Fibula pain
definition
Pain in the fibula is defined as an unpleasant, annoying, sometimes stabbing or pulling sensation. The fibula is located on the outside of both lower legs.
It is articulated to the shin near the knee, the so-called "Articulatio tibiofibularis“(Articulatio = joint, tibia = shin, fibula = fibula). However, this is a Amphiarthrosis, that means that movement in this joint is only possible to a limited extent, as a tight ligament apparatus has a restrictive effect.
The articulating bone part of the fibula is called the fibula head. Injuries or blockages to the head of the fibula can cause pain. At the other end, the fibula forms the outer ankle and stands with the ankle bone (lat. tarsus) in an articulated connection, so that the fibula on the outside contributes to the formation of the upper ankle joint. Depending on the cause of the pain, it can have a different character and can be described from stabbing and burning to pressing and throbbing.
In rare cases, the pain is limited to just a specific point on the fibula, but the pain tends to radiate or spread over a wide area.
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Causes of fibula pain
The causes of pain in the fibula are very diverse and, even if the pain is felt on the fibula itself, not only originate from the bone, but also from the surrounding muscles and nervous structures.
A simple sore muscles can be named as the first harmless cause of fibula pain, which those affected mistakenly attribute to the fibula bone.
In addition to sporting activities, muscles that have their origin in the fibula can also be damaged by wearing high shoes or incorrect foot postures to the extent that they shorten. This then leads to pulling pain.
In addition, excessive or incorrect loading can cause pain in the fibula. In worse cases, this can lead to strains or tension in individual muscles.
Another, relatively harmless cause is a bruise (lat. Contusio) of the fibula. This can be accompanied by a strong effusion, which can cause pain in the fibula as a space-consuming process. It should be mentioned here, however, that the tibia on the front of the lower leg is a more prone to bruising than the fibula.
Another trigger for the pain is a blockage of the head of the fibula due to excessive strain or incorrect posture or misalignment of the feet or the knee joint. A fibula fracture over the entire length of the bone can also be responsible for the pain in the fibula.
A final cause of the pain that should be mentioned is the involvement of nerve tissue, specifically the nerve tissue Common fibular nerve, also Common peroneal nerve called. Due to its anatomical shape, it is prone to irritation resulting in pain in the fibula. This is because the nerve, coming from the outer edge of the hollow of the knee, winds around the thin neck of the fibula below the head of the fibula.
A compression of the nerve caused by external influences therefore often triggers pain and sensory disorders in the fibula. In general, if symptoms persist in the form of fibula pain, due to the many different causes, a doctor should be consulted for a precise diagnosis.
Blockage of the fibula head
When the head of the fibula is blocked, the pain typically occurs on the outside of the knee and fibula, as the head of the fibula and the shin (lat. Tibia) is in an articulated connection.
The joint therefore bears the Latin name "Articulatio tibiofibularis". It is important to know that this joint is an amphiarthrosis, which means that it is a very tight joint with limited mobility due to a strong ligament.
Triggers for a blockage of the fibula head as an articulating part of this joint can be an overload combined with a misalignment of the foot, poor rolling when jogging, wrong shoes or bow legs.
Often the blockage is not recognized as such, since it is not a widespread disease or injury in the vernacular. Typically, patients with a blockage of the fibula head report pain on the outside of the knee, but the pain is actually more precisely localized on the fibula head. An odyssey of examinations with suspected meniscus or cruciate ligament damage often begins.
Rather, however, it is a matter of a dislocation, i.e. dislocation of the fibula head from the joint guidance. In medical jargon, especially in chiropractic therapy, which deals with such complaints, one speaks of a blockage of the fibula head. Typical movements that provoke such a blockage are a bent knee with the lower leg turned outwards at the same time. This movement pattern is common in soccer. ITBS, i.e. iliotibial syndrome, can also provoke a blockage, so that joggers in particular can be affected by the blockage of the fibula head.
Read more on the topic: Runner's knees
Fibula fracture
Compared to the thigh bone and the other lower leg bone, namely the shin, the fibula is relatively thin and therefore more prone to fractures.
Nevertheless, in addition to isolated fibula fractures, combined calf and shin fractures can also occur. A fibula can either break as a result of external violence or it can manifest itself as a fracture due to fatigue following enormous overload. Playing football or falling or accidents involving the legs are predisposed to the effects of external violence.
Diagnostically, certain signs of fracture such as step formation in the course of the bone, an open fracture, crepitations, palpable and visible deformities or an imaging, radiological proof can be present. The pain and possible swelling alone are not enough to safely assume a break.
The fracture can manifest itself along the entire length of the fibula, i.e. directly on the head of the fibula, on the shaft or in the lower bone that forms the outer malleolus.
To confirm the diagnosis, the preparation of an X-ray is indicated. Depending on the location and severity of the fracture, conservative or surgical treatment can be used.
Fibula pain from jogging
Pain in the fibula can occur for the first time after jogging. This can indicate improper and overloading. If the pain is muscular, it may be reduced under light stress while jogging.
However, all other possible causes of fibula pain represent an initial situation in which jogging only makes the pain worse.
Fibula bruises or fractures, for example, require rest without any strain in order to be able to cure optimally, i.e. jogging is contraindicated as it only worsens the symptoms.
The simultaneous presence of an ITBS, ie an "iliotibial syndrome", supports the suspicion that the pain in the fibula when jogging is based on overload, as this is a pain syndrome caused by extreme running stress. Pain in the fibula can therefore under certain circumstances be understood as radiating pain of an iliotibial syndrome, the pain of which actually only develops along the outside of the thigh down to the lower knee area, but can also radiate in worse or atypical cases.
Accompanying symptoms with fibula pain
Fibula pain rarely occurs in isolation. Instead, accompanying symptoms often appear, depending on the ultimate trigger for the discomfort. In addition to swelling or bruises in the affected area, warming and redness should be mentioned here.
Typically, the pain radiates from its origin to the entire lower leg. If a fibula fracture is responsible for the pain, it can lead to soft tissue injuries and even an open fracture. In addition to the pain, both the safe and the unsafe fracture signs are concomitant symptoms.
If there is damage to nerve tissue, it can also lead to abnormal sensations such as numbness or tingling sensation. The common fibular nerve is particularly at risk because it winds around the fibular neck while pulling from the outer hollow of the knee into the muscle groups on the outside of the lower leg.
In the case of severe damage to the nerve, for example in the form of compression, in addition to the discomfort, it can even lead to weakness of the foot, the so-called “stepper gait”, as the motor innervation for the muscles responsible for the foot elevation is no longer guaranteed.
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Diagnosis of fibula pain
Before starting a correct diagnosis of fibula pain, the first thing to do is to take a detailed medical history.
In a detailed consultation with the patient, it can be asked whether the pain is causally related to a fall or severe stress. Orthopedic problems such as malpositions or malpositions of the feet can also be inquired about.
A clinical examination should then take place. It is examined whether there are external abnormalities such as wounds, swellings or redness and whether these correspond to the painful area. In addition, the entire course of the fibula should be scanned in order to identify possible tenderness or step formation. Pressure pain near the knee joint, for example, can indicate a blockage on the head of the fibula.
A combined examination "DMS", in which the blood circulation, motor skills and sensitivity are checked, can also be indicative.
If a fracture is suspected or to be excluded, an X-ray is necessary to assess the bony structure. Depending on the soft tissue involvement, an MRI image can be made.
Treatment of pain in the wall of the wall
There are various therapeutic approaches for fibula pain, depending on the cause.
The blockage of the fibula head can be treated by a chiropractor, for example. Chirotherapy deals with joints and, among other things, restoring their mobility. As part of a mobilization, a chiropractor exerts pressure in the opposite direction to the blockage of the fibula head.The pressure must be effective enough, but it must not be painful.
A fibula fracture, on the other hand, is treated depending on its location and severity. A fracture in the shaft area can possibly be treated without a plaster of paris but with a tight bandage system. In the case of complicated fibula fractures, for example ankle fractures, surgical treatment with a subsequent plaster cast must be carried out.
With the help of various osteosyntheses, i.e. foreign material such as screws or plates that connect and fix the bone parts together again, the anatomical shape and thus stability of the once broken fibula can be restored. In general, pain medication is always helpful and treatment of all causal diseases or triggers makes sense. Accordingly, regular training breaks can be prescribed in the event of excessive strain and massages or physiotherapy can be prescribed in the event of tension or sore muscles.
Furthermore, the wearing of incorrect footwear should be avoided and an orthopedic surgeon should be consulted in the event of incorrect foot or knee posture in order to be prescribed appropriate insoles.
Duration of pain in the wall bone
How long the fibula pain lasts depends very much on what the ultimate cause was. Pain due to harmless causes, such as sore muscles, bruises or blockages, can be alleviated after a few days to weeks with the right treatment.
In contrast, the healing time of a fibula fracture is much longer. A sick leave can be issued between 4-6 weeks. During this time, therapy is carried out according to a fixed treatment scheme in cooperation with physiotherapy. This includes exactly up to when only a partial load and from when a full load is planned.
It goes without saying that the recovery time always depends on individual factors such as physical requirements and motivation.
