La cruralgia, also called crural neuralgia, is due to compression of the crural nerve. The pain usually sets in quickly and then becomes permanent. It is especially intense at night. In this article, we are going to see how to relieve nocturnal attacks of cruralgia.
Focus on cruralgia
Anatomy and definition
From an anatomical point of view, the crural nerve is the largest terminal branch of the lumbar plexus. It is made up of numerous nerve roots arising from the second, third and fourth vertebrae lumbar.
As for its course, the crural nerve immerses in the depth of the psoas muscle, then descends to the outer edge of this muscle in the internal iliac fossa. It then arrives in front of the psoas and passes under the crural arch before penetrating the thigh on the outside. There, the nerve divides into several branches: sensory branches and motor branches. These will extend along the lower limb to innervate the inside of the thigh, the inside of the knee and the ankle and the inside edge of the foot.
We are talking about cruralgia when the crural nerve is compressed along its path. The painful symptom goes from the outer part of the buttock to the front part of the knee.
Causes and symptoms of cruralgia
Cruralgia has multiple causes as :
- a herniated disc which compresses the root of a nerve at the level of the lumbar vertebrae;
- a degenerative disc;
- un narrow lumbar canal ou spinal stenosis ;
- a hematoma of the psoas muscle;
- In the most serious cases, tumor compression (neuroma) or infection.
In terms of symptoms, cruralgia causes pain in the lower back, the inside of the knee and the front of the thigh.
The patient may also experience other signs such as:
- Burns ;
- feelings of electricity (electric shocks);
- difficulty moving the leg or feet.
Depending on the severity, it is possible to have a fever overnight.
Why can cruralgia be painful at night?
In some cases, the pain of cruralgia is felt more at night than during the day. To explain this, know that at night the body is inactive. Consequently, the muscles contract and accumulate toxins. Muscular tensions are then formed which are likely to generate more pressure on the level of the crural nerve. This leads to inflammation of the latter which is the cause of pain.
How to relieve cruralgia during sleep?
There are many solutions that can help relieve the pain of cruralgia overnight.
You can for example applying ice or heat on the painful area. It is simple and efficient.
Also consider making pulling movements lumbar, stretching exercisest to release the nerve as well as muscle strengthening exercises. However, before proceeding, seek advice from a professional in order to know all the ideal exercises to perform.
If the intensity of the pain is too high, the doctor may prescribe various medications such as analgesics, anti-inflammatory to infiltrations.
You can also turn to alternative medicine. It offers a wide choice of treatment: acupuncture, acupressure mat, suction cup (cupping therapy), myotherapy, Quinton plasma, percutaneous hydrotomy, therapeutic yoga, craniosacral therapy et McKenzie method.
To define which one is suitable for your situation, just discuss with your doctor.
Positions for sleeping with cruralgia
It is important to understand that in order to relieve pain, the crural nerve must be unloaded. For this to happen, there are positions you should adopt in bed when you sleep.
To successfully sleep well when you suffer from cruralgia, it is advisable to sleep on your back and slide a pillow under your knees. This posture is performed in order to hold your nerves slightly bent and slightly elevated while you sleep. This position helps to limit inflammation.
On the other hand, if you like side lying position, think to put a pillow between your legs. This will avoid the spine to twist too much and risk compressing the roots of the crural nerve. Your position will depend on where your pain is located. If it's your left crural nerve that's hurting you, roll onto your right side and raise your left knee into “flexion,” and leave your right leg extended. Do the reverse if your pain is felt in the right side.
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