Duration of cruralgia: What is the prognosis?

Having commonalities with the sciatica, crural neuralgia ou cruralgia represents a sometimes stabbing and debilitating pain giving the impression that it can persist for a fairly long period of time.

But then what is the duration of cruralgia ? And what factors can influence this duration? what about the prognosis ? Answers in this article.

What is cruralgia?

La cruralgia constitutes a monoradiculargia, in other words a pain syndrome that affects a single nerve root, of vertebral origin. It is manifested by localized pain along the path through which the crural nerve ou femoral.

It is observed in 70% of cases in men, and is therefore predominantly male, regardless of age. However, the age range between 40 and 55 years is usually the most affected.

In general, the cruralgia has a sudden onset and readily occurs after a triggering incident such as lifting a heavy load, trauma to the lower back or lumbar region, or a coughing fit.

The pain is most often very intense, described as " nagging », it occurs preferentially at night and worsens after a banal effort of daily life such as coughing, defecation, walking or sudden movement.

As the sciatic nerve, crural nerve (or femoral) is a large nerve, therefore, the pain resulting from its damage can be very difficult to bear and relieve.

What are the symptoms of cruralgia? And how is his diagnosis made?

It is obvious that the best way to determine and confirm the diagnosis of a cruralgia is to visit his doctor, what is more when this one is chronic.

In the vast majority of cases, the doctor will ask questions and perform a clinical examination after which the following signs or symptoms may be found:

A pain : typically located in the groin, it can however be felt at the top of the thigh or radiate to the inner part of the knee. It actually depends on the nerve root of the femoral nerve being affected.

Thus it is possible that the patient describes a type L3 cruralgia ending at knee height or type L4 can reach the inner edge of the foot.

A feeling of numbness or tingling: le crural nerve has a sensory role, so it allows us to perceive skin sensation in the region it innervates. However, if this nerve is irritated, its conduction can be altered, causing abnormal sensations ofnumbness, tingling, electric shocks, paresthesias even a total anesthesia.

Decreased muscle strength: in addition to its sensory role, the femoral nerve also has a motor action, it allows in particular to contract the muscles allowing to flex the thigh on the hip (hip flexors) and the extensors of the knee. Therefore, the attack of this nerve can cause an alteration of these functions making, for example, walking difficult.

A decrease or even abolition of osteotendinous reflexes: especially the patellar reflex. These reflexes are tested using a reflex hammer which allows you to tap lightly on the patellar tendon in order to obtain an extension of the knee.

The use of examinationsmedical imaging to diagnose a cruralgia is rather rare. However, in some cases, the doctor may need to perform standard x-rays of the spine, a computed tomography or an IRM to investigate the causes of cruralgia.

What can cruralgia be due to?

The occurrence of cruralgia can be consecutive to multiple pathologies or underlying conditions, such as for example:

A protrusion ou herniated disc sitting at the level of the intervertebral spaces of L2-L3 or L3-L4;

A Osteoarthritis affecting the joints forming the Lumbar spine;

A degenerative disc disease;
Le narrowing of the lumbar canal diameter ou narrow lumbar canal;

A spinal tumor or intraspinal compressing the crural nerve root;
A infectious cause (infectious spondylodiscitis) ;

A pregnancy or the presence of a overweight;

How long does it last ?

It is quite difficult to answer such a question considering the variation of the evolution from one individual to another. However, as a general rule, the average duration of cruralgia can go up to two months.

This duration is highly dependent on the cause of the cruralgia, its initial care and certain psychosocial factors that concern the patient. Thus, a rapid and precise diagnosis of cruralgia and its cause greatly influences its duration of evolution.

Factors influencing the healing time of cruralgia

As explained above, certain factors play a major role in the healing time of a cruralgia. These include:

Du degree of irradiation of cruralgia: Cruralgia that radiates to the foot has been shown to have a poorer prognosis than when it only affects the knee, for example.

De the cause of cruralgia: Cruralgia due to significant herniated disc or has an intraspinal tumor obviously has a much longer development time than when it is due to osteoarthritis, for example.

De the involvement of the patient in the management of his cruralgia: in order to heal more quickly, a person suffering from cruralgia must make a big effort on his habits and his lifestyle.

De the mental and psychological state of the patient: clearly, stress has a negative impact on the evolution of cruralgia, it promotes, in fact, the contraction of muscles and thus aggravates the painful sensation.

How to treat and prevent the occurrence of cruralgia or its recurrence?

Treatment of cruralgia primarily depends on its cause. If the cause is obvious and requires treatment, the latter will be put in place by the doctor and the pain will automatically decrease.

If you have a idiopathic cruralgia (without obvious cause) or due to a cause not requiring specific treatment, painkillers, anti-inflammatory and corticosteroids will be proposed in association with the practice of a adapted physical activity.

In the most severe and resistant cases, cortisone injections can be proposed before resorting if necessary (depending on the cause) to surgery as a last resort.

In addition to drug treatments, the doctor will also be able to prescribe physiotherapy orosteopathy aiming to show and teach the patient the exercises and stretches adapted to his situation such as McKenzie method or lumbar traction.

Finally, the improvement of lifestyle through a healthier diet, a non-sedentary lifestyle, better quality of sleep, the practice of sport that strengthens the back and the abdominals and the maintenance of an adequate weight remains the best way to avoid the occurrence or recurrence of cruralgia.