Thread Superficial Peroneal Nerve Release

Thread Superficial Peroneal Nerve Release

Treating leg and foot numbness, tingling and burning pain caused by peripheral entrapment neuropathy.

Thread superficial peroneal nerve release is an innovative and minimally invasive procedure to help people with leg and foot numbness, tingling and burning pain caused by peripheral entrapment neuropathy.


Developed by BayCare Clinic Pain & Rehab Medicine physicians Danqing Guo, MD, and Danzhu Guo, MD, the procedure offers highly effective outcomes to relieve tingling and burning pain in the leg and foot with no surgical incision.


What is peripheral entrapment neuropathy?

Peripheral entrapment neuropathy is damage to the peripheral nervous system. When the superficial peroneal nerve is involved, symptoms are experienced in the lower extremities and feet.


Peripheral entrapment neuropathy often causes abnormal sensations that may include stabbing, burning, touching or tingling sensations that can be hypersensitive. In some cases, the superficial peroneal nerve is trapped by surrounding tissue, swelling and causing these abnormal sensations. The thread superficial peroneal nerve release procedure, or TSPNR procedure, addresses these cases.


Symptoms of peripheral entrapment neuropathy can range from mild to disabling but are rarely life-threatening. Symptoms may develop over days, weeks or years. Peripheral entrapment neuropathy is often underdiagnosed or misdiagnosed. Traditional treatment options have often been ineffective in providing relief from those symptoms.


What and where is the superficial peroneal nerve?

The superficial peroneal nerve is in the lower leg, on the outside of the fibula just below the knee. It provides sensation to the outside of the leg and the top of the foot.


How does the TSPNR procedure work?

Thread superficial peroneal nerve release is performed with ultrasound guidance. With the use of advanced sonographic techniques, ultrasound is used to examine the musculoskeletal and peripheral nerve systems. Ultrasound imaging helps to visualize the deep anatomy of the extremities.


The entrapped and swollen superficial peroneal nerve is separated from surrounding tissue by hydrodissection, a non-surgical procedure in which small amounts of fluid are injected around nerves to create space between the nerves and impinging tissue.


Then, guided by ultrasound imaging, a cutting thread is looped under deep fascia, a thin casing of connective tissue. Deep fascia, which is stiff, compresses and entraps the superficial peroneal nerve and causes the numbness, tingling and burning pain. Reciprocal movement of the thread cuts open the deep fascia and releases the entrapped superficial peroneal nerve, providing pain relief.


What are the advantages of the TSPNR procedure?

The advantages of thread superficial peroneal nerve release include

  • Minimally invasive peripheral nerve neurolysis with no scalpel or skin incisions
  • Minimal pain without the need for pain medicine for most patients
  • Minimal downtime, with some patients able to walk short distances immediately after the procedure
  • Performed in office using local anesthetic
  • Minimal need for rehabilitation

Some people return to work the next day. However, results may vary. Talk with your doctor about expectations for your recovery time.

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BayCare Clinic,, is the largest physician-owned specialty-care clinic in northeastern Wisconsin and Michigan’s Upper Peninsula. It is based in Green Bay, Wisconsin. BayCare Clinic offers expertise in more than 20 specialties, with more than 100 physicians serving in 16 area communities. BayCare Clinic is a joint partner in Aurora BayCare Medical Center, a 167-bed, full-service hospital. Follow BayCare Clinic on Facebook and Twitter.