Tibial Nerve Injury

Tibial nerve is present in the lower back region of the knee (knee pit), and it passes through the lower leg and foot. It is a branch of the sciatic nerve. At the back of the knee joint, the nerve splits into two branches. The articular branch goes to the knee joint, and the other cutaneous branch turns into the sural nerve.

Injury to the back of the knee or lower leg can lead to tibial nerve dysfunction, which is a type of peripheral neuropathy. Internal bleeding in the knee, development of tumor, or abscesses near the nerve can increase the pressure on the nerve. This increased pressure can reduce the blood supply to the nerve and cause serious damage to it.

Fractures at the back of the knee or lower leg can also damage the nerve. When a local trauma is responsible for the nerve injury, the condition is termed as 'mononeuropathy'. Systemic disorders, which affect the whole body, such as diabetes mellitus, can also result in loss of function of the nerve.

The posterior tibial nerve lies in the foot. It is present in the tarsal tunnel, the space between the sturdy bones and overlying tough fibrous tissue. Compression or entrapment of this part of the nerve is responsible for tarsal tunnel syndrome (just like a pinched nerve leads to carpal tunnel syndrome in the wrist). Fractures, bone spurs, ganglions, tumors, muscle impingement, or foot deformities can cause damage to this nerve.

In mononeuritis multiplex, systemic disorders resulting in isolated nerve damage, are often noticed. But most of the time, prolonged pressure or direct trauma is found to be the main cause of tibial nerve damage. Since the nerve passes through narrow structures, entrapment of the nerve is also one of the common causes of damaged nerve.

The nerve provides sensation and helps move the leg while walking, standing, running, or jumping. So, one should be aware of the symptoms that indicate injury and dysfunction of this nerve.

The symptoms of the injury depend upon the degree of damage to the nerve. There is a possibility that either only the myelin sheath (the insulation around the nerve) or a part of the nerve fiber (the axon) is destroyed due to the compression or pressure. This can seriously affect the conduction of impulses through the nerve, and thereby result in restricted movement of the leg or complete immobility (numbness).

Numbness, pain, tingling, or burning sensation in the lower leg or foot are some other symptoms of the injured nerve. One may experience weakness of the knee or foot. Treatment usually varies according to the cause and degree of damage.

Compression of the posterior tibial nerve in the tarsal tunnel results in numbness over the bottom of the foot. The patient may suffer from pain, and burning and tingling sensation over the base of the foot and heel. These symptoms are somewhat similar to the symptoms of plantar fasciitis or heel spurs.

People affected by incontinence or urinary urgency are benefited from the stimulation of tibial nerve. Impulses can be transferred to the nerves controlling the bladder function with the help of a low-frequency electrical stimulation of the nerve above the ankle.

Cortisone injections and anti-inflammatory medications are used to treat tarsal tunnel syndrome. Sometimes, the use of proper-fitting footwear helps relieve the nerve pain and other symptoms. As a last option, surgery can be performed to relieve the pressure on the nerve.

After examining the symptoms, the doctor may ask you to undergo certain tests to find out the exact cause of the pain or numbness. Physical therapy, occupational therapy, and painkillers can help relieve the symptoms.

As immobility can affect your daily activities, it is necessary to take care and consult a physician immediately if you notice any of the aforementioned symptoms.

Disclaimer: This story is for informative purposes only, and should not be used as a replacement for expert medical advice.