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Neuritis of the femoral nerve: main symptoms and treatment. Treatment of femoral nerve neuropathy

Neuritis is a disease in which one of the peripheral nerves. If several nerves are affected, we can talk about polyneuritis.

Neuropathy, according to some experts, is different from neuritis: it is not inflammatory nature diseases. Neuropathy femoral nerve(in other words, neuropathy) implies any dystrophic or degenerative change the largest nerve entering the lumbar plexus. It should be noted that the terminology generally accepted in the medical environment related to this disease, does not exist.

SYMPTOMS OF FEMORAL NERVE NEURITIS:

a pulling pain along the entire nerve, especially felt if pressure occurs at the site where the nerve appears just below the inguinal ligament on the thigh;
mild decrease in sensitivity (for example, numbness, tingling, sensation of “pins and needles”) of the inner or anterior surface of the thigh;
muscle weakening in the area closest to the nerve: from minimal paresis to severe paralysis and atrophy: the leg at the hip, knee and in the knee area moves poorly or “bends”;
mild or absent tendon knee reflex;
slight swelling in the knee and ankle area;
slight local depigmentation of the skin;
possible local hair loss;
rarely - manifestation of trophic ulcers.

Diagnostics

The doctor carefully listens to the patient’s pulse, conducts functional tests, with the aim of identifying movement disorders, only after this can a specialist talk about neuritis of the femoral nerve.

ANALYSIS OF THE CAUSES OF FEMORAL NERVE NEURITIS

Any neuritis is a consequence of an imbalance nervous system and the predominance of cold in the body, this is what the ancient Tibetans believed. People whose dosha is Wind, patients with a predominance neurotic reactions most prone to similar diseases, they are often brought to nervous tension, severe fatigue, depressing emotions, frequent stress.

Most probable reasons femoral nerve neuropathy:

injury. Any damage to the hip joint (both bruises, dislocations and fractures) can lead to the actual occurrence and development of neuritis in the hip area;
hypothermia. Cold can provoke a variety of diseases of the nervous system, including the one described;
inflammation in one of the pelvic organs (for example, in bladder, prostate gland, ureter, seminal vesicles, rectum, ovary, uterus, vagina);
diabetes;
infection (influenza, malaria, herpes, measles, diphtheria, brucellosis, etc.);
lack of vitamins;
vascular pathology;
intoxication; body structure features;
compression of the femoral nerve trunk. Such a pathology can arise relatively unexpectedly: it involves sleeping in an uncomfortable position, forced long-term uncomfortable position of the body, with osteochondrosis or hernia, the nerve is pinched in the spine, this happens quite often during pregnancy, accidental compression of the nerve can occur during surgery.

TIBETAN APPROACH TO ALTERNATIVE TREATMENT OF FEMORAL NERVE NEURitis

At the Naran clinic, any disease is considered as a consequence of an internal imbalance of the body’s forces; disease is only its external, visible, tangible manifestation. The basic principle of treating neuritis is the same as for other diseases: the impact on the problem troubling the patient should be comprehensive, including a review of lifestyle depending on the defining constitution of the patient, and special herbal treatment, taking into account the doctor’s recommendations, and traditional Tibetan healing methods, and working with the patient’s psycho-emotional state.

Femoral nerve neuropathy is one of the diseases that Tibetan medicine cures in 99.9% of known cases. The specialists of our clinic are firmly confident: in the vast majority of cases, you can do without antibiotics, analgesics and vasodilators.

Treatment methods:

herbal medicine that harmonizes the Wind;
adjusting your usual diet;
acupuncture. The effectiveness of this method of treatment is more than well known to everyone. Highly qualified specialists can literally work miracles with needles;
acupressure easy to remove pain syndrome and corrects violations motor activity;
cupping massage. Massage has an extremely positive effect on various types of neuropathies: it helps to activate blood circulation, tissue cells are better saturated with substances that nourish them, and the conductivity of the nerve fiber impulse is gradually restored;
moxotherapy; stone therapy and others.

Neuralgia of the femoral nerve is a pathology that brings significant discomfort to the patient. It manifests itself as a result of pinching nerve endings, often becomes a consequence various diseases or body conditions. To eliminate it, it is necessary to prescribe complex therapy - medications, physiotherapy and exercise therapy.

Common Causes

Femoral neuralgia can occur under the influence of many external factors and diseases. To treat it, it is necessary to identify the exact cause of its development.

Diseases and other conditions of the body that precede femoral neuralgia:

injury to the hip joint - fractures, dislocations, sprains, etc.;
hypothermia - sitting on cold surfaces most contributes to the occurrence of neuralgia of the femoral nerve;
course of diabetes mellitus;
joint diseases;
pathologies of the spine - osteochondrosis, hernia and protrusion of intervertebral discs;
avitaminosis;
obesity;
severe viral and infectious diseases;
inflammatory processes in the pelvis, including the genitals;
vascular diseases;
sedentary lifestyle life;
individual anatomical features;
prolonged sitting in an uncomfortable position;
pregnancy - during this period, the pelvic bones diverge, which leads to pinching.

Most often, the occurrence of femoral neuralgia is caused by diseases of the musculoskeletal system, injury to the hip joint, or lack of physical activity. That is why this pathology usually diagnosed in older and older adults.

Symptoms

Signs of pathology appear gradually. Initially, the symptoms appear weakly, but over time their intensity increases, which causes significant discomfort to the patient and impairs his motor activity.

Signs of femoral neuralgia:

painful sensations in the groin, worsening when walking, lifting legs, standing up;
impaired sensitivity in the anterior thigh area;
decreased joint mobility;
lameness - occurs under the influence of pain and when the sensitivity of the affected limb is impaired;
weakness of the thigh muscles;
burning and tingling in the leg.

Over time, lameness and pain from neuropathy intensify, forcing the patient to lead a sedentary lifestyle. Due to pinching of the lateral (cutaneous) nerve, sensitivity on the outside of the thigh becomes minimal.

Treatment measures

All treatment methods are aimed at restoring the patient’s motor mobility, eliminating inflammation and pain. For this you need complex therapy, all stages of which are usually carried out simultaneously.

To alleviate the condition of neuralgia of the external femoral nerve, they are prescribed the following types medicines:

Self-massage products that make you feel better and relieve muscle spasms - Finalgon, Nicoflex, Menovazin, essential oils of lemon, clove, pine, chamomile.
Pain relief - tablets and ointments Ketonal, Voltaren, Ibuprofen.
Drug blockades with novocaine - quickly eliminated discomfort, are carried out for acute pain syndrome.
Drugs to restore the functionality of the femoral nerve - Pentoxifylline, Milgamma.

Procedures to normalize local blood circulation, relieve inflammation, and restore limb mobility:

Additionally, the doctor prescribes therapeutic exercises for neuralgia, which should be started after the pain has subsided. It helps restore the functionality of the femoral nerve and speed up the healing process. Initially you need to do simple exercises, their complexity needs to be increased gradually.

If femoral neuralgia occurs during pregnancy, treatment methods are limited due to possible risk for the fetus. To make you feel better to the expectant mother It is allowed to do self-massage and rubbing the affected area using essential oils, Voltaren and Menovazine, perform therapeutic exercises. In some cases, visiting a chiropractor is allowed.

The femoral nerve, which runs in the pelvis and lower extremities, is responsible for flexing individual parts of the legs. Nerve fibers also innervate the muscles in the lumbar region. With neuropathy of the femoral nerve, there is a decrease in the sensitivity of the affected area due to a decrease in the conductivity of nerve impulses. At the same time, the muscle functions of the lower extremities are partially preserved. The treatment regimen for the disease is selected taking into account the characteristics of the provoking factor.

Anatomy of the femoral nerve

Understanding the anatomy of the femoral nerve can help determine the causes of pain and other symptoms associated with neuropathy. The nerve of the human thigh originates in the area where the spinal roots are located, which, when connected to each other, form a single trunk. Maximum number the fibers that make up the femoral nerve are located in the cavity formed by the iliacus and psoas muscles.

It then exits the pelvis and passes through the fibrocystic tunnel in the groin area. From here, its fibers stretch along the front of the thigh (nerve along back surface hip does not pass) and change direction to medial (middle). The nerve enters Gunther's canal, formed in the muscles, and enters the knee joint. In this area, like the groin, it lies close to the surface of the skin, so when these areas are injured, the vessels and nerves of the thigh are easily damaged.

At the end, its fibers extend to the edge of the lower leg and foot, reaching thumb legs.

The branches of the femoral nerve are responsible for innervation of various parts of the lower extremities. In this regard, the symptoms characteristic of neuropathy are localized in those areas in which the pathological process occurs.

The femoral nerve, which runs in the pelvic area, innervates the iliacus and psoas muscles, which perform the following functions:

hip flexion and supination;
lumbar flexion, which allows a person to bend their torso forward.

The nerves located just below the groin area provide:

knee flexion and extension;
sensitivity of the skin on the front and inner (partial) surfaces of the thigh.

The branches passing below are responsible for the sensitivity of the skin in the area of the foot and lower leg (on the front and middle parts), the anterior surface of the patella.

Causes of neuropathy

Problems with the innervation of the thigh arise due to two factors: compression (pinching) of nerve fibers and mechanical damage. The first option is diagnosed more often. Compression of the femoral nerve, which appears as a result of muscle spasm or hemorrhage in the pelvic area, is caused by the following factors:

mechanical damage to the specified area;
lymphomas and sarcomas;
hematomas localized in the retroperitoneal space (near the lower back);
aneurysm of the iliac or femoral artery;
bursitis, abscesses affecting the iliacus and lumbar muscles;
surgical intervention for pathologies of the kidneys and ureter (neuropathy of the left thigh develops).

Violation of the innervation of the anterior surface of the thigh is observed under the influence of the following factors:

leg hold long time V incorrect position, which causes the inguinal ligament to compress the nerve;
hernia;
lymphadenopathy;
femoral artery aneurysm;
surgical intervention during which tissue of the hip joint is excised;
insertion of a catheter into the femoral artery.

Neuropathy in the lower legs is mainly associated with knee injuries (surgery, mechanical impact). Bursitis and deformation of local bones also lead to similar disorders.

Neuropathy in the foot area is most often due to idiopathic (unidentified) causes. IN in rare cases lead to such violations varicose veins veins, thrombophlebitis or frequent knee injuries.

Symptoms

Neuropathy develops gradually. The first symptoms of pinched femoral nerve (neuropathy) occur when there is constant weakness in the lower limb and impaired flexion function.

As it progresses pathological process a pain syndrome occurs, localized along the course of the nerve and often radiating to the groin area. The intensity of pain increases in supine position or while moving.

During palpation of the area in which the femoral nerve exits the pelvis, the patient experiences severe pain burning character. Due to a violation of innervation, the skin on lower limbs ceases to feel tactile and temperature influences.

One of the symptoms of damage to the femoral nerve and resulting neuropathy is lameness. Its occurrence is due to a decrease in sensitivity in the lower limb.

Damage to the femoral nerve is characterized by dysfunction of the iliacus and psoas muscles. However, the hip joint with neuropathy continues to flex. This is explained by the fact that these muscles are also innervated by other neurons.

Except specified symptoms Paresis of the quadriceps femoris muscle, which provides flexion and extension of the knee joint, is diagnosed. Because of this, the patient loses the ability to squat normally, climb or descend stairs.

With further development of the pathological process, the muscles gradually atrophy. Moreover, the likelihood of such an outcome directly depends on the localization of compression and the degree of pinching of nerve fibers.

Diagnosis of hip neuropathy

Damage to the femoral nerve requires careful diagnosis. It is important to establish the causes of compression and the localization of the pathological process. In case of such violations, an X-ray of the spine is performed, with the help of which the degree of damage to the specified structure is established. However, this method is not very informative, since with osteochondrosis and other pathologies of the spine, compression occurs in advanced cases.

Therefore, radiography is usually complemented by EMG. Using this procedure, it is possible to determine the speed of impulses passing through the problematic nerve fibers.

IN last years If neuropathy of the femoral nerve is suspected, ultrasound is often used to assess the integrity of the nerve fibers, as well as identify degenerative processes, tumors, scars, adhesions, swelling and others pathological changes, causing compression. To assess the degree of mobility of the femoral nerve ultrasound diagnostics is carried out dynamically (the patient moves his legs).

To differentiate neuropathy from other disorders (for example, diseases that are localized in the retroperitoneal space), CT and MRI are prescribed.

How to treat the disease?

With neuritis of the femoral joint, symptoms and treatment are determined both by the localization of the pathological process and the characteristics of the causative factor.

IN severe cases When compression is caused by the development of tumors or other neoplasms, surgical intervention is used.

Surgeries are also indicated for severe sprains or tears. muscle fibers.

For pinching of the femoral nerve of a less pronounced nature, drug therapy is used, which eliminates painful sensations and the conductivity of the fibers is restored. This treatment is complemented by methods of physiotherapy and exercise therapy.

Drug therapy

The treatment regimen for femoral nerve neuritis is selected based on the cause of the development of this pathology. If compression is localized in knee joint or groin area, apply local anesthetics such as "Lidocaine" or "Novocaine". Drugs in this group relieve pain. Together with anesthetics, they resort to blocking the femoral nerve with glucocorticosteroids (Diprospan, Hydrocortisone). These medications suppress the inflammatory process.

In case of muscle paresis drug treatment neuropathy of the outer thigh is carried out using Neostigmine or Ipidacrine. Drugs in this group are prescribed for oral administration. Medicines improve the conduction of nerve signals to affected muscles.

In other cases, the following are used as part of drug therapy:

Non-steroidal anti-inflammatory drugs (Nimesulide, Meloxicam, Voltaren). Suppress the inflammatory process and eliminate tissue swelling.
Vasoactive drugs (“Aminophylline”, “Pentoxifylline”). Restores the functions of damaged nerve fibers, improves metabolic processes in the problem area. Together with vasoactive agents, vitamins B1 and B6 and thioctic acid are prescribed.
Muscle relaxants (“Mydocalm”). Eliminate muscle spasm, thereby relieving pain.
Anticonvulsants (Gabapentin, Topiramate). Suppresses cramps and relaxes muscles.
Antidepressants (Fluoxetine, Amitriptyline). Used when chronic pain caused by neurogenic lesions.

Type medicinal product and the dosage of the drug should be selected by the attending physician. A number of these medications cause severe complications.

Physiotherapy

When the thigh nerve is pinched, exercise therapy is used in combination with drug therapy. Exercises to restore the functions of the lower extremities should be performed only after the symptoms have been relieved and the causes of the disease have been eliminated.

Treatment of femoral neuralgia with various using exercise therapy techniques depends on the symptoms of the disease.

Type of exercise, degree physical activity and the order of completing tasks is also determined by the attending physician, based on the characteristics of a particular case. With the help of gymnastics you can achieve the following results:

accelerate the restoration of damaged tissues;
restore the functions of damaged nerve fibers;
enhance blood microcirculation in the problem area, thereby reducing the intensity inflammatory process;
prevent the occurrence of joint stiffness, scars and adhesions;
strengthen muscles and ligaments.

Regular exercise therapy helps rapid recovery patient's ability to work. If during classes there are intense pain, you need to stop exercising.

Traditional medicine

The attending physician must determine what to do if a nerve is pinched in the thigh. This also applies to cases where therapy is carried out with traditional medicine.

To relieve other symptoms and alleviate the condition in the treatment of femoral neuralgia, the following are used:

Clove, fir, pine, chamomile and lavender oils. These remedies help relax muscles. Oils are recommended to be used during massage of the problem area, which promotes rapid penetration medicinal substances into the affected tissues.
Burdock root decoction. To prepare the product you will need 1 tbsp. plants. The root must be brewed in 250 ml of boiling water and left for two hours. The prepared product in an amount of 50 ml should be drunk 2-3 times a day after meals.

A variety of compresses help suppress pain in the thigh.

The use of such drugs must be agreed with a doctor, since in some cases heating causes serious complications. With spastic paresis good results achieved by acupuncture.

Consequences

Without adequate and timely treatment Damage to the femoral nerve causes the following complications:

Intense pain in the lower extremities. Constant discomfort provokes changes in mental state patient. If the leg often hurts, the patient becomes aggressive and irritable.
Spread of inflammation to other structures. If the thigh nerve is pinched without timely identification of symptoms and prescription proper treatment, the plexuses in the lumbar region and above are affected.
Paralysis. This complication occurs when the inflammatory process spreads to the nerve fibers in the lumbar region.

Because of frequent pain decreases in the groin area sexual desire, both in men and women. The same symptom interferes normal sleep. In advanced cases, atrophy of the muscle fibers of the legs develops due to weak innervation.

Prevention

walk for at least 30 minutes every day;
avoid injuries, stress and physical strain;
watch your posture;
promptly stop inflammation in the pelvic area;
follow the principles of proper nutrition.

It is quite difficult to prevent inflammation of the femoral nerve, since the disease develops against the background of the influence of many factors. In this case, the effect of treatment will be maximum if therapy is started at initial stage development of the inflammatory process. Therefore, if your leg is pinched in the thigh, it is important to promptly seek help from a doctor.

Neuropathy (neuropathy) is inflammation of a nerve or damage to its myelin sheaths, leading to disruption of impulse transmission. The disease is most often caused by compression of the nerve trunk.

Reasons for the development of pathology

Anatomical formations with superficial localization or passing in narrow bone, muscle or ligamentous canals are susceptible to the development of neuropathy. Such anatomical formations include the femoral nerve. Its part is located between lumbar muscles, and then it passes directly under the inguinal ligament. This topography determines its frequent involvement in the pathological process.

Causes of femoral nerve neuropathy:

Injury to the lower back muscles and its spasm causes compression of the femoral nerve.
Compression from the outside is caused by hematomas, abscesses, and tumors of the retroperitoneal space.
Neuropathy of the left femoral nerve develops when damaged during surgery on the ureter and kidney on the left, where these organs are located below. Injury to the right nerve occurs during appendectomy surgery.
Nerve compression in women occurs during prolonged lithotomy during labor.
Metabolic disorders in diabetes mellitus.
Alcohol long-term intoxication.

Clinical picture

When the femoral nerve is damaged, the following symptoms occur:

Weakness in the leg gradually increases, it “stops obeying and bends”;
pain occurs in the groin spreading to the front and inner thighs;
pain and temperature sensitivity in the anterior inner surface legs;
bending of the leg at the knee is impaired, running and walking are difficult, climbing and descending stairs is difficult;
gait is disturbed.

During a neurological examination, a specialist identifies signs of damage to the femoral nerve: pain in the inguinal ligament, insensitivity in the projection of innervation, muscle atrophy, depression and decreased reflexes.

Diagnostics

The diagnosis of femoral nerve neuropathy is based on complaints, medical history and neurological status of the patient. To clarify the level of damage, electroneuromyography is performed - a study of the conduction of nerve impulses. The method allows you to determine the nature of the damage and control the dynamics of therapy.

Differential diagnosis of neuropathy is carried out with stroke.

Treatment

Treatment of neuropathy is determined by the reasons that caused it. If the disease arose from compression by a tumor, hematoma or abscess, then you cannot do without surgical intervention, eliminating compression. For neuropathy of a diabetic or alcoholic nature, treatment of the underlying disease is necessary.

Main medications for the treatment of neuropathy are:

(Meloxicam, Diclofenac, Ketorolac, Xefocam). They relieve pain, eliminate swelling and inflammation.
B complex of vitamins (Milgamma) for the restoration of myelin sheaths.
Means for improving impulse conduction - Proserin, Neuromidin.
Medicines to improve blood circulation (Trental, Pentoxifylline).
Antioxidants and antihypoxants (Berlition, Thiogamma, Espa-lipon).

In combination with therapy good effect provide physiotherapeutic procedures. They are selected by the doctor depending on the stage of the process, taking into account possible contraindications. Recovery is facilitated by electrophoresis with aminophylline, dibazole, vitamins B1, electroanalgesia, magnetic therapy, laser therapy, ultrasound, and electrical myostimulation.

At the stage rehabilitation treatment will fit physiotherapy, massage, acupuncture.

When conservative therapy does not bring any effect, they resort to neurosurgical help. Most often, surgery is indicated for traumatic injury. In such cases, the sooner the operation is performed, the more favorable the prognosis for restoration of limb function.

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What functions does the femoral nerve perform? What are the main symptoms of femoral neuritis? Manifestations of the inflammatory process in another nerve of the leg - the obturator.

The femoral nerve can be compared to an electrical cable, with many individual “wires” running inside it. They perform different functions: some are responsible for movement, others for sensitivity. Such nerves carrying different types nerve fibers are called mixed. So is the femoral nerve. Here are the main functions it performs:

Skin sensitivity: on the front surface of the thigh, on the inner surface of the lower leg.
Movements: hip flexion (the femoral nerve helps pull the legs towards the stomach), leg extension.

Accordingly, violations of these functions will act as the main symptoms of femoral neuritis.

Characteristic symptoms of neuritis of the femoral nerve

If the neuritis occurs in the upper part of the femoral nerve, before it exits the pelvis, clinical picture the disease will be most pronounced. Everything arises possible symptoms femoral neuritis:

Impaired hip flexion. This makes it difficult to lift the body from sitting and lying positions.
Leg extension disorder. It becomes difficult to walk, run, or climb stairs. A person tries not to bend his leg at the knee again, because after that it is difficult to straighten it. The leg is constantly strongly extended, because of this the gait changes - the patient throws his straight leg forward and places the entire sole on the floor at once.
Thigh muscle atrophy. The affected leg becomes thinner than the healthy leg, which may be noticeable externally.
Sensory impairment. The person does not feel touch or pain on the front surface of the thigh or inner surface of the lower leg.
Pain. They occur in the same places where sensory disturbances occur.

An experienced neurologist will be able to understand the symptoms that are bothering you and prescribe the correct treatment.

What symptoms does a neurologist use to diagnose femoral neuritis? What kind of examination can he prescribe?

During the appointment, the neurologist talks with the patient, clarifies complaints, and conducts a neurological examination. In addition to disturbances of movement and sensitivity, other characteristic symptoms are detected with neuritis of the femoral nerve:

Decreased knee reflex. This is the one that the doctor hits the knee with a hammer to check.
Wasserman's sign. The patient is asked to lie on his stomach and his leg is extended in hip joint. There is pain in the groin and on the front of the thigh.
Mickiewicz's symptom. The patient is also asked to lie on his stomach and his leg is bent at the knee. A similar pain occurs.