Abstract

Introduction/Background: This case highlights a male patient suffering from entrapment neuropathy of the common peroneal nerve after sustained heavy manual labor and physical strain as a football player. Peroneal neuropathy is the most common mononeuropathy encountered in the lower limbs.

Case: A 26-year-old male patient presented to the OMM clinic with right foot numbness and tingling. These symptoms were consistent and present on the dorsal and medial aspects of the foot. He did not experience pain but described the feeling as “uncomfortable and awkward”. Physical exam revealed impaired cutaneous sensation in this region of the foot. Osteopathic manipulative treatment was directed towards relevant somatic dysfunctions, including the sacrum (L unilateral flexion), pelvis (L posterior rotation), lower extremities (B/L externally rotated tibias, B/L anterior fibular heads, significant hypertonicity and myofascial restriction). The most effective localized treatments at the right foot consisted of balanced ligamentous tension, myofascial release, and counterstrain.

Results: Over the course of 3 visits, the patient demonstrated complete relief of symptoms, and a significant positive shift in mood and outlook. The patient had been on a hiatus from playing football. Since mitigating these symptoms, our patient has been named defensive MVP of his team and has been offered multiple semi-professional football contracts.

Discussion: This case provides an example of how OMM can be utilized in the treatment of entrapment neuropathy at the fibular head, namely of hypoesthesia and paresthesias. By utilizing a non-invasive treatment modality, symptomatology has remained entirely resolved for several months. This case study is limited by the lack of further objective measurements used before and after treatment, such as a numerical scale for intensity of symptoms, or imaging studies.