Cruralgia: movement to avoid (advice)

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La cruralgia is less known than its cousin the sciatica. However, it also generates very intense pain and sometimes evolves into paralysis. Like sciatica, certain movements can aggravate the symptoms and slow down the cruralgia healing time. You want to know the movements to avoid in the presence of cruralgia, we talk about it in this article. 

Lumbar Spine and Crural Nerve Anatomy

La lumbar spine is part of the mobile rachis of the spine. It is located in the lower region of the spine and consists of 5 vertebrae (L1 to L5)

Between two consecutive vertebrae is a intervertebral disc. The latter looks like a pad. He plays the role ofspine damper. It also ensures the mobility, flexibility and l'joint of the lumbar spine, but also of the other mobile spines.   

Except for the intervertebral discs, there are also nerve roots that come out between each vertebrate. These nerve roots give rise to many nerves like the crural nerve.   

Le crural nerve also called femoral nerve arises from two nerve roots. One is located between the 3e and 4e lumbar vertebra (L3 and L2 root). The other is between the 4e and 5e lumbar vertebra (the L4 root). The femoral nerve originates from the vertebrae L2, L3 et L4 et extends from the lower back to the foot.        

Cruralgia: what is it?

La cruralgia ou crural neuralgia corresponds to a compression or irritation of one of the roots originating from the crural nerve, due to many causes.

The crural nerve (femoral nerve) is both a motor nerve and sensory nerve. It allows the contraction of the lower muscles especially those of the thigh. It also transmits the sensory message (pain, tingling, pressure, contact, etc.) to the central nervous system.

Cruralgia can cause pain that radiates along the paths of this nerve.

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What causes cruralgia? 

The causes of compression or irritation of a nerve root, even a crural nerve are varied and differ from one individual to another.

Among the most common are:

  • a herniated disc ; 
  • vertebral osteoarthritis ;
  • damage to a vertebral disc ;
  • un vertebral compaction ;
  • spinal canal stenosis ;
  • psoas muscle hematoma ;
  • scoliosis ;
  • spondylosis ;
  • abscess ;
  • an infection in the spine.

In a very rare case, a benign or cancerous tumor can also be the cause of cruralgia.   

What are the symptoms of cruralgia?

Crural neuralgia is characterized by upain that is often very violent. The localization of this pain depends on the nerve root affected by cruralgia.    

When it reaches the L2 and L3 nerve roots, pain radiates to the hip, front of the thigh, and inside the knee.

If it affects the L4 nerve root, the pain is felt in the buttocks, from the outer part of the thigh to the top of the knee and foot.        

Be aware, however, that the symptom of cruralgia is not limited only to pain. This is sometimes accompanied by:

  • dysesthesias (an intense painful sensation);
  • paresthesias (a burning sensation, electric shocks, tingling, prickling);
  • hypoesthesias (loss of sensitivity, even a loss of muscle strength).

In the most serious case (emergency), cruralgia can evolve and becomes paralytic. She leads a urinary or anal disorder.

Movement to avoid in case of cruralgia

In the presence of cruralgia, certain movements must be avoided. These movements are especially those which stimulate the cruralgia, aggravate the symptoms, slow down the healing time or favor the recurrence of the affection.

It should be noted that each person will react differently, and that the symptoms will vary depending on several factors.

Generally speaking, when a person affected by cruralgia sits up, the pain becomes more intense. This is why it is necessary to adapt an adequate posture on a daily basis. Good posture is not just about staying in one position, you also have to avoid keeping the same position or inactivity for a long time (standing, sitting, lying). This is very important, especially in cases of cruralgia due to a herniated disc.     

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Sleeping position influences cruralgia. If the cruralgia is caused by lumbar osteoarthritis, the position on the back or on the stomach while holding the legs straight or stretched is often painful. In this specific case, it is preferable to adopt a fetal position aiming to open the lumbar canal and reduce nerve pressure on the crural nerve.

In addition, it is advisable to avoid making movements that stimulate strong pressure on the intervertebral discs, nerves and muscles of the lumbar region. These therefore concern the carrying of heavy loads and excessive twisting movements.

Intense physical activities should be avoided if the cruralgia is still in the healing phase. We can cite: running, bodybuilding with weight bearing… At the same time, they promote compression of the lumbar nerve roots, which aggravates the symptoms and slows down healing.   

Obviously, these activities can generally be resumed once the inflammatory phase has been controlled. A healthcare professional such as physiotherapist (physiotherapist) can help you return to sport in a safe and effective way.

What position to adopt to have a better relief of cruralgia?

The effective position to relieve pain associated with cruralgia is not the same for each person affected. It depends on the cause of the onset of the disease. This is why it is always important to consult a healthcare professional. The latter can at the same time recommend exercises that can relieve your cruralgia.

In general, the easiest technique to determine the ideal position for you is to listen to your body. It will tell you when a position intensifies or reduces the degree of pain.   

The first concern of anyone suffering from cruralgia is to choose a position to sleep better. Indeed, even while sleeping, pain occurs if the patient adopts a bad position.   

Here are some examples of positions that you can adopt: the position lying on your back, but with the affected knee and leg raised by a pillow. You can also lie on your stomach with the affected leg bent and raised to the side by a pillow underneath.

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The position lying on the side (runner's position) also seems a good idea, it consists of lying on the side not affected by the cruralgia: the knees must be at chest height then lift the sick knee in flexion (by putting a cushion or pillow between the two knees).   

Conclusion

Cruralgia is a fairly important disease, even if it is often poorly understood. The movements to avoid in the presence of crural neuralgia depend on several factors, including the cause of the disease. THowever, there are certain movements that must always be avoided, whatever the origin of the cruralgia, such as intense activities, sudden movements, etc. As for the positions to adopt to relieve the pain, it is advisable to consult a professional and seek his opinion.

References

https://www.informationhospitaliere.com/cruralgie-duree-et-meilleure-position-a-adopter-pour-dormir

https://www.lesdessousdusport.fr/cruralgie-quels-sont-les-mouvements-a-eviter/

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