False cruralgia: what other possibilities? (How to know ?)

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Groin pain or tingling in the lower limbs does not necessarily mean you have a cruralgia. There are indeed many pathologies that can be the cause of these signs. What are the other possibilities if it is a false cruralgia? We talk about it in this article.

Definition and anatomy

La spine consists of the vertebrae of the neck, back, lower back (lumbar), sacrum and coccyx.

Le femoral nerve ( crural nerve) is made up of several nerve fibers that branch from the second to the fourth lumbar vertebra. These nerve roots play a sensory-motor role. Thus, they allow to provide sensation from the pelvis to the ankles in addition to contracting the muscles on these parts.

THEgroin represents the joint between the lower extremity of the abdomen and the upper thigh. The groin is made up of muscles (adductors, iliopsoas, sartorius), tendons (rectus femoris) and connective tissue. Inside, it has an inguinal canal and a femoral canal through which nerves and blood vessels pass.

Focus on cruralgia

Un syndrome which mainly affects people who exceed the quinquennium, the cruralgia occurs due to pinching of the crural nerve. The latter becomes irritated or invisibly stuck and causes bothersome symptoms that begin in the abdomen.

Cruralgia is manifested by a numbness to tingling on the groin and on the front of the thigh. It is a sensation of electric shock or complete anesthesia associated with a very painful burning sensation.

Patients lose reflex movement and muscle strength from the groin down. In fact, a condition of the crural nerve causes a regression of its strength, thus impacting its motor functions. To confirm the existence of this pathology in an individual, it is necessary to base oneself on clinical signs.

False cruralgia: what if the pain came from elsewhere?

We tend to think that pain felt from the groin emanates from the crural nerve. Imagine that by digging further, there may be other origins to pain in the groin and in the lower limbs.

What are the differential diagnoses of cruralgia?

Except pinched nerve myth, pain in the groin could be caused by 9 other causes.

Tendinopathy or pubalgia

This is a muscle pain which often affects athletes. Tendinopathy is a muscle injury that occurs in contact athletes and those who practice sports with sudden movements. This syndrome is characterized by micro tears which lead to inflammation at the level adductors and muscles around the groin.

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Like cruralgia, the pains are aggravated by walking and movements that involve muscle contraction.

Low back pain

La lumbago ou lower back pain is one of the symptoms of cruralgia. It occurs in the lumbar vertebrae and is often caused by spinal or disc injury. It can also be caused by a problem with the facet joints.

Symptoms radiate to the muscles that make up the groin and down to the lower limbs.

Osteoarthritis attacks

Lumbar or hip osteoarthritis can cause compression of the radicular nerve. This causes tingling and pain on the iliopsoas and joints.

The pain radiates to the knees and down the front of the leg, with a feeling of paresthesia.

Stroke sequelae

The stroke sequelae are not only limited to memory impairment, but also cause motor and sensory impairment. They cause paraesthesia of the upper or lower limbs: tingling, burning sensations with loss of sensitivity.

Circulatory paresthesia

Prolonged bending or crossing of the legs constitutes a blockage in the blood circulation and also that of the nerve. Maintained over the long term, these positions lead to the compression of a nerve in the lower limbs. It also compresses several blood vessels causing venous insufficiency.

As a result, it causes numbness and electric shock sensations in the feet.

The hernie inguinale

A pathology that affects men, inguinal hernia represents a protrusion of a portion of the abdominal viscus. A small portion of the small intestine or peritoneum passes through the abdominal wall.

This pathology causes discomfort during walking or physical activities. It is painful especially in the groin and can even compress the tissues around the protrusion. In case of strangulation of the hernia, particular signs may appear:

  • sudden redness and pain in the groin;
  • difficulty passing stools;
  • inability to evacuate intestinal gas;
  • an onset of nausea and vomiting;
  • a fever.

kidney stone

Kidney stones or kidney stones arise because of the formation of crystals inside the kidneys. Intense pain is quickly felt when the stones move towards the ureter.

The pain is felt in the lower back at the level of the side and radiates towards the groin. This disease is associated with other symptoms:

  • frequent urges to urinate;
  • pain felt during urination;
  • vomiting and nausea;
  • brown or reddish or pink colored urine.

crural hernia

La crural hernia ou femoral means a protrusion of a portion of the digestive tract through the abdominal wall. Like the inguinal hernia, the tube lands in the femoral canal and can experience strangulation.

This pathology occurs mainly in women and generates a strong pain from the groin that radiates to the lower limbs.

The pregnancy

Pregnancy is one of the proven causes of pain and numbness in areas around the groin and legs.

When the uterus expands, it can jostle the organs around it, including the groin. In addition, hormones (relaxin) are secreted during this period. This causes a contraction of the ligaments followed by a reduction in their stability, and which manifests a painful sensation in the groin.

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An increase in blood flow and volume also causes venous insufficiency in pregnant women. This gives transient paresthesias in the lower part of his body.

At full term, the baby's head presses on the pelvic area causing uneven discomfort in the groin and lower body.

Peripheral nervous system damage

This syndrome is characterized by a permanent tingling sensation in the hands, feet, legs. Sometimes the patient feels heat and pain.

This sensation can come from a lesion of the peripheral nervous system often associated with multiple sclerosis. It is a neurological disease that also affects people with diabetes or adults in their sixties.

What to do to treat the pain?

In order to avoid confusion, it is essential to see a doctor who will establish the diagnosis and find the real cause of the pain. He will then refer the patient to specialists if necessary (rheumatologist, neurologist, etc.).

It is also important to go through a series of clinical, biological and medical imaging examinations which will eventually be proposed by the specialists.

That said, the method of treatment is distinct depending on the origin of the disorders.

The only common point in the treatment of all pathologies remains the way of relieving suffering. To do this, it is important to start resting the painful part before doing anything else.

The doctor will eventually prescribe medication to control the pain, depending on the clinical signs.

Acupuncture, osteopathy and various techniques used in kinesitherapy (physiotherapy) can be applied to relieve discomfort.

If the pain is triggered by poor posture, it is better to do stretching and remobilization exercises. A physical therapist (physiotherapist) will know which program to follow depending on the mechanical dysfunction encountered.

If micro tears are seen in the soft tissues, the exercises proposed aim to activate the circulation, tone and relax the muscles.

Manual massages or via devices are sometimes essential thanks to their anti-inflammatory and analgesic effect. A qualified therapist such as an osteopath or a physiotherapist are best placed to apply these methods.

Tools and accessories can also relieve pain and improve short-term feelings of well-being. It should however be noted that they will not necessarily act on the main cause of the problem.

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In all cases, it will be necessary to find the origin of the symptoms in order to treat the condition properly. Do not hesitate to consult for appropriate support.

Resources

https://www.lombafit.com/cruralgie-a-z/

https://www.lombafit.com/douleurs-a-laine/

References

https://sante.journaldesfemmes.fr/fiches-sante-du-quotidien/2647101-jambe-engourdie-que-faire-la-nuit-grossesse-sciatique-douloureuse/

https://www.osteopathes.paris/pourquoi-consulter-un-osteopathe/fourmillements/

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