A Patient Guide
Peroneal nerve decompression surgery is a procedure designed to relieve pressure on the common peroneal nerve, which runs along the outer part of the knee and controls movement and sensation in the lower leg and foot. When this nerve becomes compressed, it can lead to pain, numbness, tingling, and weakness, a condition known as peroneal nerve entrapment or entrapment neuropathy. This surgery aims to restore nerve function, improve mobility, and reduce discomfort.
This guide will help you understand the procedure, its benefits, recovery process, and what to expect before and after surgery.
At Endoscopic & Minimally Invasive Spine Specialists, minimally invasive surgical principles are at the core of our surgical approaches. We have extensive experience and expertise in peroneal nerve decompression surgery, and provide the highest-quality care in surgical and non-surgical neurosurgical care.
To learn more about peroneal nerve decompression, call the office today or request an appointment online.
Understanding Peroneal Nerve Compression
What is the Peroneal Nerve?
The peroneal nerve is a branch of the sciatic nerve that runs down the leg and controls muscles responsible for lifting the foot (dorsiflexion). It also provides sensation to the upper foot and outer lower leg. Compression of this nerve can cause a condition called foot drop, where the patient has difficulty lifting the foot while walking.
Common Causes of Peroneal Nerve Compression
- Prolonged leg crossing – Sitting with legs crossed for long periods can put pressure on the nerve.
- Knee injuries – Trauma, fractures, or dislocations around the knee can compress the nerve.
- Tight casts or braces – Orthopedic devices that are too tight can restrict nerve function.
- Tumors or cysts – Masses around the nerve can cause compression.
- Diabetes or neuropathy – Nerve damage from medical conditions can contribute to compression.
Symptoms of Peroneal Nerve Compression
- Numbness or tingling in the outer lower leg and top of the foot.
- Weakness in the foot, causing foot drop (difficulty lifting the toes/foot).
- Pain or discomfort around the knee or shin.
- Difficulty walking or tripping due to weakness in foot movement.
What is Peroneal Nerve Decompression Surgery?
Peroneal nerve decompression surgery is a minimally invasive procedure that releases pressure on the nerve by removing or loosening tight structures around it. This allows the nerve to recover and improves symptoms such as foot drop and numbness.
Who is a Candidate for Surgery?
Surgery may be recommended if:
- Symptoms do not improve with conservative treatments such as physical therapy, medications, or bracing.
- There is persistent foot weakness, numbness, or pain.
- An MRI or nerve conduction study confirms nerve compression.
The Surgical Procedure
Before Surgery
- You will have a consultation with your surgeon to discuss your symptoms and test results.
- You may need to stop certain medications, such as blood thinners and aspirin, before surgery.
- Surgery is typically performed under local anesthesia with sedation or general anesthesia.
During Surgery
- A small incision is made near the fibular head (outer knee area).
- The surgeon carefully releases tight tissues compressing the nerve, such as fascia or scar tissue.
- If necessary, any cysts or abnormal growths around the nerve are removed.
- The incision is closed with stitches, and a bandage is applied.
- The procedure typically takes less than 30–60 minutes.
Recovery and Postoperative Care
Immediate Recovery
- You will be monitored for a short period after surgery and can go home the same day.
- Mild discomfort, swelling, and bruising around the knee are normal.
- Walking is encouraged the day of surgery to promote healing.
At-Home Recovery
- Activity Restrictions – Avoid excessive knee bending, squatting, or prolonged standing for the first few weeks.
- Pain Management – Over-the-counter pain relievers or prescribed medications can help with discomfort.
- Physical Therapy – Exercises to restore strength and improve foot movement may be recommended.
- Follow-Up Appointments – You will see your surgeon to check the healing progress and remove stitches if necessary.
Expected Recovery Timeline
- 1–2 weeks: Most swelling and pain subside.
- 4–6 weeks: Improved nerve function and reduced symptoms.
- 3–6 months: Full nerve recovery, depending on the severity of compression before surgery.
Potential Risks and Complications
While peroneal nerve decompression is generally safe, risks may include:
- Infection – Rare but possible; watch for redness, swelling, or drainage at the incision site.
- Persistent symptoms – Nerve healing can take months, and some symptoms may take time to improve. Typically, anti-neuropathic medications are prescribed.
- Scar tissue formation – In some cases, new scar tissue may cause recurring nerve compression.
Conclusion
Peroneal nerve decompression surgery is an effective procedure for relieving nerve compression and restoring mobility and sensation in the lower leg and foot. By following postoperative guidelines and engaging in rehabilitation, most patients experience significant improvement in function and quality of life.
If you have persistent foot drop, numbness, or weakness, consult with one of our surgeons to determine if peroneal nerve decompression surgery is the right option for you to provide a safer, more efficient path to recovery and improved quality of life.
If you’re ready to learn more about peroneal nerve decompression surgery for patient-centered care, call Endoscopic & Minimally Invasive Spine Specialists today, or book an appointment online.
