Can a Trapped Peroneal Nerve Cause Foot Drop?

Yes. A trapped, compressed or injured common peroneal nerve can cause foot drop.

The common peroneal nerve helps control muscles that:

• Lift the front of the foot
• Lift the toes
• Turn the foot outwards
• Stabilise the foot during walking

It also carries sensation from parts of the:

• Outer lower leg
• Top of the foot

When signals cannot travel normally through the nerve, the muscles responsible for lifting the foot may become weak or paralysed.

The result can include:

• The toes dragging
• The front of the shoe catching the floor
• Foot slap after the heel lands
• A high-stepping walking pattern
• Numbness or altered sensation
• Difficulty turning the foot outwards
• An increased risk of trips and falls

The NHS identifies injury to the nerve controlling the muscles that lift the foot as the most common cause of foot drop.

What Is the Common Peroneal Nerve?

The common peroneal nerve is a branch of the sciatic nerve.

It travels:

1. Down the back of the thigh as part of the sciatic nerve
2. Towards the back and outside of the knee
3. Around the head and neck of the fibula
4. Into the outer and front parts of the lower leg
5. Towards muscles and sensory areas in the foot

The fibula is the smaller bone on the outside of the lower leg.

Near the fibular head, just below and outside the knee, the common peroneal nerve lies close to the skin and bone. This exposed position makes it particularly vulnerable to:

• Direct pressure
• Compression
• Stretching
• Trauma
• Surgical injury

The Royal National Orthopaedic Hospital describes the common peroneal nerve as lying behind the knee and supplying sensation to the top of the foot as well as the movements that lift the ankle and foot upwards and outwards.

Is the Common Peroneal Nerve Also Called the Fibular Nerve?

Yes.

You may see the same nerve described as the:

• Common peroneal nerve
• Common fibular nerve
• CPN

“Fibular nerve” is increasingly used in anatomical terminology because the nerve passes around the fibula.

The terms common peroneal nerve and common fibular nerve generally refer to the same structure.

Why Is the Nerve Easily Trapped Near the Knee?

The nerve passes around the fibular head with relatively little soft-tissue protection.

Pressure can therefore be applied by:

• The opposite knee during leg crossing
• A hard bed or chair
• A tight brace or cast
• Prolonged kneeling
• Repeated squatting
• Surgical positioning
• Swelling
• A lump or cyst
• Trauma near the outside of the knee

Pressure may temporarily block nerve signals or cause more substantial damage.

The severity depends on:

• How much pressure was applied
• How long it lasted
• Whether the nerve was stretched
• Whether fibres within the nerve were damaged
• Whether blood flow to the nerve was affected
• The person’s underlying health

Can Crossing Your Legs Cause Foot Drop?

It can.

Repeatedly or continuously crossing the legs may press the common peroneal nerve against the fibular head.

This does not mean that briefly crossing your legs will normally cause permanent nerve damage.

The risk is more relevant when pressure is:

• Prolonged
• Repeated
• Combined with reduced sensation
• Combined with substantial weight loss
• Applied while someone is unable to change position
• Applied to an already vulnerable nerve

The NHS lists crossing the legs for prolonged periods among the possible causes of nerve-related foot drop.

Someone who develops weakness after prolonged leg crossing should not assume that the nerve will automatically recover. New foot drop still requires medical assessment.

Can Kneeling or Squatting Cause Peroneal Nerve Compression?

Yes.

Prolonged kneeling or squatting can place the knee and lower leg in positions that compress or stretch the nerve.

This may be relevant for people whose work or activities involve:

• Floor fitting
• Gardening
• Plumbing
• Roofing
• Construction
• Decorating
• Repeated crouching
• Certain religious or cultural positions
• Sitting back on the heels for long periods

The NHS includes prolonged kneeling and squatting among recognised circumstances associated with nerve injury and foot drop.

Use of knee protection may reduce direct surface pressure, but it does not guarantee that the nerve will not be compressed by prolonged positioning.

Can Rapid Weight Loss Cause Foot Drop?

It can contribute.

Fat around the outside of the knee helps provide some cushioning over the nerve.

After substantial or rapid weight loss, the nerve may have less protection from pressure.

Risk may increase when weight loss is combined with:

• Prolonged bed rest
• Leg crossing
• Reduced mobility
• Illness
• Poor nutrition
• Muscle wasting
• Repeated pressure against a chair or bed

Unexplained foot drop after weight loss should be assessed rather than attributed automatically to reduced padding.

Other causes may still be present.

Can Being in Hospital Cause Peroneal Nerve Palsy?

Prolonged immobility can contribute to nerve compression.

Someone who is:

• Unconscious
• Sedated
• Very weak
• Unable to turn independently
• Recovering from major surgery
• Confined to bed for a long period

may maintain pressure against the outside of the knee without recognising or relieving it.

The NHS includes prolonged immobility, such as an extended hospital stay, among the circumstances that can contribute to nerve-related foot drop.

Positioning, pressure relief and early mobilisation may form part of prevention and recovery planning.

Can a Cast or Brace Trap the Peroneal Nerve?

Yes.

A cast, splint, brace or tight band positioned near the fibular head may compress the nerve.

Warning signs can include:

• New foot drop
• Increasing numbness
• Tingling
• Burning pain
• A tight or painful area near the outer knee
• Difficulty moving the toes
• A cold or discoloured foot
• Increasing swelling

Seek urgent advice if these symptoms develop after the application of a cast or brace.

Do not:

• Push padding underneath a tight cast
• Cut the cast yourself
• Ignore worsening numbness
• Continue tightening a brace around the outer knee

A foot drop AFO is normally positioned around the lower leg, ankle and foot, but any support must still be checked to ensure that its upper edge or strap is not creating harmful pressure.

Can a Knee Injury Damage the Peroneal Nerve?

Yes.

The common peroneal nerve may be stretched, compressed or torn during injuries involving the outside or back of the knee.

Examples include:

• Knee dislocation
• Fibular-head fracture
• Severe ligament injury
• High-energy sports injury
• Road-traffic collision
• Penetrating trauma
• Direct blow to the outer knee

The Royal National Orthopaedic Hospital identifies knee dislocation as one situation in which the common peroneal nerve can be damaged.

Foot drop following significant knee trauma requires prompt assessment because the injury may involve:

• Nerves
• Blood vessels
• Ligaments
• Bones
• The knee joint

Can Knee Surgery Cause Foot Drop?

It can occur as a complication of surgery around the knee.

The nerve may be affected by:

• Stretching
• Direct injury
• Swelling
• Scar tissue
• Surgical positioning
• Postoperative compression
• A haematoma
• A tight dressing or brace

The NHS lists knee replacement surgery among possible causes of nerve-related foot drop, and RNOH identifies total knee replacement as an example of surgery after which the common peroneal nerve may be injured.

New weakness after surgery should be reported promptly to the surgical team.

Do not assume it is ordinary postoperative stiffness.

Can Hip Surgery Cause Foot Drop?

Yes.

Foot drop following hip surgery may result from injury or compression involving:

• The sciatic nerve
• Its common peroneal division
• Nerve roots
• Surgical positioning
• Swelling or bleeding

The NHS includes hip replacement surgery among circumstances associated with nerve-related foot drop.

The exact location of the nerve problem may therefore be:

• Near the spine
• Around the hip
• Within the thigh
• Near the knee

A person can experience peroneal-pattern weakness without the nerve necessarily being trapped at the fibular head.

Is Peroneal Nerve Compression the Same as Sciatica?

No.

They can produce overlapping symptoms but involve different locations.

Peroneal nerve compression

This usually involves the peripheral nerve around the outer knee or lower leg.

Sciatica or lumbar nerve-root compression

This involves nerve roots leaving the lower spine, commonly due to a slipped disc or another spinal problem.

Both can cause:

• Weakness lifting the foot
• Numbness
• Tingling
• Pain
• Walking changes

Features suggesting a spinal source may include:

• Back pain
• Pain travelling from the back or buttock
• Symptoms affecting a broader part of the leg
• Weakness involving movements not supplied only by the peroneal nerve
• Changes in reflexes

A clinical examination and sometimes tests are needed to distinguish them.

The NHS identifies both peripheral nerve injury and slipped disc as possible causes of foot drop.

Can a Slipped Disc Cause the Same Type of Foot Drop?

Yes.

A slipped disc can compress a nerve root in the lower spine that contributes to the muscles responsible for lifting the foot.

The resulting symptoms may resemble common peroneal nerve palsy.

This is why new foot drop should not be self-diagnosed as a trapped nerve at the knee.

The treatment for:

• Peroneal nerve compression
• Lumbar nerve-root compression
• Peripheral neuropathy
• Stroke
• Muscle disease

may be very different.

What Are the Symptoms of Common Peroneal Nerve Injury?

Symptoms can include:

• Weakness lifting the front of the foot
• Weakness lifting the toes
• Difficulty turning the foot outwards
• Foot slap
• Toe dragging
• A high-stepping gait
• Numbness over the top of the foot
• Numbness over the outer lower leg
• Tingling
• Burning pain
• Electric-shock-like pain
• Reduced awareness of foot position

RNOH identifies pain, altered sensation and foot drop with weakness lifting the foot and toes upwards and outwards as signs of common peroneal nerve injury.

Not everyone will have all these symptoms.

Some people develop predominantly:

• Weakness
• Sensory change
• Pain

while others have a combination.

What Is Foot Slap?

Foot slap occurs when the front of the foot lowers too quickly after the heel contacts the ground.

Instead of being controlled smoothly, the forefoot may strike the floor with an audible slap.

This can result from weakness in the muscles that:

• Lift the foot
• Control its gradual lowering

Foot slap may be an early or partial sign of nerve weakness before complete foot drop develops.

Why Does Someone With Foot Drop Lift Their Knee Higher?

When the ankle cannot lift the toes sufficiently, the body may compensate by raising the:

• Knee
• Hip
• Entire affected side of the pelvis

This is sometimes called a high-stepping or steppage gait.

The aim is to prevent the toes catching.

Other compensations may include:

• Swinging the leg outwards
• Leaning the trunk
• Taking shorter steps
• Walking more slowly
• Watching the ground continuously

These movements can increase fatigue and contribute to discomfort elsewhere.

Can Peroneal Nerve Damage Cause Numbness?

Yes.

The common peroneal nerve carries sensory information from parts of the outer lower leg and top of the foot.

Compression or injury may cause:

• Reduced sensation
• Complete numbness
• Tingling
• Burning
• Pins and needles
• Altered sensitivity

RNOH notes that common peroneal nerve injury can cause reduced or absent sensation, particularly over the nerve’s sensory territory.

Reduced sensation is important when choosing an AFO because the wearer may not feel:

• Rubbing
• Strap pressure
• A folded sock
• A developing blister
• A foreign object inside the shoe

More frequent visual skin checks may be required.

Can Peroneal Nerve Damage Be Painful?

Yes.

Nerve pain may feel different from ordinary muscular pain.

It can be described as:

• Burning
• Crushing
• Shooting
• Stabbing
• Tingling
• Electric shocks
• Hypersensitivity

RNOH specifically lists burning, crushing and electric-shock-like pain among possible symptoms of common peroneal nerve injury.

Some people have significant weakness with little pain.

The absence of pain does not mean that the nerve is unaffected.

Can a Peroneal Nerve Injury Affect Only Part of the Foot?

Yes.

The common peroneal nerve divides into branches that control different muscles and sensory areas.

Depending on the site and severity of injury, someone may experience:

• Weak ankle lifting
• Weak toe lifting
• Reduced outward foot movement
• Numbness mainly between particular toes
• Numbness across the top of the foot
• A combination of movement and sensory symptoms

A partial injury may therefore look different from complete foot drop.

Can Foot Drop Appear Suddenly?

Yes.

It may develop suddenly after:

• Knee trauma
• Surgery
• Prolonged compression
• A tight cast
• A spinal-disc problem
• Stroke
• Acute nerve injury

It may also develop gradually through:

• Peripheral neuropathy
• Repeated compression
• A growing lump
• Progressive neurological disease
• Long-term spinal problems

Sudden foot drop should not be ignored, even when there has been no obvious injury.

Can Peroneal Nerve Compression Affect Both Feet?

It is possible but less typical for a local compression at one fibular head.

Foot drop affecting both feet may raise concern about:

• Bilateral nerve compression
• Peripheral neuropathy
• A spinal condition
• An inherited neuropathy
• Neuromuscular disease
• A wider neurological condition

Bilateral foot drop should be medically assessed rather than assumed to be caused by the same local trapped nerve on both sides.

How Is a Trapped Peroneal Nerve Diagnosed?

The assessment commonly begins with a history.

The clinician may ask:

• When the weakness began
• Whether onset was sudden or gradual
• Whether there was an injury
• Whether surgery was performed
• Whether the legs were crossed for a long period
• Whether you had prolonged kneeling or squatting
• Whether you recently lost weight
• Whether you have back pain
• Whether you have diabetes
• Whether there is numbness
• Whether symptoms are worsening
• Whether both feet are affected

The physical examination may assess:

• Ankle dorsiflexion
• Toe extension
• Outward foot movement
• Sensation
• Reflexes
• Knee and hip movement
• Walking
• Muscle wasting
• Tenderness around the nerve
• Back and nerve-root signs

The NHS advises that a GP may examine the leg, foot and walking pattern and refer for investigations to establish the cause.

What Tests May Be Used?

Depending on the presentation, tests may include:

• Nerve-conduction studies
• Electromyography
• MRI
• Ultrasound
• X-ray
• CT
• Blood tests

RNOH identifies MRI, X-ray and nerve-conduction studies among investigations that may be used for common peroneal nerve injury.

The test selected depends on whether the clinician suspects:

• Local compression
• Traumatic nerve injury
• A spinal cause
• A mass or cyst
• A fracture
• Peripheral neuropathy
• Another neurological condition

What Are Nerve-Conduction Studies?

Nerve-conduction studies measure how electrical signals travel through a nerve.

They may help identify:

• Where signal transmission is reduced
• Whether the nerve is blocked
• Whether nerve fibres have degenerated
• How severe the injury may be
• Whether recovery is occurring

Electromyography may assess the electrical activity of muscles supplied by the nerve.

These investigations form only part of the diagnosis and must be interpreted alongside the clinical examination.

Can an MRI Show a Trapped Nerve?

An MRI may help identify:

• A mass
• A cyst
• Swelling
• Scar tissue
• Structural injury
• Spinal-disc compression
• Changes in nearby soft tissue

It may not be required in every case.

Ultrasound may also be used to examine a superficial peripheral nerve and surrounding structures.

The clinician will select imaging according to the suspected location and cause.

What Is a Conduction Block?

A conduction block occurs when nerve signals cannot pass normally through an injured or compressed area even though the nerve fibres beyond it have not necessarily died back.

This is sometimes called neurapraxia.

RNOH explains that this type of injury may recover without surgery, although decompression is occasionally required.

Recovery time varies and should not be predicted solely from the presence of foot drop.

What Is an Axonal or Degenerative Nerve Injury?

A more substantial injury can damage the internal nerve fibres.

The affected fibres may need to regrow towards the muscles and skin they supply.

Recovery can take much longer because the nerve must regenerate over distance.

RNOH notes that degenerative injuries may take many months to recover and that final function may not be known for a considerable period.

The degree of recovery depends on:

• Injury severity
• Injury location
• Distance to the muscle
• Age
• General health
• Timing of treatment
• Whether scar tissue or ongoing compression remains

Will a Trapped Peroneal Nerve Recover?

Sometimes.

Recovery is more likely when:

• Compression was mild
• Pressure was removed promptly
• The nerve remains structurally intact
• There is a conduction block rather than severe fibre loss
• The underlying cause is treated

Recovery may be slower or incomplete when:

• The nerve was severely stretched
• The nerve was cut
• Compression continued for a long time
• There is substantial degeneration
• The muscle has been denervated for an extended period
• An underlying condition continues to affect the nerve

The NHS states that foot drop can improve on its own or with treatment but can sometimes be permanent.

How Long Does Recovery Take?

There is no single recovery time.

Improvement might begin over:

• Days
• Weeks
• Months

More substantial nerve injuries can take considerably longer.

RNOH advises that common peroneal nerve recovery is highly variable and that final function may not become clear for up to one or two years in more serious cases.

Progress should be monitored clinically rather than judged only by time passed.

Can the Nerve Regrow?

Peripheral nerve fibres may regrow after certain injuries.

However, successful recovery depends on whether:

• The pathway remains available
• The distance is manageable
• Scar tissue does not block growth
• The muscle remains capable of responding
• The nerve fibres reconnect appropriately

RNOH explains that peripheral nerve fibres can regenerate but may do so slowly, and surgery is sometimes required to support or guide recovery.

What Treatments Are Used?

Treatment depends on why the nerve is affected.

It may include:

• Removing external pressure
• Avoiding prolonged leg crossing
• Changing kneeling or squatting habits
• Physiotherapy
• An AFO
• Pain treatment
• Management of diabetes or neuropathy
• Treatment of a spinal cause
• Surgical decompression
• Nerve repair or grafting
• Tendon-transfer surgery in selected long-term cases

The NHS lists physiotherapy, braces and splints among common foot-drop treatments and notes that surgery may be considered where movement loss is permanent.

Should You Stop Crossing Your Legs?

Avoid prolonged pressure over the outside of the knee, particularly when peroneal nerve compression is suspected or diagnosed.

Helpful changes may include:

• Keeping both feet supported
• Changing position regularly
• Avoiding sustained leg crossing
• Avoiding sitting with the outer knee pressed against a hard edge
• Using appropriate positioning during rest
• Taking regular movement breaks

Do not attempt to press or massage the nerve aggressively.

Persistent symptoms need assessment rather than relying only on posture changes.

Should You Avoid Kneeling?

You may need to reduce or modify prolonged kneeling and squatting while the nerve is recovering.

Where kneeling is unavoidable:

• Change position regularly
• Avoid sustained pressure near the fibular head
• Use appropriate occupational equipment
• Follow advice from physiotherapy or occupational health
• Stop if numbness or weakness increases

Knee pads protect against direct surface pressure but may themselves be too tight or sit in an unsuitable position.

Can Physiotherapy Help?

Physiotherapy may help by addressing:

• Ankle range
• Muscle activation
• Walking technique
• Knee and hip strength
• Balance
• Falls risk
• Safe use of an AFO
• Prevention of stiffness
• Use of a walking aid

Exercise cannot force a severely damaged nerve to recover immediately.

The programme should match:

• The location of injury
• Degree of nerve function
• Ankle flexibility
• Knee control
• Stage of recovery

Do not repeatedly exercise the ankle to exhaustion when movement is weak or absent without professional guidance.

Can an AFO Help Peroneal Nerve Foot Drop?

Yes.

An AFO may help manage the functional effect of the weakness by:

• Holding or assisting the forefoot
• Improving toe clearance
• Reducing foot slap
• Making foot placement more consistent
• Reducing the need for excessive high stepping
• Improving confidence during walking

It does not:

• Release the trapped nerve
• Repair nerve fibres
• Treat a spinal cause
• Guarantee recovery
• Prevent every fall

An AFO may be used:

• During nerve recovery
• During rehabilitation
• While investigations are ongoing
• For longer-term support where weakness persists

Which AFO May Be Suitable?

The choice depends on how much control is needed.

Textile support

May suit some people with relatively straightforward flaccid foot drop and good ankle stability.

Flexible leaf-spring AFO

May provide more consistent mechanical dorsiflexion assistance while allowing controlled movement.

Reinforced AFO

May be considered when a basic leaf spring flexes too much.

Carbon AFO

May provide lightweight structured support and dynamic response for a suitable wearer.

Custom-made AFO

May be needed where there is:

• Significant instability
• An unusual leg shape
• Pressure risk
• Fixed ankle restriction
• Knee involvement
• Inadequate control from stock devices

Recommended Leaf-Spring Support

The Ankle Foot Orthosis Light, SKU AFO, is a prefabricated polypropylene leaf-spring AFO intended for flaccid foot drop.

Its current features include:

• Dorsiflexion assistance
• A lightweight posterior leaf-spring design
• Injection-moulded polypropylene
• A full-length trimmable footplate
• An open heel
• A detachable washable padded calf band
• Professional heat modification where appropriate
• Separate left- and right-foot versions
• Small, Medium, Large and X Large sizing

The product contains latex.

It may suit someone with peroneal nerve-related flaccid foot drop where:

• The ankle remains flexible
• The foot and leg fit a standard size
• Side-to-side instability is limited
• The heel can remain seated
• Suitable supportive footwear is available

It may not provide enough control where:

• The foot turns strongly
• Significant spasticity is present
• The ankle is fixed
• The knee is substantially unstable
• Skin or sensation creates complex pressure risk

Can You Use a Textile Brace Instead?

Possibly.

A textile support such as Boxia® or StepUp® may help lift the front of the foot where the presentation is:

• Flaccid
• Flexible
• Relatively stable from side to side
• Suitable for adjustable traction assistance

A textile support may be preferred where:

• Less room inside the shoe is available
• A low-profile option is wanted
• Shoeless indoor use is important
• The wearer can manage its straps

It may not provide the same mechanical consistency or ankle stability as a structured AFO.

Should You Wait for the Nerve To Recover Before Using a Brace?

Not necessarily.

Leaving the toes to drag can increase the risk of:

• Trips
• Falls
• Repeated shoe scuffing
• Compensatory walking
• Fatigue
• Reduced confidence
• Avoidance of activity

An AFO may provide temporary functional support while recovery is monitored.

Using a brace does not prove that the weakness is permanent.

The wearing plan should be reviewed as nerve function changes.

Does Wearing an AFO Stop the Nerve Recovering?

An appropriately selected AFO does not physically prevent the nerve from regenerating.

Its purpose is to support the limb while walking.

The wearer may also complete prescribed exercises or rehabilitation outside the brace where appropriate.

Do not stop using an AFO simply because you believe the muscles must work without assistance for the nerve to recover.

Discuss changes with the treating clinician.

Will the AFO Need To Change During Recovery?

Possibly.

As movement improves, the wearer may require:

• Less dorsiflexion assistance
• A more flexible device
• A textile support
• Different strap tension
• Less wearing time
• No AFO for selected activities

If weakness worsens or the ankle becomes less stable, more support may be required.

Review is appropriate when:

• Active movement changes
• The brace begins feeling too strong
• The knee moves differently
• Toe clearance changes
• The device becomes loose
• Swelling reduces
• Walking goals increase

Can Functional Electrical Stimulation Help?

FES is normally used for selected foot drop of central neurological origin, such as following stroke or with multiple sclerosis.

It depends on an intact peripheral nerve-and-muscle pathway that can respond to stimulation.

Where the common peroneal nerve itself is substantially damaged, stimulation may not produce an effective response.

An AFO is therefore often a more practical mechanical option for peripheral peroneal nerve palsy.

Suitability should be determined through specialist assessment rather than trialling a general electrical stimulation unit independently.

Can Surgery Release the Nerve?

Sometimes.

Surgery may be considered where:

• Ongoing compression is suspected
• Scar tissue surrounds the nerve
• A structural problem is present
• Recovery is not progressing as expected
• The nerve was cut or severely damaged
• Pain or function may benefit from exploration

Possible procedures include:

• Decompression
• Neurolysis, which releases scar tissue
• Nerve repair
• Nerve grafting
• Tendon transfer in selected long-term cases

RNOH explains that common peroneal nerve exploration may involve releasing scar tissue and, in more serious injuries, nerve grafting.

Surgery is not required for every compressed nerve.

When Is Tendon Transfer Considered?

Where nerve recovery is unlikely or foot drop has become permanent, a tendon from a functioning muscle may sometimes be repositioned to help lift the foot.

This is a specialist surgical decision.

It may be considered according to:

• Duration of weakness
• Nerve recovery
• Ankle range
• Muscle strength
• Foot alignment
• General health
• Walking goals

An AFO may still be required before or after surgery.

Can You Drive With Peroneal Nerve Foot Drop?

Driving depends on whether the affected leg can operate the vehicle controls safely.

Consider:

• Whether the right or left foot is affected
• Manual or automatic transmission
• Strength
• Sensation
• Speed of movement
• AFO restriction
• Pedal accuracy
• The underlying cause

Do not drive if you cannot:

• Move reliably between pedals
• Apply the brake firmly
• Release the accelerator
• Judge pedal pressure
• Prevent the brace or shoe catching

Check DVLA and insurer requirements and obtain a specialist driving assessment where control is uncertain.

Can You Continue Working?

It depends on the job and severity of symptoms.

Work may be affected when it involves:

• Prolonged standing
• Long walking distances
• Ladders
• Uneven ground
• Kneeling
• Squatting
• Heavy machinery
• Driving
• Safety footwear
• Carrying loads

Occupational-health advice may help identify:

• Temporary restrictions
• Alternative duties
• Seating
• Reduced kneeling
• Additional breaks
• Suitable footwear
• AFO accommodation
• Falls precautions

Do not conceal new foot drop when it creates a workplace safety risk.

How Can You Reduce Falls Risk?

Helpful measures include:

• Wearing well-fitting supportive footwear
• Using the prescribed AFO
• Using a walking aid where needed
• Keeping floors clear
• Removing loose rugs
• Securing electrical cables
• Improving lighting
• Using handrails on stairs
• Slowing down when fatigued
• Taking care on thresholds and uneven surfaces

The NHS advises supportive footwear, walking aids where required, clear floors, good lighting and stair handrails because foot drop increases the risk of tripping and falling.

When Should an AFO Be Reviewed?

Arrange a review if:

• Toe clearance remains poor
• The heel lifts
• The brace slips
• The foot turns inward or outward
• The knee gives way
• The knee moves sharply backwards
• The device rubs
• Redness persists
• The skin blisters or breaks
• Sensation changes
• The brace cracks
• Nerve function improves or worsens
• The footwear no longer fits
• Activity needs change

Take the:

• AFO
• Usual socks
• Regular footwear
• Walking aid
• Details of any falls
• Photographs of skin marks

to the appointment.

What Should You Avoid Doing?

Avoid:

• Ignoring new weakness
• Assuming all foot drop is caused by the knee
• Continually crossing the affected leg
• Prolonged pressure against the outer knee
• Tight bands around the fibular head
• Aggressive self-massage of the nerve
• Forcing the ankle into a brace
• Altering an AFO yourself
• Walking through repeated toe catching
• Buying electrical stimulation equipment without assessment
• Waiting for a fall before seeking help

Simple Peroneal Nerve Foot-Drop Checklist

Seek medical assessment if you notice:

• Difficulty lifting the foot
• Difficulty lifting the toes
• New foot slap
• High stepping
• Numbness on top of the foot
• Numbness outside the lower leg
• Weakness turning the foot outwards
• Burning or electric-shock-like pain
• Symptoms after knee injury or surgery
• Symptoms after prolonged pressure near the knee
• Worsening weakness
• Repeated trips

While awaiting assessment:

• Avoid prolonged pressure over the outer knee
• Use supportive footwear
• Keep floors clear
• Use your prescribed walking aid
• Do not drive if pedal control is unreliable
• Inspect numb skin
• Seek advice about an AFO
• Record when and how the symptoms started

Can a Peroneal Nerve Injury Permanently Cause Foot Drop?

Yes, but not every case becomes permanent.

A mild compression may recover.

A severe injury may leave:

• Lasting weakness
• Reduced sensation
• Ongoing nerve pain
• Permanent foot drop
• A continuing need for an AFO

The outcome depends on the severity and type of nerve injury.

RNOH notes that some injuries recover without surgery, while more severe damage can require prolonged recovery, decompression, repair or grafting.

Can an AFO Cure the Nerve Injury?

No.

An AFO manages the movement problem caused by the nerve weakness.

It does not:

• Decompress the nerve
• Regrow nerve fibres
• Remove scar tissue
• Treat a slipped disc
• Cure neuropathy

Its purpose is to help maintain safer and more efficient mobility while the underlying condition is assessed, treated or monitored.

When Should You Seek Urgent Help?

Seek urgent medical attention if foot drop is:

• Sudden
• Rapidly worsening
• Associated with major trauma
• Accompanied by severe pain or swelling
• Associated with a cold or discoloured foot
• Affecting both legs unexpectedly
• Accompanied by widespread weakness or numbness

Call 999 if leg weakness occurs with:

• Facial drooping
• Arm weakness
• Speech difficulty
• Confusion
• Sudden severe neurological symptoms

Seek urgent assessment if foot drop occurs with:

• Severe or worsening back pain
• Numbness around the genitals, buttocks or inner thighs
• Difficulty starting urination
• Loss of bladder or bowel control
• Rapidly worsening leg weakness

A brace should not be used to delay assessment of new neurological symptoms.