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Tibial nerve dysfunction
Neuropathy - posterior tibial nerve; Tarsal tunnel syndrome
Tibial nerve dysfunction is a loss of movement or sensation in the foot from damage to the tibial nerve.
Tibial
The tibia is the larger of 2 long bones in the lower leg. It is sometimes called the shin bone.
Causes
Tibial nerve dysfunction is an unusual form of peripheral neuropathy . It occurs when there is damage to the tibial nerve. This nerve is one of the lower branches of the sciatic nerve of the leg. It supplies movement and sensation to the calf and foot muscles.
Peripheral neuropathy
Peripheral nerves carry information to and from the brain. They also carry signals to and from the spinal cord to the rest of the body. Peripheral n...
Tibial
The tibia is the larger of 2 long bones in the lower leg. It is sometimes called the shin bone.
A problem in function with a single nerve group, such as the tibial nerve, is called mononeuropathy . The usual causes are:
Mononeuropathy
Mononeuropathy is damage to a single nerve, which results in loss of movement, sensation, or other function of that nerve.
- Direct trauma
- Pressure on the nerve for a long period
- Pressure on the nerve from nearby body structures
Entrapment creates pressure on the nerve when it passes through a narrow structure.
The damage may destroy the myelin sheath that protects and insulates the nerve, or part of the nerve cell (the axon). This damage reduces or prevents the movement of signals through the nerve.
Myelin
Myelin is an insulating layer, or sheath that forms around nerves, including those in the brain and spinal cord. It is made up of protein and fatty ...
The tibial nerve is often injured by pressure from a ligament on the inner part of the ankle. Injury or disease of structures near the knee may also damage the tibial nerve. The tibial nerve may also be affected by diseases, such as diabetes , which damage many nerves.
Diabetes
Diabetes is a chronic disease in which the body cannot regulate the amount of sugar in the blood.
In some cases, no cause can be found.
Symptoms
Symptoms may include any of the following:
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Sensation changes in the bottom of the foot and toes, including burning sensation,
numbness
, tingling, or other abnormal sensation
Numbness
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
ImageRead Article Now Book Mark Article - Pain in the bottom of the foot and toes
- Weakness of foot muscles
- Weakness of the toes or ankle
In severe cases, the foot muscles are very weak and the foot can be deformed.
Exams and Tests
Your health care provider will examine your legs and ask about your symptoms.
During the exam, your provider may find you have the following signs:
- Inability to curl the toes, push the foot down, or twist the ankle inward
- Weakness in the ankle, foot, or toes
Tests for tibial nerve dysfunction may include:
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EMG
(a recording of electrical activity in muscles)
EMG
Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.
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Nerve biopsy
Nerve biopsy
A nerve biopsy is the removal of a small piece of a nerve for examination.
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Nerve conduction tests
(recording of electrical activity along the nerve)
Nerve conduction tests
Nerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve.
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Other tests that may be ordered include blood tests and imaging tests, such as ultrasound or MRI .
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
MRI
A magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...
Treatment
Treatment is aimed at restoring feeling and strength to the foot and toes. In some cases, no treatment is needed, and people will recover on their own. Severe loss of sensation may lead to toe or foot sores (ulcers) and infections.
Surgery to enlarge the tarsal tunnel or transfer the nerve helps reduce pressure on the tibial nerve. This may help some people.
Over-the-counter pain medicines may relieve mild pain. Other medicines may be prescribed to help control severe pain.
Physical therapy may help some people maintain muscle strength.
A change in job or retraining may be recommended.
Outlook (Prognosis)
A full recovery is possible if the cause of the tibial nerve dysfunction is found and successfully treated. Some people may have a partial or complete loss of movement or sensation. Nerve pain may be uncomfortable and last for a long period of time.
Loss of movement
Muscle function loss is when a muscle does not work or move normally. The medical term for complete loss of muscle function is paralysis.
Nerve pain
Neuralgia is a sharp, shocking pain that follows the path of a nerve and is due to irritation or damage to the nerve. Common neuralgias include:Posth...
Possible Complications
Untreated, tibial nerve dysfunction may lead to the following:
- Deformity of the foot (mild to severe)
- Movement loss in the toes (partial or complete)
- Repeated or unnoticed injury to the leg
- Sensation loss in the toes or foot (partial or complete)
When to Contact a Medical Professional
Call your health care provider if symptoms of tibial nerve dysfunction are present. Early diagnosis and treatment increases the chance that symptoms can be controlled.
Prevention
Prevention varies depending on the cause of the nerve damage.
References
Katitji B, Koontz D. Disorders of the peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 76.
Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 420.
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Tibial nerve - illustration
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. It may be affected by systemic diseases such as diabetes mellitus. The nerve can also be damaged by pressure from a tumor, abscess, or bleeding into the knee. Treatment usually depends upon finding the source of the tibial nerve damage.
Tibial nerve
illustration
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Tibial nerve - illustration
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. It may be affected by systemic diseases such as diabetes mellitus. The nerve can also be damaged by pressure from a tumor, abscess, or bleeding into the knee. Treatment usually depends upon finding the source of the tibial nerve damage.
Tibial nerve
illustration
Review Date: 2/3/2015
Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
