Peripheral Nerve Injury Map

saphenous

Provides sensation to the inside part of the knee, lower leg and foot.^12,13

Common causes of saphenous nerve injury:

• Entrapment of the nerve from traumatic injury or previous surgery
• Traumatic injury during saphenous vein graft harvest procedures¹² or from other surgeries of the knee and ankle¹²

Symptoms: Pain, tingling, burning, numbness or loss of sensation to inside part of the foot and ankle.

radial

Provides sensation to the back of the hand and wrist, controls the ability to pinch things between the finger and thumb.

Common causes of radial nerve injury:

• Entrapment of the nerve
• Traumatic injury from a power tool, glass or knife cut, or during a car accident
• Fractures or breaks in the humerus bone

Symptoms: Numbness (loss of full or partial feeling), tingling or weakness in the wrist, fingers and thumb; may also cause wrist drop.¹⁰

digital

Provides sensation to the fingers.

Common causes of digital nerve injury:

• Cut or laceration
• Traumatic injury, such as a power tool accident

Symptoms: Numbness (loss of partial or full sensation), tingling or pain.

cavernous

Facilitates penile erection and urinary continence.

Common causes of cavernous nerve injury:

• Cut or stretched during prostate, pelvic, bladder or colorectal surgeries

Symptoms: Erectile dysfunction or urinary incontinence.

obturator

Provides sensation and motor control of the thigh.

Common causes of obturator nerve injury:

• Pelvic or abdominal surgery
• Entrapment of nerve

Symptoms: Loss of sensation (numbness) in the thigh, weakness in the quadricep muscle, inability to pull leg into the body or walk independently.¹¹

sacral

Provides sensation to the buttocks and thigh, and helps control urinary and fecal excretion.

Common causes of sacral nerve injury:

• Traumatic events, such as serious falls resulting in sacral fracture
• Vaginal childbirth
• Hysterectomy
• Surgical removal of tumors

Symptoms: Muscle weakness and/or shooting, burning or stabbing pain running from buttocks to thigh; potential problems with urination and/or defecation.

sciatic

Provides sensation to the back of the thigh, leg and foot. Also provides motor control of the muscles in the leg and foot.

Common causes of sciatic nerve injury:

• Hip implant surgeries
• Traumatic injuries, such as an ATV accident or gunshot wound
• Intramuscular injections

Symptoms: Pain, weakness and/or numbness down the back of the leg to the knee, loss of sensation below the knee.

plantar digital

Provides sensation to the toes.

Common causes of plantar digital nerve injury:

• Traumatic and sports-related injuries
• High heels or poor fitting shoes

Symptoms: Pain or tingling between the toes and on the ball of the foot, or the sensation of walking on a marble.

tibial

Provides sensation and motor control of the calf and foot.

Common causes of tibial nerve injury:

• Traumatic event, such as a car accident or sports injury
• Fractures in the back of the knee or lower leg
• Compression that leads to tarsal tunnel syndrome

Symptoms: Loss of function, sensation or pain in the lower leg, specifically in the calf and foot.

median

Provides sensation and motor function to the hand, specifically the thumb, index, middle and part of the ring fingers. Also provides motor control of the forearm, hand and thumb.

Common causes of median nerve injury:

• Traumatic injuries from firearms, power tools, glass or knife cuts, or car accidents.
• Entrapment of the nerve near the wrist causing carpal tunnel syndrome

Symptoms: Numbness (loss of partial or full sensation), pain, and/or inability to move the forearm, wrist or hand; inability to hold objects with the hand.

sural

Provides sensation to the outside of the ankle and foot.¹²

Common causes of sural nerve injury:

• Entrapment from trauma or surgery^12,14
• Excision for nerve autograft or nerve biopsy

Symptoms: Pain, numbness, aching or burning sensation at the outside leg, ankle or foot^12,14; excision: complete loss of sensation of the outside of the ankle and foot, pain.

femoral

Provides sensation to the front and inside portion of the thigh and controls the muscles of the thigh and the inside of the leg and foot.

Common causes of femoral nerve injury:

• Trauma: gunshot, stab wounds, laceration by glass or as a result of pelvic fracture
• Injury during surgery on the femoral artery, hip surgeries or hernia repair¹⁵
• Infection or hematoma of nearby muscles can compress the femoral nerve¹⁵

Symptoms: Loss of sensation in the front and inside portion of the thigh. May also cause loss of sensation on inside of the knee and lower leg because the femoral nerve branches to form the saphenous nerve. Groin pain and weakness of the knee extensor muscles may also occur.

common peroneal

Provides sensation to the outside of the leg just past the knee and controls the muscles in the leg that lift the ankle and toes upward.¹⁶

Common causes of common peroneal, aka common fibular, nerve injury:

• Trauma associated with knee dislocation, fracture of the fibula or tibia, or during total knee arthroscopy surgery
• Compression/entrapment caused by leg crossing, a tight cast or splint, positioning during surgery, or because of illnesses like diabetes or arthritis

Symptoms: Pain, tingling, skin sensitivity, numbness and foot drop (inability to lift the front part of the foot).¹⁷

superficial peroneal

Provides sensation to the outer shin portion of the lower leg and the top of the foot and toes, with the exception of the first web space.¹⁶

Common causes of superficial peroneal, aka superior fibular, nerve injury:

• Entrapment by surrounding soft tissues like fascia, muscle or a mass
• Stretch injury may result from ankle instability¹⁸

Symptoms: Pain, numbness, or tingling in the lower outside portion of the leg or the top of the foot during activity.¹⁴

deep peroneal

Provides sensation to the space between the big toe and the second toe and controls the muscles of the shin and foot.

Common causes of deep peroneal nerve injury:

• Compression of the nerve from trauma, prolonged stretching, external sources like shoes/boots
• Traumatic injury during foot or knee surgery

Symptoms: Inability to raise the toes (dorsiflexion) or pain, numbness or tingling of the top of the foot.

infrapatellar

Provides sensation to the knee.

Common causes of infrapatellar nerve injury:

• Knee or tibia surgery
• Trauma

Symptoms: Numbness or persistent pain.

facial

Involved in taste sensation and motor control of the muscles of the face.

Common causes of facial nerve injury:

• Trauma
• Viral infection
• Stroke

Symptoms: Weakness, twitching, or paralysis of the muscles of the face, alterations in taste, or dry mouth.

anterior cutaneous

Provides sensation to the middle of the abdomen.

Common causes of injury to the anterior cutaneous nerve:

• Entrapment or squeezing of the nerve by abdominal fascia
• Trauma

Symptoms: Acute or even chronic localized pain on the lateral edge of the abdominal muscles that worsens with a change in body position, when tightening the abdominal muscles or when skin over the site is pinched. Can sometimes be mistaken for gastrointestinal issues.⁸

Recurrent Laryngeal

Provides sensation to the larynx, esophagus and trachea.

Common causes of recurrent laryngeal nerve injury:

• Traumatic injury to the neck
• Injury sustained during endotracheal intubation
• Surgery near the thyroid, parathyroid, thymus, heart, or for non-small cell lung cancer or mediastinal tumors
• Compression of the nerve by nearby tumors of the thyroid, parathyroid, esophagus, tracheal lung or lymph nodes)
• Viral infection

Symptoms of nerve injury: Injury to the recurrent laryngeal nerves can result in a weakened voice (hoarseness) or loss of voice (aphonia) and may also cause respiratory problems such as difficulty breathing, choking fits or a weak cough.¹

greater auricular

Provides sensation (feeling) to the lower, outer part of the face and ear.

Common causes of greater auricular nerve injury:

• Unintended injury of the nerve during facelift procedures or shoulder arthroscopy
• Surgical procedures, such as removal of the parotid gland, submandibular gland or cervical lymph node
• Use as a donor nerve for autograft nerve repair procedures
• Trauma, such as a blow to the side of the head or neck

Symptoms: Tingling, pain and/or loss of feeling in the side of the face and ear. Bursts of pain can occur when turning the head or neck, repositioning the neck during sleep, jaw movement, or touching the neck.²

inferior alveolar

Provides sensation to the lower jaw, lip and teeth.

Common causes of inferior alveolar nerve injury:

• Unintended injury of the nerve during tooth extraction (such as wisdom tooth removal), root canal or dental implant procedures
• Surgical procedures to remove a cyst or tumor from the lower jaw
• Traumatic injuries that fracture the lower jaw

Symptoms: Tingling, pain or loss of sensation (numbness) in the lip and chin. Numbness may lead to biting or burn injuries of the lower lip, altered taste, speech, chewing and drooling.³

lingual

Provides sensation to the tongue and inside of the cheek.

Common causes of lingual nerve injury:

• Unintended injury of the nerve during tooth extraction (such as wisdom tooth removal), dental anesthetic injection or dental implant procedures

Symptoms: Tingling, stinging, burning, tenderness, pain or loss of sensation (numbness) of the tongue or inner mouth. Numbness-caused lingual nerve injuries can lead to tongue biting, drooling, speech difficulties, problems chewing, swallowing, drinking, kissing or the inability to distinguish hot from cold foods.⁴

spinal accessory

Provides motor control of the vocal cords, neck and shoulder.

Common causes of spinal accessory nerve injury:

• Unintended damage to the nerve during surgical procedures such as lymph node removal, or cardiac or pulmonary surgeries
• Radical neck dissection due to cancer
• Traumatic injuries
• Excessive stretching or carrying heavy weights

Symptoms: Slumping shoulder, limited ability to lift the arm or shrug shoulders, and pain in the upper back.

intercostals

Provides sensation to the skin of the chest or breast area, as well as portions of the abdomen.

Common causes of intercostal/breast nerve injury:

• Entrapment from cancers, pregnancy or scarring around the nerve

Traumatic injury or cutting of these nerves may occur during surgeries such as a mastectomy, thoracotomy, breast augmentation or abdominoplasty. In the case of a mastectomy, these nerves often need to be cut and removed along with the rest of the breast tissue. This often leads to chest numbness or sometimes chronic pain if the nerves are left unrepaired.

• Diabetes
• Injuries to the chest, ribs or abdomen

Symptoms: Numbness of the chest, pain, aching, burning, or tingling in the band of skin that wraps around the chest and back, or in the abdomen.⁵

lumbosacral plexus

Provides sensation to the lower body.

Common causes of lumbosacral plexus nerve injury:

• Diabetes
• Traumatic injury such as hip dislocation or pelvic fracture
• Pregnancy
• Scarring around the nerve after gynecological or pelvic surgery
• Compression from abdominopelvic cancer

Symptoms: Low back or leg pain on one side, numbness, tingling, and/or sphincter dysfunction.⁶

cluneal

Provides sensation to the buttocks.

Common causes of cluneal nerve injury:

• Injury during reconstructive surgery or bone harvest procedure
• Compression by nearby muscles or fascia

Symptoms: Pain or burning, numbness, tingling in lower back, buttock or leg; burning sensations at thigh, scrotum or labia majora; or sensory loss. Pain may worsen with walking or sitting on hard surfaces.⁷

occipital

Provides sensation to the skin along the back of the scalp and to the top of the head or scalp.

Common causes of occipital nerve injury:

• Traumatic injury, whiplash or surgery to the back of the head
• Compression of the nerve due to osteoarthritis, nearby tumors or muscular structures
• Degeneration of the upper spine
• Infection
• Diabetes

Symptoms: Pain in the upper neck or head; may feel like a migraine.

ilioinguinal

Provides sensation to the inner and upper thigh and genitals.

Common causes of ilioinguinal nerve injury:

• Injured during lower abdominal surgery
• Entrapped by surrounding fascia
• Stretch injury during pregnancy
• Traumatic injury

Symptoms: Pain or abnormal tingling, numbness, prickling, burning, chilling sensations in the upper thigh or genitals.

phrenic

Provides sensation to the diaphragm, which separates the chest and abdominal cavities.

Common causes of phrenic nerve injury:

• Thoracic, neck or cardiac surgery
• Trauma

Symptoms: Dysfunction or paralysis of the diaphragm, shortness of breath, recurrent pneumonia, anxiety, insomnia, morning headache, excessive daytime sleepiness, fatigue or difficulty weaning from mechanical ventilation.⁹

pudendal

Provides sensation to the genitalia and anus.

Common causes of pudendal nerve injury:

• Stretch-induced damage during childbirth, cyclists (from their bicycle seats) or straining during defecation
• Entrapment found in professional cyclists
• Compression by a tumor or injury from tumor removal surgery
• Prolonged sitting, repetitive hip flexion, trauma and radiation can also cause injury
• Congenital anomalies

Symptoms: Pelvic or genital pain, aching, tingling; bladder, bowel, sexual and autonomic dysfunction.

axillary

Provides sensation to and motor control of the shoulder.

Common causes of axillary nerve injury:

• Improper use of crutches or placement of a cast
• Traumatic event, such as a car accident
• Fracture of the upper arm bone or dislocation of the shoulder joint
• Unintended injury during shoulder arthroscopy

Symptoms: Numbness or weakness in outer shoulder; inability to raise shoulder or lift objects.

brachial plexus

Provides sensation to the hand, wrist, elbow and shoulder. Also provides motor control of most muscles of the arm.

Common causes of brachial plexus nerve injury:

• Traumatic event, such as a car accident
• Damage during birth (Erb’s palsy)

Symptoms: Limp arm and loss of sensation in the shoulder, arm and hand; may be unable to lift arm or flex at the elbow; pain or numbness may also occur; severe cases may cause complete arm paralysis.

musculocutaneous

Provides sensation to the outside of the forearm.

Common causes of musculocutaneous nerve injury:

• Overuse of the biceps muscle can cause stretching or compression of the nerve
• Traumatic injuries to the shoulder or arm
• Injury during surgery on the humerus bone or shoulder

Symptoms: Pain, tingling, numbness of the outside of the forearm.

ulnar

Provides sensation and motor function to the wrist, ring and pinky finger. Also provides motor control of the muscles of the forearm and hand.

Common causes of ulnar nerve injury:

• Entrapment of the nerve around the elbow or in the palm of the hand
• Traumatic event, such as a glass cut or car accident
• Long-term compression from bicycle handlebars or long hours at a desk while using a computer mouse

Symptoms: Numbness, pain, tingling or weakness in the hand; loss of coordination or ability to move the fingers and weakness when flexing the hand.