What are the treatment options for deep peroneal nerve entrapment?

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

Nonsurgical care of patients with deep peroneal nerve entrapment most importantly involves patient education to eliminate predisposing factors. For example, padding of the tongue of the shoe, the elimination of shoes with laces, or the use of alternative lacing methods, as well as the avoidance of high heels, may be sufficient to resolve symptoms.

Physical therapy is useful for strengthening the peroneal muscles in cases associated with weakness and in individuals with chronic ankle instability; physical therapy may also improve symptoms.

In-shoe orthotic devices are helpful for certain applications, such as for correction of a biomechanical malalignment in gait (eg, in patients with severe flatfoot or cavus foot).

NSAIDs and antineuritic medication may be helpful as adjuncts to other treatment modalities. Injection of steroids plus lidocaine near the site of involvement can reduce symptoms in some individuals.

In addition, consideration should be given to a metabolic workup to rule out thyroid dysfunction and diabetes in select individuals. Further workup may be necessary to rule out lumbar radiculopathy.


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