Lower Limb Pain Associated with Nerve Entrapment

Compression of a nerve can result in discomfort in the lower leg along the distribution of that nerve.

Nerve	Muscles	Sensory
superficial peroneal	peroneus longus, peroneus brevis	medial side great toe; second through fifth toes except first interdigital cleft and lateral side of fifth toe
deep peroneal	anterior tibial compartment; weakness ankle dorsiflexion; extensor hallucis longus	first interdigitial cleft
sural		posterior and lateral aspects of distal third of the leg; lateral side of foot including fifth toe
saphenous		medial side of leg; medial aspect mid-foot

Mechanism of compression:

(1) compartment syndrome (associated with increased compartment pressure)

(2) muscle herniation through a fascial defect

(3) repeated trauma (dislocations, etc.)

(4) fibrosis

Nerve	Location Where Often Compressed
superficial peroneal	fascia delimiting the lateral compartment
deep peroneal	intermuscular septum delimiting the anterior compartment
deep peroneal	entrance to the fibular tunnel at the origin of the peroneus longus
sural	calf
saphenous	subsartorial (Hunter's canal)

Clinical Features:

(1) leg pain, which may be persistent

(2) burning sensation and/or paresthesias along the distribution of a nerve

(3) weakness or atrophy of muscle supplied by the nerve

(4) Tinel's sign (distal tingling on proximal percussion) may be present

(5) abnormal nerve conduction

(6) improvement on decompression

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