The common peroneal nerve, also known as the common fibular nerve, is a peripheral nerve that branches off from the sciatic nerve. It and its branches provide sensation and some motor functions to the lower leg and dorsum of the foot.
Anatomy
The sciatic nerverootlet themRückenmarkin the two lowest regions of the spine—thelumbarand sacral regions. The roots connect them together and run down through the buttocks and hamstrings.
When the sciatic nerve reaches the back of your knee, which you may refer to as the "knee pit" but healthcare providers refer to as the popliteal fossa, it splits into two main branches:
- shin nerve
- Common peroneal nerve
The tibial nerve continues down the back of the leg, while the common peroneal nerve wraps around the outside of the knee to reach the front of your calf.
Anatomy of the sciatic nerve
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Structure
The common peroneal nerve has a relatively short course. Soon after it branches off from the sciatic nerve, it gives off two skin branches. "Skin" means dealing with the skin; These skin branches give sensation to the skin of your lower leg. They are called the common sural nerve and the lateral sural cutaneous nerve. It also sends a branch, the geniculate branch, to the knee joint.
The common peroneal nerve then divides into its two terminal branches: the deep peroneal nerve and the superficial peroneal nerve.
Location
From its origin just above the popliteal fossa, the common peroneal nerve runs along the inner border of the Mbiceps femoris muscle, over the head ofGastrocnemius. There the two skin branches split off.
The common peroneal nerve then wraps around the neck of theprimer(the calf bone on the outside of your leg), pierces the long fibular muscle and divides into its terminal branches on the outside of the leg, not far below the knee.
Anatomical Variations
There is at least one report of the common peroneal nerve dividing into its two branches at the popliteal fossa rather than at the level of the fibula head.This variation could have implications for decompression surgery or emergency care when regional nerve blocks are administered to numb the foot.
function
The common peroneal nerve and its terminal branches have both motor and sensory fibers, but its motor function is limited. The rest is purely sensory, sending information to and from the brain about things like temperature and pressure.
engine function
The nerve connects to the short head of the biceps femoris muscle. This is part of the hamstring muscle that allows your knee to bend. This is the only part of the main nerve that serves a motor function.
However, the superficial peroneal nerve provides movement of the peroneus longus and peroneus brevis muscles on the outside of your calves, allowing you to rotate your toes outward.
The deep peroneal nerve, on the other hand, connects to the muscles of the front of your calf, including the anterior tibialis, long extensor digitorum, and long extensor hallucis. These muscles allow you to flex your foot and straighten your toes.
Anatomy of the lower leg muscles
sensory function
The common peroneal nerve and its branches also serve sensory functions:
- The sural nerve connects to a branch of the tibial nerve to innervate the skin over the outside back of your calf and the outside edge of your foot.
- The lateral sural cutaneous nerve provides the feel of the muscle on the outside of your calf just below the knee.
- The superficial and deep peroneal nerves also have sensory functions. The superficiality allows for an in-skin feel on the outer front of the lower half of your calf and down over the top of your foot to the tips of your toes.
- The deep peroneal nerve gives sensation to the skin in a small area between your first and second toe.
Associated Terms
The common peroneal nerve can be damaged by injury or disease.
Common causes of nerve injuries include:
- knee trauma orDislocation
- fibula fractures
- Prolonged or regular pressure, such as from a tight cast, crossing your legs regularly, or wearing tall boots regularly
- Pressure on the knee due to positioning during sleep, surgery, or when in a coma
Diseases that can damage the peroneal nerve include:
- autoimmune diseasessuch as polyarteritis nodosa
- Neurom(Tumor on the nerve sheath)
- Other types of tumors or growths
- Diabetes
- alcoholism
- Charcot-Marie Tooth disease
Symptoms of common peroneal nerve neuropathy may include:
- Decreased sensation, numbness, or tingling in the skin innervated by this nerve or its branches
- Pain in the lower leg or foot
- Weakness in the biceps femoris
- Weakness in foot and ankle
- foot fall(Inability to dorsiflex foot while walking due to ankle and foot extension paralysis)
- The affected foot makes a "slapping" sound with each step
- pulling toes
- Loss of muscle mass due to lack of nerve stimulation
Common peroneal nerve neuropathy is typically diagnosed using a combination of methods depending on the specific symptoms and suspected causes. This can include:
- Physical examination
- Electromyography (EMG), which is a test of electrical activity in muscles
- nerve conduction tests, which measure how fast electrical signals travel through nerves
- Magnetic resonance imaging (MRI)
- nerve ultrasound
- blood tests
- X-rays
- Andere Scans
Rehabilitation
The first step in treating common peroneal nerve neuropathy is treating the underlying cause, whether it is a disease or an injury. If this isn't enough to relieve symptoms, or if symptoms are severe enough to warrant immediate treatment, you have several options.
- Physiotherapy to maintain or regain muscle strength
- Occupational therapy to help you maintain or regain mobility and function
- Braces, splints, orthopedic shoes or other devices to help you walk
Over-the-counter pain relievers can help relieve symptoms. If they don't provide enough relief, your doctor may prescribe other medications used specifically for nerve pain. These include:
- Gabapentin
- carbamazepine
- Amitriptyline or other tricyclic antidepressants
If your neuropathic pain is severe, you should ask your doctor to see a pain specialist.
Corticosteroid injections may be considered in some patients to reduce swelling and pressure on the nerve.
Surgery may be an option when:
- Movement is severely impaired
- The neuropathy does not go away unless the underlying cause is treated
- The nerve axon is damaged
- Something, such as a tumor, is putting pressure on the nerve
3 sources
Verywell Health uses only quality sources, including peer-reviewed studies, to back up the facts in our articles. Read ourseditorial processto learn more about how we fact-check our content and keep it accurate, reliable, and trustworthy.
Hardin JM, Devendra S.Anatomy, bony pelvis and lower extremity, peroneal (fibular) nerve of calf. In: StatPearls.
Arora AK, Verma P, Abrol S.An abnormal variation in the division pattern of the common peroneal nerve.Int J Appl Basic Med Res. 10.4103/2229-516X.91159
Lezak B, Massel DH, Varacallo M.Injury to the peroneal nerve (fibularis).. In: StatPearls.
Additional reading
Kitamura T., Kim K., Morimoto D., et al.Dynamic factors involved in peroneal nerve entrapment neuropathy. Acta Neruochir. 2017 Sep;159(9):1777-1781. doi:10.1007/s00701-017-3265-2
Neuromuscular Disease Center, Washington University.Common peroneal nerve.
Physiopedia.Common peroneal nerve.
TeachMeAnatomy.The common fibular nerve.
Van den Bergh FR, Vanhoenacker FM, De Smet E, Huysse W, Verstraete KL.N. Peroneus: Normal anatomy and pathologic findings on routine MRI of the knee. Insights imaging. 2013 Jun;4(3):287-99. doi:10.1007/s13244-013-0255-7
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Adrienne Dellwo is a veteran journalist who has been diagnosed with fibromyalgia and has written extensively on the subject.
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FAQs
What does the common peroneal nerve do? ›
The peroneal nerve is a branch of the sciatic nerve. It supplies movement and sensation to the lower leg, foot and toes. Common peroneal nerve dysfunction is a type of peripheral neuropathy (nerve damage outside the brain or spinal cord).
Where is the peroneal nerve located and what is its function? ›The superficial peroneal nerve provides motor innervation to the muscles of the lateral compartment, the peroneus longus and brevis muscle. Sensory innervation is provided to the anterolateral side of the lower leg, where the nerve pierces the crural fascia, and to the dorsum of the foot.
What does the common peroneal nerve supply? ›The superficial fibular (peroneal) nerve supplies the muscles of the lateral compartment of the leg and provides sensation to the anterolateral aspect of the leg. The deep fibular (peroneal) nerve, on the other hand, mainly supplies the muscles of the anterior compartment of the leg and the dorsum of the foot.
How do you assess the common peroneal nerve function? ›Electrodiagnostic studies, including nerve conduction velocity (NCV) tests and electromyography tests (EMG), can be used to diagnose peroneal nerve palsy. These tests help in the evaluation of the motor and sensory axons of the peroneal nerve and its branches. They are also helpful in the localization of nerve injury.
What muscles does the peroneal nerve affect? ›The deep peroneal nerve provides motor innervation to the four muscles of the anterior compartment: the tibialis anterior, extensor digitorum, extensor hallucis longus and peroneus tertius muscle.
What are the muscles that are affected if the common peroneal nerve is damage? ›Peroneal nerve injuries affect the nerve that runs from your glutes, down the back of your thigh and around your knee, and down the front and side of your legs, to your feet. If you have a peroneal nerve injury, you may have numbness in your lower leg or foot. Many people develop a foot drop.
What are the symptoms of peroneal nerve damage? ›- numbness, tingling, or loss of sensation in the top of your foot or outer part of your lower leg.
- changes to the way you walk, such as dragging your toes or walking with a higher-than-normal step.
- tripping more often than usual due to foot drop.
The common peroneal nerve, also known as the common fibular nerve, is a major nerve that innervates the lower extremity. As one of the two major branches off the sciatic nerve, it receives fibers from the posterior divisions of L4 through S2.
How do you strengthen your peroneal nerve? ›Sitting upright on the floor, place the resistance band around the ball of one foot and then extend that leg out in front. Point the toes on the extended leg away from the body, then slowly flex the ankle by pulling the toes toward the shin. Repeat the movement up to 10 times. Repeat the exercise on the other leg.
Where is common peroneal nerve? ›The common fibular nerve (also known as the common peroneal nerve, external popliteal nerve, or lateral popliteal nerve) is a nerve in the lower leg that provides sensation over the posterolateral part of the leg and the knee joint.
What nerve causes pain from knee to foot? ›
Tibial nerve dysfunction occurs when there is damage to the tibial nerve. Symptoms can include numbness, pain, tingling, and weakness of the knee or foot. The tibial nerve is commonly injured by fractures or other injury to the back of the knee or the lower leg.
Which peroneal nerve causes foot drop? ›The most common cause of foot drop is compression of a nerve in the leg that controls the muscles involved in lifting the foot. This nerve is called the peroneal nerve. A serious knee injury can lead to the nerve being compressed. It can also be injured during hip or knee replacement surgery, which may cause foot drop.
Can sciatica affect peroneal nerve? ›Partial sciatic nerve injuries usually affect the lateral division (common peroneal nerve) more commonly than the medial division (tibial nerve); this is believed to be due to limited supportive tissue surrounding the peroneal nerve and the fact the peroneal nerve is taut and secured at both its proximal and distal ...
How do I know that my peroneal nerve is healing? ›Another indication of healing may be muscle twitching, particularly for individuals with severe foot drop after a neurological injury. As the brain rewires itself through neuroplasticity, initial signs of movement may involve muscle twitching, indicating muscle activation which is a sign of healing from foot drop.
What is common peroneal nerve irritation? ›Common peroneal nerve entrapment is usually due to scar tissue in the region of the common peroneal nerve, which can lead to localized pain, numbness over the anterior and lateral aspects of the leg and foot, and weakness of the foot in dorsiflexion, toe extension, and foot eversion.
Can peroneal nerve damage cause ankle pain? ›Damage to the peroneal nerve can cause pain, tingling or numbness at the top of the foot. It may become difficult to raise your toes, your toes or ankle may feel weak, or your foot may feel like it is dropping when walking. In severe cases, you may be completely unable to lift your toes or foot or turn your ankle.
What is the most common site of injury of the peroneal nerve? ›The common sites of involvement are either at the spine (lumbar nerve roots) or at the knee (common peroneal nerve). Specifically, when the peroneal nerve is involved, it is the deep branch that is responsible for the loss of action.
Can peroneal nerve damage cause knee pain? ›A peroneal nerve injury is damage to the nerve on the outer part of the lower knee. This nerve sends impulses to and from the leg, foot, and toes. Damage can cause weakness, numbness, and pain.
What doctor treats peroneal nerve damage? ›By taking a multidisciplinary approach to treatment, your surgeon will have access to other specialists—from intensivists and hospitalists, to endocrinologists and physical therapists—that will work closely together to diagnose and treat your condition.
Can the peroneal nerve repair itself? ›Abstract. Aim: Common peroneal nerve (CPN) injuries represent the most common nerve lesions of the lower limb and can be due to several causative mechanisms. Although in most cases they recover spontaneously, an irreversible damage of the nerve is also likely to occur.
What is the success rate of peroneal nerve surgery? ›
The majority of patients reported that they had experienced an improvement due to the surgery (63%), that they were satisfied with the results of the surgical treatment (76%), most would undergo the surgery again if they had known the results (88%), and just above one-third of patients noticed a significant pain relief ...
What is common peroneal nerve compression? ›If you have trouble lifting your foot when you walk, tingling in your feet, or difficulty straightening your toes, you may have a condition called common peroneal nerve compression. This condition, more commonly referred to as foot drop, can interfere with your mobility and quality of life.
How do you treat common peroneal nerve damage? ›Nonsurgical treatments, including orthotics, braces or foot splints that fit inside the person's shoe, can bring relief. Physical therapy and gait retraining can help the person improve their mobility. Some injuries may require peripheral nerve surgery, including one or more of these procedures: Decompression surgery.
What exercises can you do for common peroneal nerve pain? ›Peroneal Nerve Flossing Gliding Exercises
Lay on your back. Pull the affected knee towards the chest, supported by your hands. Gently straighten leg by lifting foot towards the ceiling until a light stretch is felt. Slowly point your foot and turn it towards the inside.
Treatments for Peroneal Neuropathy
Patient can try applying heat or ice pack on the painful areas to relief the pain. However, as these options are only symptomatic relief only, it is recommended for patients to consult a healthcare professional to first addressing the underlying cause of the condition.
There are various causes. Your knee joint can wear down as you get older, or you might injure your knee and tear the ligament or cartilage in it. Two common conditions that cause pain behind the knee are a posterior cruciate ligament injury and a popliteal cyst (Baker's cyst).
Which nerve is responsible for leg pain? ›Sciatic nerve
The sciatic nerves branches from your lower back through your hips and buttocks and down each leg. Sciatica refers to pain that travels along the path of the sciatic nerve. The sciatic nerve travels from the lower back through the hips and buttocks and down each leg.
The tibial nerve enables the lower leg to receive messages from the brain. It starts above the knee in the back of the leg. The nerve connects to 21 muscles that make it possible to move your leg, foot and toes.
What muscles are weak in foot drop? ›Muscle weakness affects both ankle dorsiflexion (tibialis anterior), toe extension (e.g., extensor hallucis longus), and ankle evertors (peroneus longus and brevis).
Is foot drop reversible? ›Foot drop can get better on its own and with treatment, but sometimes it can be permanent. Less common causes of foot drop include: inherited conditions like Charcot-Marie-Tooth disease. muscle weakness caused by muscular dystrophy, spinal muscular atrophy or motor neurone disease.
Can peroneal nerve damage heal on its own? ›
Abstract. Aim: Common peroneal nerve (CPN) injuries represent the most common nerve lesions of the lower limb and can be due to several causative mechanisms. Although in most cases they recover spontaneously, an irreversible damage of the nerve is also likely to occur.