femoral nerve after kidney excision from cancer

by joyce
(canada)


I have suffered from back, hip and groin pain for a few years, had several cortisone shots in the facet joint which has helped, but the pain always came back.

I walk with a limp, my knee has very little reflex and is numb about 65 percent. Recently I was told it was the femoral nerve and given a series of exercises to do. How long before I see improvement? I am a diabetic but it seems to be under control.

Anyways here's a question, I had my kidney removed; cancer. And it was shortly after that I noticed the groin and hip pain; could my surgeon have severed or nicked my femoral nerve during surgery.

Hello Joyce,
There are a lot of imponderables here. Only a very thorough examination can determine what is the primary cause of your problem, and there may be more than one thing going on.

Firstly, a limp in this case suggests weakness of the quadriceps muscle. The difficulty is that both a femoral nerve lesion, and diabetes, often affect the quad. In this instance, if your DM is well controlled and you have numbness around the knee, then it's probably an irritated or frankly pinched nerve in your back. The two big questions are:

1. If you bounce on one leg, does the knee tend to give compared to the other thigh? How is it on the stairs?

2. Is the femoral nerve stretch positive? Ask your doctor.

Major surgery in the kidney area could certainly affect both the femoral nerve, and possibly the superior cluneal nerves that supply the buttock, and some authorities reckon the groin too. This is less likely as the latter is purely sensory and doesn't extend down to the knee. I wouldn't give you a limp.

Bleeding after surgery might cause a hematoma around the psoas muscle where the femoral nerve penetrates on its way from the mid lumbar spine to the groin and thigh.

Lastly, just to be sure, pull your knee towards the chest and opposite shoulder. No pain in the groin? Hip arthritis also causes a limp and groin pain, and you could by the way have a hip condition.

This is complex, Joyce, and frankly I wouldn't trust too much on any source on the web. I'm simply throwing out a few ideas; you need to trust your doctors who are able to examine you. Nevertheless, the Good Lord gave you a brain, so there's no harm in thinking and asking a few leading questions!

Lower back exercises will always help; as to whether they can help a damaged femoral nerve is difficult to predict. Do them anyway, I recommend that everyone does them daily; best before getting out of bed.

I hope this contributes. Let me know what comes of it all.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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