Slimmer's Palsy

FarmgirlRebel

FarmgirlRebel

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Medically, this is known as "common peroneal neuropathy," and it also goes by "common fibular neuropathy."

When it results from losing weight, the condition is frequently labeled weight-loss–associated peroneal neuropathy, or "slimmer's paralysis."

**Yep, this is me now — it makes walking both entertaining and pretty silly to watch 😅.

How mine presented: it began with several rounds of tripping. I've never been especially coordinated, but I definitely noticed more stumbling than usual... by the following day, my leg below the knee wasn't moving the way the other one does, and it felt asleep, except without any pins and needles. The numbness covers the outer part of my calf and the top of my foot***

For everyone here who's deep into weight loss, here's the rundown — just something to keep in mind:

Slimmer's palsy is a nerve issue that can show up following major or fast weight loss (-205lbs in my case). When the fatty padding that protects the peroneal nerve — located near the outer knee — is lost, that nerve becomes easier to compress through crossing the legs (that's me), squatting for long stretches, or certain sleep positions (a knee pillow is worth trying).

What to watch for: Numbness or an "asleep" sensation down the outer lower leg and across the top of the foot, weakness at the ankle, and in some cases foot drop — trouble raising the front of the foot, which leads to dragging the toes or tripping.

Getting better happens differently for everyone: some see improvement once the pressure is off the nerve plus physical therapy, but a serious nerve injury may cause ongoing problems. Any new numbness or weakness should be checked by a doctor; don't just assume weight loss is the cause.

Silver lining: horses are still something I can ride, even while I walk like a drunken sailor... 😅
 
Last year I had a mild case of this in both legs. Tapping the muscle on the outer side of the shin, roughly 10cm above the ankle, would set it off, and there were sharp shooting pains across the top of my feet. That spot is one of the branches of the common peroneal nerve. Luckily there was no muscle weakness, though the electric, stabbing, shooting pain part was not much fun.

I genuinely have no idea why it happened to me, since most of the weight had already come off 2 years earlier. While I was looking into ways to get it sorted out, it simply faded after a few months, or at least improved a lot, to the point where I could tap the right spot and trigger it, but otherwise it was gone. Apparently it's supposed to be really common with massive weight loss.
 
lessthanhalf said:

Last year I had a mild case of this in both legs. Tapping the muscle on the outer side of the shin, roughly 10cm above the ankle, would set it off, and there were sharp shooting pains across the top of my feet. That spot is one of the branches of the common peroneal nerve. Luckily there was no muscle weakness, though the electric, stabbing, shooting pain part was not much fun.

I genuinely have no idea why it happened to me, since most of the weight had already come off 2 years earlier. While I was looking into ways to get it sorted out, it simply faded after a few months, or at least improved a lot, to the point where I could tap the right spot and trigger it, but otherwise it was gone. Apparently it's supposed to be really common with massive weight loss.
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Glad yours cleared up. Mine went the other way — no pain at all, just weakness in the muscle and a foot that flops and feels unsteady...though my body appears to be picking up the slack fairly well, and a few days in I'm steadier now.
 
Have you already been evaluated by a physician? Since muscle weakness is present, the issue should be addressed if at all possible while there is still a chance for the nerve to heal. Permanent damage can set in when a nerve remains compressed for an extended period. I don't recall the exact timeframe, and it likely varies with how badly the compression is, but my advice would be to seek an expert opinion from a neurologist, general surgeon, or neurosurgeon without delay. You certainly can't keep it pinched for years and hope for improvement, and depending on whether the nerve was only crushed once, say during sleep, or is being continuously compressed, surgical decompression may become necessary. In most cases the compression point sits close to the knee - the classic slimmers palsy presentation - or above the ankle, where the nerve passes through the muscle to sit just beneath the skin, which is the version I had. Occasionally a high definition ultrasound or MRI is needed to pinpoint exactly where the damage is occurring. I'm not sure nerve conduction studies would add much? Much of this comes from chatgpt back when mine happened, along with a general grasp of what compression does to nerves.

It's good that you're free of pain - nerve pain tends to be quite unpleasant - and I also have a peripheral neuropathy, though fortunately it only involves my toes, which have cold allodynia or sometimes burning essentially all the time, not severe but irritating in that it never lets up. Do you have a splint to support your foot? Otherwise walking can be difficult.
 
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