Femoral nerve pain

by Judy
(Moseley, VA)

Femoral nerve pain in the upper thigh

My left thigh pain has gotten progressively worse and more frequent during the last 4 years. The radiating sharp pain travels across the left groin, down the front of my thigh and on the sides of my knee. The pain is disabling at times, causing me to limp and avoid walking.

I also have moderate pain in my lower back and left hip. After sitting for awhile, I experience stiffness and pain in my thigh when I stand which lessens after movement.

I have had a CT myelogram and an MRI of the spine, which showed moderate stenosis and a slipping disk as well as scoliosis in the lumbar spine (L2-6). Epidural injections have given little relief. The injection in the L2-3 area gave me complete relief for a week or so.

Nerve conduction tests show that I have femoral nerve damage. My knee does not buckle yet. My doctors just prescribe pills and send me on my way. I really would like to know the cause of the damage before it gets severe.

Hello Judy,
Mmm, it already is severe, I'm afraid. It's become chronic, four years is a long time and it is affecting sitting and walking, and obviously making you miserable. Chronic pain does that.

You make no mention of exercises. Frankly, choosing the right exercises for you, and doing them properly and correctly in difficult cases like yours usually needs professional help. But you can make a start at lower back exercises if you're willing to try for yourself.

Chronic nerve pain can be very disabling. I don't know the degree of degeneration in your back, but until you've seen a local chiropractor, you won't know whether chiro will help you or not. I often find that McManus traction helps a lot.

Sitting often aggravates the condition, especially in low chairs and couches. Choose your chairs carefully, and generally sit less.

I wish I could tell that all cases respond as well as this Femoral nerve casefile … but that's not the case. This is a difficult condition.

One small thought: Lie on your back, and pull your knee to your chest, and then to the opposite shoulder. Compare with the right leg. Is the left much more stiff and painful in the hip/groin? An arthritic hip also causes groin and pain that radiates to the front of the thigh.

Gather your scans, and start talking to friends and neighbours and your doctor, and get the name of a local chiro. This is a condition I treat on a daily basis. Whilst you may not get a "cure" would you be happy if it was 50-80% less painful?

Good luck, keep us abreast of developments.

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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