Tibial Nerve Injury (L4-S3)

Overview


Plain-Language Overview

Tibial nerve injury (L4-S3) affects a major nerve in the lower leg that controls muscles and sensation in the calf, foot, and sole. This nerve is part of the peripheral nervous system and helps with movements like walking and standing on tiptoes. When injured, it can cause weakness, numbness, or pain in the lower leg and foot. People may have difficulty with balance and foot movements, leading to problems with walking. The injury can result from trauma, compression, or medical conditions affecting the nerve.

Clinical Definition

Tibial nerve injury (L4-S3) is a peripheral neuropathy involving damage to the tibial nerve, which arises from the sacral plexus (nerve roots L4 to S3). The injury commonly results from trauma, compression (e.g., tarsal tunnel syndrome), or iatrogenic causes such as surgery or prolonged immobilization. This nerve innervates the posterior compartment of the leg and the plantar foot muscles, providing motor function for plantarflexion and toe flexion, as well as sensory innervation to the sole. Clinically, it manifests as weakness in plantarflexion, loss of sensation in the sole, and sometimes foot deformities due to muscle imbalance. The injury can significantly impair gait and balance, increasing the risk of falls and disability.

Clinical Presentation


Diagnostic Workup


Pathophysiology


Treatments


Prevention


Outcome & Complications


Differential Diagnoses


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