Tibial nerve neuropathy

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Tibial nerve (n. tibialis)

The tibial nerve (n. tibialis) is a nerve with mixed functions (it is also responsible for movement and sensitivity). The tibial nerve is the other main branch of the sciatic nerve. The tibial nerve consists of fibers from L4 to S3 - the spinal nerves.

Functionally, the tibial nerve is largely an antagonist of the peroneal nerve. Its motor fibers innervate the flexor muscles of the foot, the flexor muscles of the fingers, and the muscles that rotate the foot inward.

The formation of the tibial nerve comes from the sciatic nerve.

Sensory fibers of the tibial nerve innervate the posterior surface of the lower leg, the sole and plantar surface of the toes with an approach to the dorsum of the terminal phalanges and the outer edge of the foot, consisting of fibers of the peroneal and tibial nerves.


Diagnostics of the tibial nerve neuropathy

Damage to the tibial nerve (tibial neuritis) causes paralysis of the muscles that flex the foot and toes (plantar flexion) and rotate the foot inward. Achilles reflex in tibial neuritis is lost.

Sensory disorders in neuritis of the tibial nerve occur on the back of the lower leg, sole, plantar surfaces of the fingers, on the back of their terminal phalanges. Articular-muscular feeling in the toes does not suffer from the preservation of the function of the peroneal nerve (it is disturbed only when both nerves are jointly damaged, i.e., the peroneal and tibial or the main trunk of the sciatic nerve).

Muscle atrophy in neuritis of the tibial nerve is usually significant and relates to the posterior muscle group of the lower leg and sole (deep arch of the foot, retraction of the intertarsal spaces). The foot is in the extension position. The gait is difficult but less than with a drooping "peroneal" foot; in this case, the patient stands on the heel due to the existing extension of the foot.

Diagnosis of the level of damage to the tibial nerve in neuritis is performed using electroneurography (ENG).

Tests for the determination of movement disorders in tibial neuritis are:

  1. Inability to flex (plantar) the foot and toes and turn the foot inward
  2. Inability to walk on toes

Pain with neuritis of the tibial nerve (and its fibers in the sciatic nerve) is often extremely intense.

Injuries to the tibial nerve and its bundles in the sciatic nerve trunk can cause the causalgic syndrome. Vasomotor-secretory-trophic disorders are also usually significant. In this respect, there is a certain similarity between the tibial nerve and the median nerve.

Post-traumatic neuropathies of the tibial nerve can occur when the tibia is fractured.


Tibial nerve neuropathy treatment

Treatment for neuritis of the tibial nerve is selected individually in each case. It includes a set of conservative procedures:

  • acupuncture
  • nerve and muscle stimulation
  • vitamins of group "B", "C" and "E"
  • homeopathic remedies
  • surgical treatment (neurolysis, stitching of the nerve trunk, etc.)

The use of acupuncture is very effective in the treatment of tibial neuropathy.

Neurostimulation (physiotherapy) eliminates paresthesias and pains, restores strength in the muscles with tibial neuropathy.

See also