Humans are able to move around and perform many daily activities with the presence of healthy limbs. Limb’s health is often taken for granted and many may not pay attention to it. To take care of your health means to take care of every single aspect of the body and mind, including the limb. In this article, we will be learning about what happens when one of the nerves of the lower limbs known as the sural nerve, is damaged.

First thing first, what is the sural nerve? Sural nerve is a cutaneous nerve, a nerve that functions to transmit sensation on the skin. For this reason, the sural nerve is also known as a sensory nerve. It is located under the skin, at the back of the calf of each leg. The sural nerve gives sensation to the back of the leg below the knee, ankle outer part of the foot and heel. The sural nerve detects touch, pain, temperature and vibration. This helps in foot placement by detecting the foot position and sensation. The sural nerve contains tiny string-like fibres that are wrapped with myelin and become nerve bundles. The nerve bundles connect to the spinal cord. The nerve signals travel quickly to and from the brain along the nerve bundles. In the case of the sural nerve, the nerve signals send the sensory message such as from touch on the ankle to the spinal cord. The spinal cord then makes contact with other nerve cells before the message is sent to the brain to be interpreted as a harmless touch.

          Now that you have known what the sural nerve and its function is, you probably can guess by now what happens when it is damaged. Yes, it affects the sensory function. When the sensory function is impaired, it leads to symptoms such as numbness, increased sensitivity to touch, pain, loss of sensation, burning pain and tingling. In some cases, it may lead to ankle instability and restricted range of motion, meaning the ankle or lower leg will have limiting movement. There can be many causes behind damages to the sural nerves, below are the examples of common causes:

1)    Sural nerve entrapment- Nerve entrapment is a condition of tissues that presses the nerve. The sural nerve may be impinged by a baker cyst (fluid-filled lump at the back of the knee), ganglion cyst (fluid-filled sac grows near joint or tendon), osteochondroma (overgrowth of cartilage and bone of the leg bones) and injury to the back of the foot or the feet itself.

2)    Diabetes- Sural nerve is one of the common affected nerves in people with diabetes. The high level of blood sugar causes damage to the small blood vessel supplying the sural nerve. This results in damage to the nerve fibres of the sural nerve.

3)    Sports injuries- Ankle sprain is the common sport injury. Ankle sprains stretch or tear the ankle’s ligament. The injury mechanism of tripping leading to the sprain itself may have damaged the sural nerve. Injuries may also occur when wearing ski boots, heel straps, laced boots, horse saddle ankle straps or casts too tight.

4)    Surgery complications- During a surgery procedure, the sural nerve may have been injured by the surgical instrument, especially in ankle or foot surgery. Complications may also happen when the hardware is attached to the leg such as screws that are meant to repair, break and rub against the sural nerve.

          In essence, there can be many causes behind damages to the sural nerve. Symptoms of sural nerve damage usually revolve around sensation problems. Thus, when a person experiences any symptoms relating to the damaged sural nerve such as discomfort in the lower leg or the foot, they should seek medical advice. It is best to get checked by a doctor immediately.

          Prevention is indeed the best cure. There are actually things you can do to make sure the sural nerve is in healthy conditions. This includes to maintain a healthy blood sugar level, wear proper athletic footwear, and to lead a healthy lifestyle such as smoking cessation and a healthy diet. Taking supplementation of vitamin B12 may help to alleviate symptoms regarding nerve damages.

          Why is it important to keep the sural nerve in good shape? Sural nerve has few uses in medical procedures. For example, when a person needs to undergo biopsy procedure due to the unknown cause of unusual sensation of the leg or suspected symptoms of vasculitis, amyloidosis or leprosy, the sural nerve can be the site for the doctor to take a sample. This is because the sural nerve is easy to find and close to the skin surface. Another use of the sural nerve is nerve grafting. Nerve graft is a healthy tissue used to repair or replace damaged nerves. Sural nerve is the best candidate for nerve grafting as it provides a long tissue sample. Nerve graft can help treat many conditions such as facial paralysis, sciatic, nerve injuries and erectile dysfunction.

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