What are the treatment options for superficial peroneal nerve entrapment?

Updated: Oct 15, 2019
  • Author: Minoo Hadjari Hollis, MD; Chief Editor: Thomas M DeBerardino, MD  more...
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Answer

Vague and diffuse symptoms can create a diagnostic and therapeutic challenge for the treatment of superficial peroneal nerve entrapment. The use of multiple diagnostic modalities, including repeat examinations, selective injections, and electrodiagnostic studies, is required. Treatment of the underlying cause should be undertaken, as should release of the entrapped nerve and excision of existing neuromas.

Nonoperative options include the use of NSAIDs combined with relative rest, physical therapy for strengthening of muscles in cases of associated weakness or recurrent ankle sprains, and elimination of predisposing or triggering factors. Aids, such as braces, can be used to avoid recurrent ankle sprains. In-shoe orthotic devices may be helpful in certain instances, such as the correction of a biomechanical malalignment in gait for patients with severe flatfoot or cavus foot.

At times, injection of steroids plus lidocaine near the site of involvement in the lower leg can reduce symptoms and serve as a diagnostic tool in confirming the zone of nerve compression. The use of antineuritic medication (eg, gabapentin) can also be helpful in reducing or sometimes eliminating symptoms, particularly in cases associated with complex regional pain syndrome (CRPS). In these cases, combination treatment with medication, physical therapy, and local and sympathetic nerve blocks may be required.


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