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Suggest Remedy For Fibular Nerve Entrapment In Leg

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Posted on Wed, 25 Feb 2015
Question: dear doctor,
good day.

I have fibular nerve entrapment in my left leg causing 75% weak dorsiflexion, what is the best non surgical treatment

thanks

XXXX
doctor
Answered by Dr. Dr. Erion Spaho (51 minutes later)
Brief Answer:
Steroid injections and ankle splint may help.

Detailed Answer:
Hi, I have gone through your question and understand your concerns.

Conservative treatment of peroneal nerve entrapment at fibular head consists on avoiding movements that exacerbate pain ( avoiding squatting), steroids injections at the entrapment site and ankle splinter.

NSAID drugs can help relieve pain.

Steroids injection could be tried up to three times with a 20 days interval.

If these measures fail to improve your symptoms after about three months, decompressive surgery is indicated.

Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Erion Spaho (1 hour later)
thank you doctor for your professional reply. i want to ask if taking botox injection in the entrapment region og fibular nerve will remove the compression...please advise....thx
doctor
Answered by Dr. Dr. Erion Spaho (1 hour later)
Brief Answer:
Botox can be used when muscle is responsible.

Detailed Answer:
Hi and thanks for asking back.

Botox relaxes muscles ( a temporary paralysis) when injected, so if a muscle is responsible for compressing/ entrapment of a nerve ( verified clinically and with tests), then Botox can be of value if used properly.

If bones/ ligaments are responsible for compressing/entrapment of the nerve, then Botox is not of value.

In my opinion, steroids injection should be tried first.

Botox injection needs the certainty of muscle being responsible for entrapment.

Hope this helps. Wishing you good health.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Dr. Erion Spaho (38 minutes later)
hello doctor,
can i use doppler machine to see if the muscle is responsible or ligament for entrapment....or only MRI to be used...thanks
doctor
Answered by Dr. Dr. Erion Spaho (1 hour later)
Brief Answer:
MRI needed.

Detailed Answer:
Hi again.

Echography can give a clue of such tissue relationship, MRI and a careful clinical examination are essential in proper diagnosis of entrapment syndrome together with nerve conduction study (EMG).

Hope I helped you understand better your concerns.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Dr. Erion Spaho (25 minutes later)
dear doctor...please find attached my emg. please check and advise...thanks
doctor
Answered by Dr. Dr. Erion Spaho (29 minutes later)
Brief Answer:
Ankle MRI needed.

Detailed Answer:
Hi again.

According to new information you provided, you have anterior tarsal entrapment syndrome.

This condition is not entirely responsible for dorsiflexion deficit of the foot, so if there is ankle contracture, there may be a talo-crural articulation underlying condition.

There is need for a left ankle MRI and a Orthopedist evaluation.

After this orthopedic evaluation, the true impact of the entrapment syndrome on your concerns is assessed and treatment modalities should become clear.

Best regards.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Dr. Erion Spaho (20 minutes later)
thank you doctor..finally i attached left ankle and knee mri reports...please have a look and pls give me your final review...best regards..XXXX
doctor
Answered by Dr. Dr. Erion Spaho (21 minutes later)
Brief Answer:
Orthopedic treatment needed.

Detailed Answer:
Hi again.

According to uploaded imaging studies, there is degenative joint disease of your knee structures, traumatic damages of your knee, ankle and calf muscles with venous drainage involvement of your leg and foot.

Nerve disfunction in this case may be due to contused nerve due to trauma or entrapment from orthopedic and degenative changes of your left leg and foot.

In my opinion, there is need to treat orthopedic and degenative changes first (rest, NSAID drugs, physical therapy) and after correct treatment of orthopedic problems nerve disfunction and venous drainage involvement should be improved and reevaluated.

In conclusion I suggest you to consult a Orthopedic surgeon, discuss your concerns and treatment possibilities.

Hope I helped you.

Wishing you good health.



Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4502 Questions

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Suggest Remedy For Fibular Nerve Entrapment In Leg

Brief Answer: Steroid injections and ankle splint may help. Detailed Answer: Hi, I have gone through your question and understand your concerns. Conservative treatment of peroneal nerve entrapment at fibular head consists on avoiding movements that exacerbate pain ( avoiding squatting), steroids injections at the entrapment site and ankle splinter. NSAID drugs can help relieve pain. Steroids injection could be tried up to three times with a 20 days interval. If these measures fail to improve your symptoms after about three months, decompressive surgery is indicated. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.