine and rehabilitation clinics of North America vol. 27,1 (2016): 217-36. doi:10.1016/j.pmr.2015.08.006
Sridhara, C R, and K L Izzo. “Terminal sensory branches of the superficial peroneal nerve: an entrapment syndrome.” Archives of physical medicine and Rehabilitation vol. 66,11 (1985): 789-91.
An acute injury or changes to the upper body over time can cause a compressed/pinched nerve in the shoulder. A pinched nerve in the shoulder happens when a muscle, ligament, tendon, or bone irritates or presses on a nerve exiting the neck. Shoulder nerve pain can develop from various sources, such as overuse work injuries, sports injuries, household chores, tendinitis, arthritis, torn cartilage, and other medical conditions, and injuries can contribute to symptoms. Chiropractors are highly qualified to treat pinched nerves. They are trained in whole-body realignment and rehabilitation techniques that find the root source and relieve pressure on compressed nerves.
Shoulder Nerve Pain
The shoulder joint is one of the most complex joints because of its wide range of motion. It is used so frequently that repetitive motion strain is common, often leading to injury. It is usually because of the continued use combined with an unhealed strain/injury that leads to shoulder nerve injury or when surrounding tissues like cartilage or tendons irritate or compress the nerves.
Pinched nerves also occur when a nerve root in the neck is damaged through wear and tear or an acute injury.
Individuals 50 years and older are likely to experience pinched nerves because of degeneration in the cervical spine and/or arthritis.
A nerve can become pinched when bone spurs form around the spinal discs.
Bone spurs are formations of bone that grow when discs weaken with age.
Bone spurs grow around the discs putting pressure on the nerve root.
Symptoms
Compressed Pinched Nerve/Cervical Radiculopathy
Pain sensations in the shoulder.
Tingling and/or pins and needles in fingers or hand.
Weakness in shoulder and arm muscles.
Symptoms have been known to overlap with shoulder arthritis, frozen shoulder, swimmer’s shoulder, or rotator cuff tears, so it’s always best to consult a chiropractor to understand possible causes. Other conditions with symptoms to compare:
Shoulder Arthritis
Stiffness in the joint.
Aching inside the shoulder.
Grinding when moving the joint.
Frozen Shoulder/Adhesive Capsulitis
Stiffness in the joint.
Pain in one shoulder.
Decreased range of motion and movement.
Swimmer’s Shoulder/Impingement
Pain and discomfort in the shoulder.
Weakness in the surrounding area.
Stiffness or tightness in the joint.
Impeded range of motion.
Rotator Cuff Tears
Pain and discomfort symptoms when moving the shoulder.
Weakness in the arm.
Deep aching sensations along the top and side of the joint.
Chiropractic Treatment
Chiropractors are experts on the neuromusculoskeletal system. First, a thorough medical examination will be conducted, including health history and regular activities, to understand the nature of the symptoms. Depending on the type of injury, tests, and exams may be needed to help diagnose and pinpoint the cause. Then the chiropractor will develop a personalized treatment plan. The objective is to relieve pressure and tension on the nerves and relax the muscles. In addition to adjusting the joint or other impacted areas, the therapy team will provide at-home exercises and stretches to maintain the adjustments and expedite healing.
Chiropractic Rehab
References
Kokkalis, Zinon T et al. “Nerve Injuries around the Shoulder.” Journal of long-term effects of medical implants vol. 27,1 (2017): 13-20. doi:10.1615/JLongTermEffMedImplants.2017019545
Leider, Joseph D et al. “Treatment of suprascapular nerve entrapment syndrome.” Orthopedic reviews vol. 13,2 25554. 11 Jul. 2021, doi:10.52965/001c.25554
Matzkin, Elizabeth, et al. “Swimmer’s Shoulder: Painful Shoulder in the Competitive Swimmer.” The Journal of the American Academy of Orthopaedic Surgeons vol. 24,8 (2016): 527-36. doi:10.5435/JAAOS-D-15-00313
Neviaser, Andrew S, and Jo A Hannafin. “Adhesive capsulitis: a review of current treatment.” The American Journal of sports medicine vol. 38,11 (2010): 2346-56. doi:10.1177/0363546509348048
Safran, Marc R. “Nerve injury about the shoulder in athletes, part 1: suprascapular nerve and axillary nerve.” The American Journal of sports medicine vol. 32,3 (2004): 803-19. doi:10.1177/0363546504264582
Strakowski, Jeffrey A, and Christopher J Visco. “Diagnostic and therapeutic musculoskeletal ultrasound applications of the shoulder.” Muscle & Nerve vol. 60,1 (2019): 1-6. doi:10.1002/mus.26505
A peroneal nerve injury/peroneal neuropathy can be caused by direct trauma to the outer knee with symptoms and sensations of numbness, tingling, pins-and-needles sensations, pain, or weakness in the foot that can cause a condition known as foot drop. Chiropractic can perform spinal manipulation, realignment, and decompression to restore the nerve’s function. They can also help with walking and mobility by providing muscle strengthening and stretching exercises to correct abnormal gait caused by foot drop and increase the range of motion in the ankle.
Peroneal Nerve Injury
The peroneal nerve begins near the sciatic nerve at the glutes/hip and buttocks. It travels down the back of the thigh to the knee, which wraps around the front of the leg and extends into the feet to the toes. It provides sensory input from the lateral aspect of the lower leg and the top of the foot. It also provides motor input to the muscles responsible for lifting the foot off the ground lifting the toes and ankles and turning the foot outwards.
Causes
Structural problems in the spine or misalignment can affect the functionality of the nervous system and lead to peroneal neuropathy. Traumatic nerve injury causes include musculoskeletal injury, peroneal nerve paralysis, compression, or laceration. Injuries by trauma and nerve compression include:
Compression of the nerve in the leg.
Knee dislocation.
Knee or hip replacement surgery.
Knee or leg fracture. Fractures of the tibia or fibula, especially in the areas closer to the knee, can injure the nerve.
Ankle fracture.
Blood clot.
Compression by a nerve sheath tumor or cyst.
Certain underlying medical conditions can cause symptoms of peroneal nerve injury. It is recommended to be evaluated by a medical professional who can diagnose and offer appropriate treatment options. Neurologic disorders that can cause similar symptoms:
Herniated lumbar disc
Multiple sclerosis
Parkinson’s disease
Amyotrophic lateral sclerosis – ALS or Lou Gehrig’s disease.
Metabolic syndromes – diabetes, alcohol abuse, exposure to toxins.
Symptoms
Nerve injury symptoms include:
Numbness, tingling, or loss of sensation in the top of the foot or outer part of the lower leg.
Inability to flex toes or ankles upward/dorsiflexion.
Inability to flex the ankle to take a step forward.
Inability to move the foot.
Weakness in foot eversion/rotating outward.
Flopping or slapping sounds when walking.
Gait changes – dragging the toes or lifting the knee higher than the other to raise the foot off the ground.
Tripping often.
Pain in the foot or lower leg.
Diagnosis
In diagnosing a peroneal nerve injury, a healthcare provider examines the leg and analyzes symptoms. Tests can include:
Imaging tests – CT scan, ultrasound, or MRI.
Magnetic resonance – MR – neurography is a specialized high-resolution MRI of the nerves.
An electromyogram measures how muscles react to nerve stimulation.
Treatment for a peroneal nerve injury depends on the severity and can be surgical or non-surgical. Non-surgical options include orthotic footwear, chiropractic care, and physical therapy. A physical therapy program could consist of the following:
Icing
Massage
Manual manipulation
Stretching
Strengthening exercises
Mobilization exercises
Balancing exercises
Ankle bracing
Ankle taping
Shoe inserts – splints, braces, or orthotics can improve gait.
Longo, Diego, et al. “The Muscle Shortening Maneuver: a noninvasive approach to treating peroneal nerve injury. A case report.” Physiotherapy theory and practice, 1-8. 31 Jul. 2022, doi:10.1080/09593985.2022.2106915
Milenković, S S, and M M Mitković. “Common peroneal nerve schwannoma.” Hippokratia vol. 22,2 (2018): 91.
Radić, Borislav et al. “PERIPHERAL NERVE INJURY IN SPORTS.” Acta clinica Croatica vol. 57,3 (2018): 561-569. doi:10.20471/acc.2018.57.03.20
Thatte H et al. (2022). Electrodiagnostic evaluation of peroneal neuropathy. ncbi.nlm.nih.gov/books/NBK563251/
T Francio, Vinicius. “Chiropractic care for foot drop due to peroneal nerve neuropathy.” Journal of bodywork and movement therapies vol. 18,2 (2014): 200-3. doi:10.1016/j.jbmt.2013.08.004
Nerve irritation occurs when the nerves exiting the spine become irritated and sensitized. Also known as nerve gliding restriction, it is a condition whereby a nerve becomes irritated by inflamed swelling of structures close to the nerve, such as joints, ligaments, muscles, or discs, that have sustained an accumulative strain which results in swelling and inflammation. A thorough chiropractic assessment and examination can diagnose the extent of the irritation and develop a personalized treatment plan.
Nerve Irritation
When swelling and inflammation interfere with the nerve root, the nerve transmits signals to the brain to let it know there is a threat. The brain interprets these signals and creates a protective response to avoid worsening the damage to the nerve. The protective reactions vary from person to person but can include the following:
Muscle tightness and guarding
Aching sensation
Cramping
Radiating discomfort or pain
Pins and needles
Tingling
Numbness
Nerve root irritation also inhibits the body from recovering as fast as it should.
Nerve irritation is not to be confused with nerve root compression or radiculopathy. This is when the nerve becomes compressed/pinched, resulting in the loss of its functions like muscle strength and sensation. Sometimes individuals with nerve irritation can also experience increased neural tension. The nerves adapt to the mechanical loads placed on them through regular movements. Restrictions to neural mobility can cause symptoms to worsen along the pathway and distribution of the nerve.
The nervous system consists of the brain, spine, and nerve branches.
The branches, similar to electrical cables, cannot stretch.
Tension is generated when straightening out body areas, creating a pull and gliding of the nerve to the spinal cord.
When nerve irritation occurs, signals are sent to protect the body, brain, spine, and branches.
Causes
Most commonly, nerve irritation occurs when a structure adjacent to the nerve; this could be a joint, ligament, and/or muscle that accumulates strain and becomes dysfunctional, swollen, inflamed, and/or spasms resulting from protective guarding.
Mild nerve irritation can include accumulated strain from postural overload and swelling from a minor tear in an adjacent ligament.
Often nothing shows as a problem on an MRI scan.
Severe nerve irritation can include disc herniation and shows up on an MRI scan; surgery could be required in some cases.
Symptoms
Stiffness
Tightness
Aches
Pains
Persist even after days of rest, stretching, targeted exercises, avoiding movements, etc.
Stretching feels good at first, but the pain returns or worsens a few hours later or the next day.
The irritation blocks the effective recovery of muscle, joint, tendon, and ligament discomfort symptoms.
Chiropractic Care
Treatment involves various therapies and strengthening the supporting structures while relaxing and releasing tight structures to avoid recurring injuries. Chiropractic care realigns the spine, corrects joints that have shifted out of place, helps to regulate the nervous system’s function, and relieves irritation and inflammation. Whether in the form of an adjustment, traction, or guided exercise, all systems in the body are moved closer to a balanced state. This includes the:
Nervous system
Immune system
Respiratory system
Circulatory system
Endocrine system
Skeletal system
All help support the body’s self-healing process and increase the nervous system’s function.
The chiropractic team will guide the patient through the rehabilitation process to get back to full strength.
Peroneal Nerve Irritation
References
Ellis, Richard F, and Wayne A Hing. “Neural mobilization: a systematic review of randomized controlled trials with an analysis of therapeutic efficacy.” The Journal of manual & manipulative therapy vol. 16,1 (2008): 8-22. doi:10.1179/106698108790818594
Gibson, William, et al. “Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults.” The Cochrane database of systematic reviews vol. 9,9 CD011976. 14 Sep. 2017, doi:10.1002/14651858.CD011976.pub2
O’Shea, Simone D et al. “Peripheral muscle strength training in COPD: a systematic review.” Chest vol. 126,3 (2004): 903-14. doi:10.1378/chest.126.3.903
Rozmaryn, L M et al. “Nerve and tendon gliding exercises and the conservative management of carpal tunnel syndrome.” Journal of hand therapy: official Journal of the American Society of Hand Therapists vol. 11,3 (1998): 171-9. doi:10.1016/s0894-1130(98)80035-5
Sipko, Tomasz, et al. “Mobility of cervical spine and postural equilibrium in patients with spinal overload syndrome.” Ortopedia, traumatologia, rehabilitacja vol. 9,2 (2007): 141-8.
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