pain in the right hamstring and knee| walk with a limp| sciatica | common peroneal nerve injury | Auckland acupuncture clinic

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Yesterday I met a patient who told me that he suffered from sciatica for 3 weeks. he was walking with a limp to my consult room. He went to see a doctor and took painkillers, and then he went to see a physiotherapist, There was no more improvement, and his family doctor recommended a specialist to him, and he will do a lumbar MRI.

Short video for the people cannot watch the You tube.

What do you do in this situation for the patient, his doctor and physiotherapist did treatments, but he still has more pain in the leg and walks with a limp, and a specialist suggested he will do a Lumbar MRI. maybe many acupuncturists will do acupuncture based on sciatica with a lumbar problem, putting needles in the lower back, and leg.

For me, I will do a physical examination, especially a neurological exam, regardless of what the family doctor or specialist thinks. I will get my diagnosis in Western medicine through my exam and symptoms. I found these positive signs, dorsiflexion of the right foot is weakness, and dull feeling in the superior lateral of the right lower leg, so I do not think it is a lumbar spine, lumbosacral plexus problem, or sciatica.

There rarely is a dropped foot if it is a lumbar spine disc problem, because it is a solo nerve root injury; not only they have the weakness of the dorsiflexion of the foot, but they also have the weakness of the plantar flexion of the foot if it is lumbar spine disc or lumbosacral plexus injury. In this case, it has only the weakness of the dorsiflexion of the right foot. so I think it is a common peroneal nerve injury.

For the common peroneal nerve entrapment, there are two types of entrapments, one is in the peroneal tube, which is very common in the clinical, another one is in the Popliteal fossa lateral groove.

    Lateral groove and peroneal tube

It does not have the hypoalgesia in the superior lateral of the right lower leg if the common peroneal nerve entrapment level is in the peroneal tube, for this case, I will not think it is a common peroneal nerve entrapment because there is a hypoalgesia superior lateral of the right lower leg.

the sensation of the superior lateral of the right lower leg is controlled by the Lateral sural cutaneous nerve which is divided from the common peroneal never over the peroneal tube. for this case, it has lateral sural cutaneous never injury and the common peroneal never injury, so the level of never entrapment is over the peroneal tube.

So, I think the entrapment level is in the popliteal fossa lateral groove, for this case, there is more tenderness in the area when I did the pressure. and the patient felt very well after the first session needle nerve relaxation method.

What do you think? hope to get your opinions!

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