Peroneus paresis overnight
A 62-year-old man consulted me about peroneus paresis (foot lift weakness) on the left. She performed overnight several months ago without any apparent reason. The toes 1 and 2 on the left have also tingled since then (paraesthesia). To walk, he wore a rail to prevent tripping, he could drive without a rail. In the functional test, the foot-lifting muscles on the left were shown with reduced strength 4.
An MRI image had intervertebral disc protrusions from LWK3 to SWK1, slight facet anesthesia and a very narrow neuroforamene LWK5/SWK1 on the left. A neurological measurement of the nerve conduction speed does not show peroneal damage, but rather indicated damage to the nerve root L5 on the left.
The previous medical treatment attempts did not bring any improvement.
During my examination, I found dysfunction of the tibial fibular joint on the left proximal...or in other words: The calf head was restricted in movement on the shin head. There, the peroneus nerve runs along the calf head. If the calf bone can no longer move properly there, there is increased pressure and shearing forces on the nerve, which can be irritated by it. This can lead to discomfort in the area of the back of the foot or on the side of the lower leg. However, it is also possible to reduce the strength of the foot lifters, as the nerve fibers for these muscles also have to pass the calf bone head.
That's how it was with my patient! I mobilized his tibiofibular joint and manually treated the N. peroneus to free him from this pressure, which had lasted for a long time. For the second treatment, about 6 weeks later, my patient appeared and reported that he no longer needed the splint shortly after the first treatment. He can walk normally again.
Anatomy is the basis of osteopathy. The exact knowledge of their connections, functional and topographical, is essential for daily work.