From Dr. Natalie Meiri’s Clinical Pearl Stories:
Chiropractic Treatment for Foot Drop Due to a Peroneal Neuropathy
Author: Natalie Meiri, D.C. Posted: 5/17/21
This was a 69 year old patient who had a chief complaint of aching pain in her right leg. To be HIPAA compliant, I will call her Andrea instead of her real name. It interfered with all her daily activities and she couldn’t sleep due to the pain. It had started about 3 months ago without any trauma. This was the first time she ever had this problem. And it had come on insidiously (progressed gradually). She had been seeing another doctor and came to see me when her chief complaint didn’t improve after 12 visits. Andrea was told her pain was coming from her low back (sciatica).
She presented to my office limping. Andrea had difficulty lifting the front part of her right foot. In other words, she had a foot drop on the right. On her intake form, Andrea specifically noted pain in her right knee, leg, ankle, and foot. Andrea had no history or symptoms of any systemic condition that could cause a neuropathy (i.e. diabetes). She was taking over the counter drugs such as acetaminophen (for pain) and a NSAID (Non-steroidal anti-inflammatory drug for inflammation) which seemed to help very little.
Andrea’s Examination and X-rays
Upon examination, there were positive tests for her low back, right hip, right knee, right ankle and right foot. Furthermore, she had positive tests for entrapment neuropathy in the lower right extremity (leg) of her superficial and deep peroneal nerves. After that, I took some x-rays of her lumbar spine (low back) and right knee. Findings on her x-rays were degenerative joint disease/ osteoarthritis (wear and tear arthritis) of her low back, right hip and right knee. Neurodiagnostic testing (EMG/NCV) would be ordered if there was no improvement within 12 visits for the peroneal neuropathy.
Andrea’s Chiropractic Treatment
for Foot Drop Due to a Peroneal Neuropathy
Andrea’s chiropractic treatment for right peroneal neuropathy consisted of chiropractic manipulation/ adjustments of the right knee, right ankle and associated regions. Associated regions that were adjusted were her lumbar spine and right hip, which were misaligned (subluxations or intersegmental dysfunctions) due to the condition she had. Additionally, soft tissue therapy (myofascial release, pressure point and various post isometric relaxation procedures) to the soft tissues/muscles entrapping the peroneal nerve (i.e. peroneus longus, brevis, tibialis anterior, extensor digitorum longus) were provided. And modalities (cold/heat therapy and electric muscle stimulation) were administered. Finally, she was given home therapeutic exercises and recommendations for ergonomics/activities of daily living (i.e. not crossing her legs, proper gait/posture).
Outcome for Chiropractic Treatment
for Foot Drop Due to a Peroneal Neuropathy
The outcome for Andrea was excellent! She started feeling better after the 2nd visit and gradually got better. Chiropractic adjustments restore joint mobility and function, resolves joint inflammation and reduces the patient’s pain. Anatomically, the kinetic chain describes the interrelated groups of body segments, connecting joints, and muscles working together to perform movements. Andrea’s lower right kinetic chain (ankle, lower leg, knee, hip, lumbar spine) needed realigning.
Injury to the common peroneal nerve results in a foot drop described as slapping or tripping. Pain and parethesia (pins and needles) may occur at the site of compression as well as distally into the lateral leg. At times there may be a radiation of pain into the thigh. Numbness and tingling can occur along the lateral leg and dorsum (upper surface) of the foot. Peroneal neuropathies occurring at the fibular (outer of two bones of the lower leg) neck (upper part of fibula) affect the DPN (deep peroneal nerve). The SPN (superficial peroneal nerve) entrapment occurs in the lower leg at the ankle frequently due to a twisting of the ankle.
Do you know someone who needs Chiropractic Treatment for Foot Drop Due to a Peroneal Nerve Neuropathy? Contact Meiri Chiropractic serving North Palm Beach, Jupiter, West Palm Beach, and Palm Beach Gardens today at 561-253-8984 for this or some other ailment.