Tibial Nerve

What is the tibial nerve?

The tibial nerve is in the back of your leg. It has many branches that enable the lower leg to receive messages from the brain.

What type of nerve is it?

The tibial nerve is a mixed nerve with both motor and sensory function, and part of the peripheral nervous system. Mixed motor and sensory nerves enable electrical impulses to travel between muscle cells and the spinal cord. Impulses from the tibial nerve then travel to the brain to provide sensory information and help control voluntary and involuntary movement of your lower limbs.

What is the function of the tibial nerve?

Branches of the tibial nerve connect to (innervate) muscles in the back of the leg. Tibial nerve innervation enables you to move your leg, foot and toes.

Innervation also makes it possible to sense:

• Body positioning.
• Temperature changes.

How does tibial nerve innervation affect leg and foot functioning?

The tibial nerve supports the arch in your foot. It also enables precise movements, such as:

• Pressing the foot down and away from the body, like standing on or pointing your toes.
• Turning the foot inward, like standing pigeon-toed.
• Wiggling your toes.
• Lengthening the front of your hip, which occurs when you stand and extend your leg behind you.
• Bending and straightening your knee.

What is the anatomy of the tibial nerve?

The tibial nerve branches off from the sciatic nerve. This nerve starts in the lower spine and innervates the lower body.

The tibial nerve starts above the knee in the back of the leg.

• As it travels downward, it branches off to innervate muscles in the hamstrings.
• Continuing toward the heel, the sural nerve branches off, which innervates the calf.
• Once the tibial nerve reaches the foot, it passes through the tarsal tunnel. This structure protects nerve fibers as they round the bend from your leg to your foot.
• Near the tarsal tunnel, the tibial nerve branches off to innervate the toes and bottom of the foot.

What conditions affect the tibial nerve?

Tibial nerve dysfunction is a group of conditions that often cause tibial nerve pain.

These conditions include:

• Tarsal tunnel syndrome: Damage to the tarsal tunnel can put pressure on ligaments, arteries and the tibial nerve.
• Tibial compartment syndrome: Pressure from your muscles can decrease blood flow to the nerves, affecting their functioning.
• Tibial nerve entrapment (pinched nerve): Tibial nerves can get trapped by swollen nearby tissue. This can occur due to trauma, overuse or other injuries.

Other causes of tibial nerve pain include:

• Surgical complications: The tibial nerve’s location near other important structures increases the risk of injury during surgery. These procedures include sciatica surgery, knee replacement and more.
• Trauma: Severe injuries, including a bone fracture or deep cut, can injure the tibial nerve.
• Diabetes-related neuropathy: Nerve damage that occurs due to ongoing high blood sugar.
• Other medical conditions: Other issues affecting this nerve include bone cancer, bone spur, ganglion cyst or varicose veins.

How can I prevent tibial nerve issues?

Steps you can take to prevent tibial nerve dysfunction include:

• Eating a healthy diet with foods containing vitamin D and vitamin B12, which support nerve health.
• Keeping blood sugars within a healthy range if you have diabetes.
• Seeking prompt medical attention for conditions affecting the leg or foot.
• Quitting smoking if you use tobacco.
• Wearing supportive footwear, especially if you have flat feet. This condition increases your risk for tarsal tunnel syndrome.

When should I call a healthcare provider about tibial nerve pain?

You should contact your healthcare provider if you notice symptoms of tibial nerve dysfunction. These include:

• Burning sensation.
• Changes in flexibility (range of motion).
• Difficulty moving part of your leg or foot.
• Foot drop.
• Muscle weakness or tightening.
• Numbness.
• Sensation of pins and needles.
• Sharp pain.
• Tingling.

A note from Cleveland Clinic

The tibial nerve runs down the back of your leg and into your foot. It has both motor and sensory function that makes it possible to transmit sensations and flex your foot, turn it inward or press it behind you. Tibial nerve pain can be due to tarsal tunnel syndrome, nerve entrapment or diabetes-related neuropathy. You can protect your tibial nerve by wearing supportive footwear and seeking timely care for injuries.