La cruralgia occurs when the nerve in the front of the thigh is irritated or blocked. This leads to burning sensations, muscle weakness and numbness in the lower back. The sensations radiate to the ankle.
In the majority of cases, the nerve is not pinched, and the pain and paresthesia disappear following conservative treatment. However, nerve compression is sometimes possible, and this condition requires invasive treatment. This article explains how to unlock the crural nerve, and provides alternatives for less severe cases.
Some anatomical points
Zoom on the pelvis and the femur
Located under the abdomen, the pelvis or pelvis represents a bony belt which serves as a junction between the spine and the lower limbs. The pelvis articulates with the lumbar vertebrae using the sacrum. This is linked, posteriorly, with the coxal bones of the hip by the garlic of the ilium. These form a joint between the sacrum and the iliac bone. The iliac bone is attached to the femur bone using an articular cavity which receives it.
The pelvis and the femur are associated with muscles supplied by several vessels and innervated by nerves. The muscles of the abdomen insert on the upper edge of the wing while the psoas major muscle is located on the lateral part of the Lumbar spine. The latter is attached to the edge of the pool.
What is the crural nerve?
The pelvic cavity is strongly innervated. Indeed, the lumbar plexus is located in the lateral part of the thigh. The sacral plexus is located in the posterior part of the thigh.
The crural nerve exerts a mixed, sensory and motor function. It branches at the level of the last four lumbar vertebrae and connects with the roots of the spinal cord. This nerve runs through the psoas major muscle and heads towards the inner side of the thigh.
The femoral nerve ensures the flexion of the thigh and the extension of the leg. It also transmits the sensation felt at the level of the anterior aspect of the thigh, the knee, the leg and the ankle.
Close up of pinched nerve and cruralgia
Often referred to as "the sciatica from the front cruralgia or crural neuralgia represents a nerve disorder of the anterior aspect of the thigh. It is sometimes associated with compression of the roots of the femoral nerve, located on the lumbar vertebrae (L1, L2, L3, L4).
When this nerve becomes irritated, it causes inflammation of the muscles, vessels and tissues around it. This results in a sharp pain in the front of the lower limb. Symptoms are felt in the lower back then the buttocks and radiate to the leg and ankle.
Moreover, cruralgia can occur without the crural nerve being compressed by a bony structure or by other tissues. However, a high level of irritation of the femoral nerve means that its root sometimes gets stuck. It can come from a herniated disc voluminous at the lumbar level.
In these relatively rare cases, the symptoms are amplified since the nerve signals are poorly transmitted. Indeed, the patient begins to feel a pain similar to electric shocks associated with tingling. Serious motor impairment such as paralysis of the lower limbs remains possible.
How to treat cruralgia?
Conventional treatment
As soon as the first symptoms appear, cruralgia can be relieved by conventional treatment. Taking analgesics and anti-inflammatories helps to reduce pain and inflammation. A 15-day rest is necessary as a temporary measure. Then, care should be combined with physiotherapy (physiotherapy).
These initial treatments are often accompanied by complementary measures aimed at relaxing the muscles. To this end, hot, cold and therapeutic massage are applied to relieve stiffness.
Naturopathy
Naturopathy also helps relieve inflammation. This consists of monitoring the diet and concocting herbal teas that reduce pain. Foods rich in vitamin C contribute to the elimination of toxins produced by inflamed muscles. Some plants act positively against cytotoxins, namely devil's claw, red clover, aloe, etc.
In addition, acupuncture involves stimulating specific points on the body using needles. Osteopathy, on the other hand, is a manual therapy that consists of pressing manually on the painful area.
How to unlock the crural nerve?
Use nerve infiltration
Despite initial care, symptoms can become chronic in some people. A moderately invasive technique is recommended for this purpose in order to unblock the crural nerve when it is really compressed. This is an infiltration method which consists of injecting a dose of corticosteroid in contact with the conflict zone of the crural nerve.
The injection is done as an epidural. This technique is carried out with the help of radiographic identification and does not require any anesthesia. It is effective, but its practice depends on the causes of the irritation of the femoral nerve. The infiltration can be carried out more than once. On the other hand, it is necessary to limit oneself to the first intervention if this one is considered ineffective.
Surgery: to overcome the pinched nerve
Surgery involves freeing the crural nerve or its root stuck in the spinal canal. This invasive treatment method is recommended in cases of major suffering that prevents walking and sleeping. It is recommended to apply this treatment in the presence of paralyzing after-effects of nerve damage.
There are several ways to operate on the open nerve. This requires emergency primary suture such as laminectomy, microdiscectomy and herniectomy.
References
https://sante.journaldesfemmes.fr/fiches-maladies/2477422-cruralgie-symptome-cause-duree-traitement/
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