Neuropathy

Neuropathy means damage to a nerve or a disease affecting nerves which may present as altered sensation, numbness, weakness, or pain. Neuropathy can affect a single nerve (mono-neuropathy), multiple nerves or have a more widespread effect on nerves (peripheral neuropathy.) Diseases causing peripheral neuropathy include most commonly diabetes, alcoholism, auto-immune disorders, medications, inherited diseases and hypothyroidism. Physical examination, blood tests and nerve conduction studies can be helpful to diagnose peripheral neuropathy. Treatment focuses on finding the underlying cause and treating the disease. Frustratingly, many times the real cause of the neuropathy cannot be found.

Peroneal neuropathy, usually from compression of the peroneal nerve around the knee, is the most common single nerve affecting neuropathy in the legs. This can present like sciatica with loss of sensation over the outside part of the leg and top of the foot and weakness or difficulty lifting the foot, also known as a foot drop. The differentiating symptom from sciatica is a peroneal neuropathy is mostly pain-less. The peroneal nerve comes from behind the knee and divides into a superficial and deep nerves near the fibular head and can be compressed from frequent crossing of the legs, prolonged squatting or kneeling, knee braces, knee surgery, direct trauma. This can be diagnosed with electrodiagnostic testing. Treatments focus on physical therapy to strengthen the leg, improve ankle range of motion, possible use of a brace if there is weakness, patient education to change activities such as frequent squatting, and to remove any compressive source.