Femoral nerve neuritis: symptoms and causes

Find out more about nervous diseases starting with the letter “N”: Sleep disturbance; Narcolepsy; Hereditary cerebellar ataxia of Pierre-Marie; Spinal circulatory disorders; Trigeminal neuralgia; Neuralgia of the submandibular and sublingual nodes; Neuralgia of the glossopharyngeal node; Neuralgia of the ear ganglion; Neurasthenia; Neural amyotrophy of Charcot-Marie-Tooth; Acoustic neuroma; Neuroma; Optic neuritis; Pharyngeal neuritis; Neuritis of the facial nerve; Neuritis; Obsessive-compulsive neurosis; Pharyngeal neurosis; Neuroses; Neurosis-like stuttering; Femoral nerve neuropathy.

Femoral nerve neuropathy is an injury to the most powerful nerve in the lumbar region, has various origins, causing pathologies in the penetration of nerve signals. Symptoms depend on the type of injury, appearing in the form of pain, sensory disturbances in the lower extremity, mainly in the anteromedial areas of the thigh and lower leg. Gait disorders occur due to difficulties in knee extension.

The diagnosis is made based on ultrasound of the femoral nerve and EMG. The therapy is complex and is aimed at eliminating nerve compression and inflammation, relieving pain and swelling, restoring innervation and metabolism. A course of electrical stimulation therapy and physical therapy is required.

general information

In 1822, the disease was described for the first time as anterior crural neuritis. Inflammation of the femoral nerve has been studied for almost 200 years, but remains poorly understood. Among mononeurotic pathologies, femoral neuritis is more common than others. The lack of complete information on this type of neurological disorders leads to the fact that the disease cannot be differentiated from radicular syndrome or myelopathy. Difficulties arise due to the variability of clinical symptoms from sensory distortions to movement disorders, depending on etiological factors.

Femoral nerve neuritis: symptoms and causes

Femoral nerve neuritis: definition and characteristics of the disease.

Femoral nerve neuritis is a lesion of the femoral nerve, which manifests itself in the form of muscle and sensory disturbances in the lower extremities.

This disease can manifest itself in the form of gait disturbances and pain in the hip area.

The disease can appear regardless of a person’s age, including in children. The cause may be, for example, hypothermia or infection.

Treatment of any disease should not be postponed. If something in your body goes wrong, there is a reason for it. We will consider further what signals the body can tell you that you are developing neuritis of the femoral nerve.

Femoral nerve neuritis: the first symptoms to pay attention to.

• Gait disturbance
• Pain in the hip area
• Mild tingling and numbness on the inner or front thighs
• Feeling of muscle weakness in the affected area
• Mild swelling in the ankle or knee area

Here's what you should pay attention to. As mentioned above, if you experience gait disturbances and pain in the hip area, it is possible that you are developing neuritis of the femoral nerve.

Thus, if some or all of the symptoms present in the lists appear in you, then it’s time to take care of your health.

Remember, it is easier and faster to treat a disease in the early stages, when it has not yet taken root deep into your body.

Don’t let it go and don’t leave it to chance or “maybe it will go away on its own.” Undoubtedly, the body's resources are great. And Tibetan medicine is for the body to cope with the disease itself.

However, in the conditions of our modern life and without knowing the true causes of the disease, you should contact a specialist and undergo a free diagnosis in our clinic. At the very least, you will know your exact diagnosis, the cause of the disease and recommendations for a quick recovery.

Let's continue the research, and first let's find out where the roots of all diseases come from, in particular neuritis of the femoral nerve.

Neuritis of the femoral nerve: foci of disease formation.

Our world is diverse and complex for some, but simple and great for others. The ability to behave, to subordinate thoughts to one’s will, to manage one’s condition in different situations, to launch the correct biochemical processes, allows a person to have strong energy and strong immunity, and therefore resistance to any diseases.

The integrity of the body begins to collapse with psycho-emotional factors that affect us every day. If a person knows how to cope with them, processing any emotional surges towards a positive shift forward for himself, he will be able to react easily to any uncomfortable situation, remain in good health and, moreover, develop his energy potential.

Otherwise, under the influence of a crazy pace of life, stressful situations at work, at home or on the road, a negative energy charge begins to accumulate, gradually destroying a person’s energy shell.

First, this affects a person’s psychological health; later, the destruction moves to the physical level, where internal organs begin to suffer and various sores appear.

Let's move on directly to the causes and factors that contribute to the appearance of damage to the femoral nerve.

“Whoever wants to be healthy is already partially well.”

Giovanni Boccaccio

Femoral nerve neuritis: the main causes of the disease.

• Physical exercise
• Hypothermia
• Infection
• The result of compression of the peripheral nerve trunk
• Thigh numbness

Why can a disease be resistant to treatment, and when everything seemed to have passed, a relapse occurs? Because at the diagnostic stage the doctor did not determine the cause of the disease.

Treating symptoms means driving the disease even deeper inside, where it will affect more and more new areas, developing a whole “network” of associated diseases.

And, one “fine” day, they will make themselves felt with all their bouquet, which will also be joined by side effects from medications. Is it worth it? Of course not. There is always a choice

Next, we will consider the approach of Tibetan medicine to the treatment of neuritis of the femoral nerve.

Femoral nerve neuritis: treatment and recovery using Tibetan medicine.

• Acupuncture
• Moxibustion therapy
• Stone therapy
• Tibetan massage
• Vacuum therapy
• Hirudotherapy
• And others.

Rapid restoration of the body using Tibetan methods occurs thanks to methods of external and internal influence. Everything that can contribute to rapid recovery is taken into account. Lifestyle and nutrition also play an important role here.

During a free pulse diagnosis, you are given an accurate diagnosis, your predominant constitution is determined, which is one of the most important points for establishing the correct treatment, the causes of the disease, concomitant diseases are determined, and based on these data, treatment is prescribed.

Again, nutrition and lifestyle play an important role in the healing process. Therefore, it is important to know your natural constitution and the state of affairs in general. And based on this data, determine the necessary diet, with the presence of plenty of fluids and the exclusion or limitation of foods that are not suitable for you by nature.

In combination with herbal medicine, the procedures provide a tremendous healing effect and allow you to quickly relieve pain and alleviate the condition.

Properly selected herbal remedies have an immunomodulatory, antibacterial and anti-inflammatory effect, harmonizing the state of the body's internal systems.

An integrated approach is the basis of Tibetan medicine. External influence by the above procedures leads to the following:

• Recovering the femoral nerve
• Its functionality improves
• Stagnation is eliminated
• Increases immunity
• Relieves pain and discomfort
• Concomitant diseases go away
• The general condition of the body improves
• Improved physical and emotional well-being
• And other manifestations of the disease.

Tibetan medicine has helped many patients regain lost health. Even in those cases when ordinary doctors refused the patient, saying that he could no longer be helped, Tibetan medicine helped.

Not because she has some kind of magic pill, but because she has enormous knowledge about human nature and its interaction with this world. This experience has been accumulated over thousands of years and is now quickly gaining popularity due to its amazing results.

Without chemicals, antibiotics, painful procedures and surgeries, we manage to get people back on their feet, significantly improving their condition.

People also come to us to prevent diseases. Relax, unload your emotional state, raise your vitality and restore your energy.

After complex procedures, a person gains harmony with himself and the outside world for a long time. He simply glows with love, energy and life.

Therefore, if you have any health problems, come, we will help you.

Health to you and your loved ones!

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Yakhno N.N., Barinov A.N., Podchufarova E.V. Neuropathic and musculoskeletal pain. Modern approaches to diagnosis and treatment//Clinical Medicine. - 2008. - T. 86, No. 11. - P. 9-15.

Eckert M, Schejbal P. Therapy of neuropathies with a vitamin B combination //Fortschr Med. - 1992, Oct 20. - No. 110(29). — P. 544-548.

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Features of the anatomical structure of the femoral nerve

The lumbar processes of the spinal nerves arise at the level of L2, L3, L4 and merge into a single nerve trunk - the femoral nerve. N. femoralis passes between the iliacus and psoas major muscles, descends to the inguinal ligament and extends to the anterior thigh. Here there is a division into cutaneous, muscle branches and subdermal nerve. The femoral nerve innervates the muscle tissues through which it passes. Muscle functions include flexion and rotation of the hip, and with a stable hip, lumbar flexion and forward bending.

The processes coming from the femoral nerve under the inguinal ligament provide innervation to the hip flexor and knee extensor muscles. Dermal processes guarantee sensitivity of the frontal and part of the inner thigh. The subdermal nerve is the longest, exits in the area of ​​the inguinal ligament, then along the anterior surface of the thigh enters the muscular canal and follows along the medial edge of the knee with the origin of the infrapatellar branch, with innervation of the anterior part of the patella.

Then the subcutaneous branch goes along the median surface area of ​​the leg, foot - to the beginning of the big toe. It provides sensory sensation to the anterior and middle surfaces of the lower leg and the medial part of the foot.

Incidence (per 100,000 people)

Factors in the formation of the disease

Muscle spasms, injuries and hemorrhages in the psoas muscle lead to compression of the femoral nerve at the iliopsoas border. The cause of compression may be abdominal tumors or hematomas. Hematomas are the result of thrombocytopenia, hemophilia, complications during treatment with anticoagulants in patients with thrombosis, and abdominal aortic aneurysm. Femoral nerve neuropathy can result from damage to the nerve during operations for appendicitis, on the ureters and kidneys, with abscesses of the iliopsoas muscles, and bursitis.

Compression of the femoral nerve in the groin area is caused by femoral hernias, lymphogranulomatosis inguinal, or prolonged forced positioning of the hip. The condition of neuritis occurs as a complication after operations on the hip joint, surgical treatment of inguinal hernias.

In the area of ​​Gunther's canal, femoral neuropathy occurs when the adductor muscles are tense during sports or professional work. Pathologies and instability of the knee joint can also cause muscle tension. The result of knee surgery is iatrogenic femoral neuropathy. Neuropathy of the infrapatellar part of the femoral nerve is associated with the development of thrombophlebitis, varicose veins, and knee injuries.

Recommendations

Consultation with a neurosurgeon and magnetic resonance imaging of the retroperitoneum are recommended.

Clinical manifestations

Symptoms of the disease depend on the cause of the condition. If the process taking place in the iliopsoas region, motor, sensory and vegetative-dystrophic disorders develop throughout the entire innervation zone. Impairments may occur alone or as a combined combination of motor and sensory impairments.

Absolute neuropathy is accompanied by disruptions in the activity of the iliopsoas muscles due to the possibility of alternative innervation. The ability to rotate and flex the hip is maintained. The decrease in the potential of the quadriceps extensor muscle of the knee joint is significantly pronounced. The patient strives to keep his leg straight even while walking.

It is difficult to walk, especially up the stairs, as well as running. There is a change in gait. The lower limb on the corresponding side is stable in the hyperextension position. There is no knee reflex. Tactile and pain sensations are impaired in the anterior inner area of ​​the thigh and lower leg, and the medial area of ​​the foot.

The process is expressed in the form of trophic and vegetative disorders, pain of an irrigation nature. The Wasserman symptom is pronounced - lying on the stomach, the patient experiences pain in the anterior part of the thigh when trying to raise the straightened leg to the maximum height, as well as the Mickiewicz symptom - the inability to bend the leg at the knee joint.

If the process takes place in the inguinal ligament area, the symptoms are similar to those described above. The most common motor disorders are those accompanied by pain when pressing on the inguinal ligament. Compression of the femoral nerve shaft in Gunther's canal is accompanied by pain and numbness of the skin of the central part of the knee joint, the anterior inner surface of the leg and the inner part of the foot.

Spontaneously occurring pain and paresthesia intensify with extension of the leg. The patient keeps his legs bent in a standing position and when walking. The knee reflex is preserved. Tinel's symptom is clearly expressed - when tapped with a hammer, paresthesia passes along the saphenous nerve, significant pain is detected at the site where the nerve exits the conductive canal.

Clinical picture

The disease develops gradually. The first complaint of patients is weakness in the leg (“doesn’t obey, as if it’s giving way”) (100%), difficulty walking (60%). Also concerning is pain in the leg, which increases with extension (90%). Less commonly noted is a decrease in sensitivity along the anterior inner surface of the thigh (40%).

An objective examination of the patient reveals pain below the inguinal fold, along the anterior inner surface of the thigh (70–90%), hypalgesia in the area of ​​innervation of the femoral nerve; decreased knee reflex, weakness of the anterior thigh muscles, muscle atrophy.

Diagnostics

For an accurate diagnosis, it is important to determine the cause of neuropathy. The conclusion is made by a neurologist after carefully collecting anamnesis and studying the results of instrumental research methods. X-ray of the spinal column is not a reliable diagnostic method, since identified spinal defects do not exclude the manifestation of neuropathy. EMG allows you to resolve controversial issues in making a diagnosis.

Neuropathy corresponds to the slow passage of impulses along the femoral nerve column, a decrease in the amplitude of the M-response, symptoms of impaired innervation in the corresponding muscles, as well as the muscles of the L2-L4 segments. Using ultrasound diagnostics, the integrity of the femoral nerve is traced, pathological neoplasms, swelling, adhesive-scar changes and degenerative phenomena are determined. The level of nerve mobility in the adductor canal is confirmed by ultrasound with dynamic tests.

Differential diagnosis is aimed at excluding radiculopathies of the lumbar vertebrae of vertebrogenic origin, lumbosacral plexopathy caused by diabetes mellitus, injuries and gonarthrosis of the knee joint. To differentiate diseases of the abdominal cavity, ultrasound, MRI or CT are performed.

Treatment

If the femoral column is compressed by abdominal tumors, surgical intervention is performed urgently. If a traumatic violation of the integrity of the nerve with interruption of its fibers is confirmed, surgical treatment is also performed. For other established causes of the pathology, conservative treatment is carried out aimed at eliminating swelling, restoring blood supply, metabolism of the femoral nerve, and eliminating pain.

Glucocorticoid drugs are prescribed for decongestant and anti-inflammatory purposes when the nerve fiber is compressed under the inguinal ligament or in the muscle canals. Blockades are performed in the compression zone with solutions of glucocorticoid drugs (hydrocortisone, diprospan) in a cocktail with local anesthetics (solutions of lidocaine, novocaine).

If nonsteroidal anti-inflammatory drugs in combination with analgesics do not relieve intense pain, treatment is supplemented with antidepressants (amitriptyline) and anticonvulsants (pregabalin, topiramate, gabapentin). To restore the normal functioning of the femoral nerve, it is advisable to prescribe medications to improve blood supply to nerve cells (nicotinic acid, pentoxifylline) and drugs that improve tissue metabolism (combined forms of vitamins B6, B1).

To prevent muscle contractures and atrophies in cases of detected paresis of the quadriceps muscle and lumbosacral muscles, it is advisable to prescribe a complex of exercise therapy, electrical stimulation physiotherapy, and prescribe medications that restore the transmission of neuromuscular impulses (ipidacrine, neostigmine).