Pain Around the Peroneal Nerve in Knee

Hi,

For about a year now, I have had episodes of acute pain that traces along what I've been told is the peroneal nerve in my right knee.  I am not sure that it is the nerve itself, but the pain is certainly in that area.  I have been seeing an orthopedist/surgeon for around 9 months and we have tried many things with no real help.  I have two MRIs that revealed that I also have a small cyst along/attached to my right tibia or fibia (sorry can't remember).  When my nerve area hurts, I can also feel a lesser amount of pain around that area, which is in the center of my right leg not too close to the nerve pain area.

Aspiration procedures have been unsuccessful b/c the cyst is blocked from ultrasound location b/c of the bone.  I have tried physical therapy and am now also seeing a neurologist about the nerve area pain, which is really bad - I'd say a solid 7 on the pain scale.  Again, it is episodic, but I can't say what triggers it.  

The one EMG on my nerve came back normal and I dont have any obvious neurological problems like lifting up my toes.  But the pain is very localized and obvious in that area, also there is a little tingling.

My doctor is mulling over "minimally invasive" surgery on that nerve region on the outside of my knee. I guess to relieve any swelling or scarring or something rubbing up against the nerve.  The neurologist isn't so sure.  But the nerve pain medication he prescribed isn't doing much to help it.

Does anyone have any ideas as to what could be the problem??  Please!  I am really out of options and it hurts, but I have yet to hear one solid theory about what it could be.  I am open to suggestions also about who else, if anyone, to ask.  

Btw, surgery to remove the cyst would be very complicated and invasive because of its location, so thats more or less been ruled out.

Thanks!!

J

[jambezi]

Sorry,

If relevant, I did not have one single traumatic injury like a football tackle that blew out my knee.  However, I did use to do martial arts/wrestling and I think I hurt it doing takedowns in which my knee was bent funny.  The MRI showed slight bruising on three areas around my patella, but steroidal injections on the other side of the patella have not helped this pain at all, which is to the right side of the right patella.

I have also had problems with my super-high arches and resulting bad knee/leg posture for which I was prescribed orthopedic shoe inserts.

I am an otherwise healthy 23 yr old male.

[delta899]

A cyst on long bones such as the Fibula or Tibia is a very rare form of malignant bone cancer. Your doctor should of told that if the cyst developed within the bone tissue. There are many benign type of soft tissue cyst that occurs in muscles and even along the nerve outer fiber. They can put pressure on the nerve causing pain and can be severe pain. Most all are benign. Normal EMG only means the nerve, like a power cord, a electrical wire, is functioning property, no damage, but a cyst or even damaged muscle tissue putting pressure on a nerve can be very painful. As for the surgery remember the neurologist is an expert within the CNS & PNS, I would sway toward his/her advice concerning any neurological procedures. If it is a damaged muscle putting pressure on the nerve muscle relaxants can relieve the symptoms, adding physical therapy has high rates of success but with PT remember, no pain no gain. the following types of bone cancer/cyst are malignant and are very rare, check with your doctor if these are what they found, (Malignant fibrous histiocytoma, Fibrosarcoma, Leiomyosarcoma, Undifferentiated sarcoma of the bone. Also see link (http://www.cancerbackup.org.uk/Cancertype/Bone/General/Typesofprimarybonecancer) good luck.

[delta899]

Sorry, Leiomyosarcoma, would not be involved. Chondrosarcoma are another type bone cancer.

[Mcki]

Hi
I am experience a similiar type pain in my knee.  It started rather suddenly and within a few days grew to the point of pain that involuntarily causes me to scream out loud.  Each episode lasted no longer than 30 seconds or so, and were usually spaced out by hours of no pain.  At it's worse, it felt like a wave of increasing levels of pain all within 30 seconds or so, the first few seconds were tingling and sharp but caused no more than a grimice, then it felt like a knife digging into the center of my knee, then a dozen knives and finally like hot molten lava was being poured in.  The pain seems to be centered on the knee, nothing on the leg.  There was some minor swelling underneath both of my knees and they were a little tender to the touch in some areas all of the time.  

The weird thing, is that there was no correlation between the activities I was doing and the pain erupting.  I could be sleeping, sitting quitely, standing, walking, or doing aerobics.  And once the 30 second episode was over, there was absolutlely no pain and I could jump up on down on the knee with no affect.   However, after the pain left, it did take me a few mintues to recover from each attack, my breathing was very labored and endorphines (or something) were still rushing around.  I found out later this was an effect from the Sympthetic Nervous System being activated.

When the pain was so severe I couldn't go to work I went to an emergency care center where they took an X-Ray and an ultrasound of the leg but found nothing.  They told me it was a sprain knee and I should ice it and elevate it.  Yeah right.  But at least it ruled out bone fractures, arthritis, cysts or blood clots.  I thought it might be a pinched nerve so I went to Chriopratic Physican.  He listened to my symptons and looked at my leg and noticed that my pelvic bone was not aligned right which was causing a constant strain on my leg muscles.  My knee was caught in the middle of this tug of war.  I was surprised to find out that one leg was actually 1.5 inches shorter than the other due to the misrotation.  He adjusted my pevlic bone and worked on the leg muscles to restore balance and the pain immediately reduced.  It took a few more adjustments and daily stretching exercises at home but the pain is so minimal that it almost feels more like a vibration.  I had lumps on my opposite outside thiegh and inside ankle that I orginially thought might be cysts, although my general doctor couldn't make head or tails of them.  Turns out they were muscle knots from this same condition and they are getting smaller and disappearing as my sacroiliac joint function improves.  

It might be worth while to have a chriopratic examination.  It is totally noninvasive and a spinal misalignment might be a cause of so many ailments.  I wish you luck, it is so hard to funtion with unexplained pain, and not knowing what the condition is can be so frustrating.

[Pete73]

I had a sarcoma tumour on my right knee. To fill in the hole after excising the tumour, the surgeons took muscle and skin tissues from my thigh, and both sides of my calf. I experienced foot drop for a few months but it is almost gone now. However, although the surgery was successful, nerve pain developed. The plastic surgeon says the nerve pain is a result of the brian misinterpreting the nerve signals for normal body senses. Sometimes the pain is quite severe. It feels like my leg is asleep but with a more severe kind of needles sticking into me. It's also like an electrical shock striking me. It's a patchwork of varying degrees of intensity from my knee down to my toes. I am taking gabapentin, hydromorph contin, and methadone to control the pain but I am concerned that the morphine opiate will cause me to be addictive to that medication. I am currently trying acupuncture but to date with no success. Another method is desensitizing the skin by rubbing a variety of materials to train the nerve pathways to interpret the signals as normal rather than pain giving. So far, nothing works too well. Does anyone have any other suggestions? Does anyone have similar experiences?
Peter

[Lilybug007]

I have peroneal nerve pain in my left knee/calf.  The pain is non-stop and is completely aggravated by riding my horse and practicing yoga.  Before riding my horse I ice my calf and outer knee so that I can ride.  Riding is my passion and not something I am willing to give up.  I work very hard as a Pediatric Cardiac ICU nurse and find riding is a excellent balance.  I need to find a solution to this irritating/painful problem.  Has anyone tried cortical steroids injections into this area?

[Crazycincy]

I am getting ready to have surgery next week to have my peroneal nerve on in my left knee released as it is being pinched, and causing me pain continuously. I have pain that goes down my leg into my foot and causes numbness and tingling into my toes its awful and painful. I have tried everything for this pain and nothing takes this nerve pain away I cant take it anymore so they are going in and releasing the area that is being pinched.

[juan27]

i have  had knee surgery 1 year ago and my recovery should have been   6 to 8 week , and it been 18mos. and im still having knee pain, losing  strength in leeft leg but seen that no doctor im under cares. so i just gotten a emg/ncs test done and it shows L4,L5, S1 NERVE.SO NEVER LESS no knows whats going on . in pain . and it not good.

[Uptowned]

I have been experiencing the same for years. I found some running/ski tights that support the peroneal nerve in particular. AlignMed sells them or used to bit may be able to direct you. Foray relief in 10 years although they are designed for something so different, I am totally sold on terms of pain relief. I also use a kinesiologist specifically trained in ART since they understand the nerve/muscle relationship well. Of course a neurologist would be a good start they tend to thrive more on research imho.

[Pbo1273]

I had a bad fall from a horse this summer and landed directly on my knee from a cantering spin.  I was very lucky in that I just escaped with a bone bruise basically.  However the pain is very persistent and now they are thinking I have nerve damage.  I'm heading in for an injection this week to see if it is helpful at all.  Riding is my profession so the fact I am in pain when I ride is very troubling.  Here's to hoping the injection works!