Cruralgia: what complications and how to prevent?

man experiencing crural type pain

La cruralgia is a potentially disabling pathology that mainly affects people over the age of 50. It usually manifests as a sharp pain in the front of the leg. Inflammation of one of the two crural nerves can last a few weeks or even a few months. This calms down spontaneously, but in some cases returns to the point of invalidating the patient. We will take stock in this article.

Some anatomical notions

Le crural nerve, also called the femoral nerve, connects the muscles and skin of the legs to the central nervous system. Both sensory and motor, this nerve is responsible for sensations in the leg. It also allows flexion-extension of the latter.

The crural nerve begins at the level of the spinal cord, at the lower back, between the iliac and psoas muscles and extends all along the muscles of the lower limbs: the thigh, the knee, the ankle to the internal edge of the foot. When compressed, pain is felt throughout its journey. We then speak of cruralgia.

Cruralgia: short reminder

Cruralgia, also called "crural neuralgia" is a disease that occurs when the crural nerve is compressed by various potential causes, mainly intervertebral discs. It is also called " sciatica front" due to the similarity of symptoms.

The difference with sciatica lies in particular in the location of the affected roots. Cruralgia is manifested by inflammation of the crural nerve. Indeed, the pain radiates throughout the course of the latter, from the pelvis to the foot.

The causes of this disease remain varied. It can occur following a herniated disc, vertebral compaction, an infection or even other pathologies such as lumbar osteoarthritis or scoliosis. Nevertheless, cruralgia must be taken care of by a doctor from the first symptoms in order to limit the consequences. In addition, surgery is necessary in some cases.

To learn more about this pathology, click on this link.

What complications can occur after cruralgia?

Cruralgia can cause general malaise, hence the importance of treating it at the first symptoms. Here are the possible complications:

  • chronic pain in the lower limbs: cruralgia can cause very severe pain over the long term. This is similar to a burn or an electric shock;
  • Sensitivity disorders: A person with cruralgia may feel a tingling, numbness and tingling sensation. This may progress to a partial or total loss of sensation in the area where the crural nerve is compressed;
  • paralysis: this is the most severe complication that can occur following cruralgia. First, the sufferer is likely to describe it as a weakness to perform movement. In the long term, this leads to the total inability to move the affected part. This is called complete motor deficit. Recovery is possible, but it depends on many factors. It can cause permanent sequelae;
  • A loss of function: Cruralgia often causes bladder and sphincter disorders. This is the achievement of the muscles that innervate the perineum. The affected person has urinary leakage or faecal incontinence. Advanced cases are manifested by insensitivity of the perineum. These disorders are defined as "the cauda equina syndrome ". In this case, it is advisable to go to a doctor as soon as possible, otherwise there will be significant functional sequelae for life.

How to treat and prevent these complications?

It is advisable to consult a doctor in order to establish a diagnosis at the first signs. He will carry out a clinical examination which will consist of:

  • determine the origin of the disease;
  • assess the possible consequences, particularly in terms of sensory or motor deficit or bladder and sphincter disorders;
  • look for a pathology that may be associated with it.

To do this, an analysis of the statics as well as the way the patient walks will be carried out. Then, the doctor will examine the back in order to identify if the latter presents a stiffness or a muscular tension which is directed towards the rachis at the origin of the cruralgia. After that, a neurological study of each of the muscles will be performed. The goal is to eliminate a weakness if it arises.

The patient will be required to walk on tiptoes and try to get up unaided from a squatting position. A test can also be carried out at home in a monitoring context. As for the reflexes, the doctor will proceed with the hammer.

On the other hand, the arms and hands will be examined in order to eliminate the risk of neurological damage most often caused by cervical compression of the spinal cord. Finally, an examination of the hips will take place to identify whether it is rather muscle tendonitis or osteoarthritis.

In some cases, an imaging examination is still necessary to confirm the diagnosis. This depends in particular on the presentation of the pathology, in other words the intensity of the pain or the associated paralysis, for example.

After his diagnosis, the doctor may first prescribe analgesics and anti-inflammatories to relieve the pain. Then, the patient will be redirected to physiotherapy to soften the spine, strengthen the back and adopt the appropriate postures.

If this fails, other therapies such as taking natural products or osteopathy can be considered. However, the opinion of a doctor remains obligatory.

The practice of regular physical activity is also recommended in order to prevent recurrences of the disease.

In the most severe cases, more invasive therapies such as spinal cortisone infiltration or surgery are possible. The latter is proposed more particularly when cruralgia is accompanied by paralysis or sphincter control disorders. The goal of the intervention would be to release the compressed root. The type of surgery to be performed will depend on the cause of the disease. It can be:

  • removal of a herniated disc;
  • stretching a narrowed spinal canal;
  • the rectification of a vertebral deformity.

References

https://www.masseur-kinesitherapeute-lanneau-thierry.fr/articles/cruralgie/article/quest-ce-que-le-nerf-crural-nerf-femoral

https://rachis.paris/pathologies-problemes-de-dos/le-rachis-lombaire/cruralgie-sciatique/

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