Comments for Lateral Femoral Cutaneous Nerve Pinched by Knotted Iliopsoas Muscle

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Feb 06, 2016
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Femoral nerve entrapped
by: Mike

Hi,

I am going through the same thing. My femoral nerve is trapped in the illiac groove. I still have a way to go but here is what has helped:

Activation of glutes, quads, and psoas(knee floats). Many people don't realize that their muscles have shut down pulling pelvis out of place. Do these for at least two to three weeks before stretching.

Dry needle the illiacus, quads, glutes, to reactivate muscles and release toxins. 4-5 sessions.

Pelvic tilts every other day (build up slowly)

After a month of dry needling, perform side laying quad stretch and Thomas stretch - gradually build up each - go slow at first not to cause to much inflammation. Slow and steady wins the race.

I will post back if I defeat this thing. I have been gradually improving with this approach. My muscle were totally deactivated and dysfunctional - the activations were key to getting me on the road.

Good luck!

Mike

Thanks for your contribution, Mike. It's a tough condition and no standard answer.

Dr B



Jun 08, 2015
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Current Status Update
by: Garry Anderson

Since November 2014 I have continued my daily routine of 2 inversion, 2 miles walking per day, and Deep Tissue Massage once per week.

As I continue to improve, I have stopped taking all Advil, and my pain level has dropped below 1/10 except when I stretch some muscle too much, at which point I can hit 3/10.

I have been able to reduce my massage sessions to once per week, and now I can go for 6-hour plane rides with no problem and I can sit for long periods of time (but I try to get up every 30 minutes to keep moving).

So, I think I have taken total control of this situation so that the pain no longer controls me. I will report later when the Psoas muscle finally decides to give up the fight, because I am not giving in to a "dumb" muscle.

I hope my stories help other people.

Take charge of your cure.

Garry Anderson.

Hello Garry,
It's always encouraging to hear the success stories from those who take reponsibility for their own health.

Well done. It doesn't mean that you won't need professional care in the future, but I'm impressed that you are prepared to spend over an hour a day on your health. The benefits of that walking of course go far beyond your knotted psoas muscle.

Lovely. Six hour plane ride? Mm, I've never been much over four in my glider, so I take it's a small plane or overseas.

Dr B

Nov 12, 2014
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Week-by-Week Improvement
by: Garry Anderson

Although my situation is getting better (2.5 years now), I am making slow improvements week-by-week. My daily routine consists of morning & evening Inversion Table, plus morning gym machine exercises, plus morning & evening walking totalling about 2 hours per day. On weekends, I make an extra 2 hour hike in the mountains during the day, which appears to give much improvement. Although the knotted muscles and pinched nerves have not released yet, I think it will release within the next 6 months. Dr. B's comments about Meralgia Paresthetica appear to be quite accurate. I am also getting some nerve stretching done by my RMT in the Inguinal area as well as twice-weekly deep tissue trigger point massage on QL, Piriformis, Erectors, Psoas, Iliacus, TFL, hamstrings, Quadricepts, and IT Band area. Very painful but gives relief for a couple of days. Stretching and Yoga is difficult because the muscles are in knots and don't give easily. I hope these comments help others.

Hello Garry,
Good that it's improving; a thought, what provokes the pain? Bending forwards, backwards, to the side?

I'm on holiday at the moment and my brother has very similar symptoms. Extension of the spine immediately provoked the butt and side of thigh pain; it was coming from the L4 joint and has responded quickly to side posture adjustments.

Dr B

Nov 04, 2014
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Femoral cutaneous nerve
by: Anonymous

I had the same problem, EMG confirmed it. Yoga helped and I will go back to yoga since the pain has returned. Anyone try a nerve block????

I don't have the research to back my opinion, there is none to my knowledge, and I've not treated the large number of patients necessary for a serious study, but I'm fairly convinced that by addressing the upper lumbar facet syndrome with a combination of manipulation, massage and exercise, AND the groin, this can be successfully treated conservatively.

Dr B

Feb 02, 2014
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Modifications to Part 1 & 2
by: Garry Anderson

Hi Dr. B:

Please make some corrections to my Part 1 & Part 2 solution.

Please change "Anonymous" to "Garry Anderson"

In Part 1, fourth paragraph, please change "30+" to "10+".

Thanks,

Done
Garry.

Jan 27, 2014
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I Have the Solution - Part 2
by: Garry

Continued from Part 1:

At the end of two months of continual treatment from Jan, I could now run for about 30 seconds every 5 minutes while walking. At the end of my time in Hawaii, I think I had about 80% improvement. Jan and I both discussed that it was up to me to take control of the rest of my recovery, so after returning home I implemented a plan every morning, and again every evening, as follows: 10 minutes inversion table, then 10 minutes Gym Machine with moderate weights for legs, shoulders, back, etc, then 5 Km treadmill for 60 minutes, then finally 10 minutes inversion table again, followed by a hot shower. So, I do this twice per day, and I think I am about 95% improved and I can run again for spurts while on the treadmill. Every day I keep getting better, and the pain and knots are going away while the muscle response is getting better. I have reduced the Advil to 1-3 times per day because the pain is so much less.

So, in a nutshell, the solution to my neuro-muscular problem was to implement a "recovery routine" of Inversion Table, Walking, Massage Therapy with Jan Walker, and Gym Machine for forcing the muscles to work in spite of the pain, with some Advil as necessary to manage the pain. I predict that within 3 months, I will achieve 100% cure. Now that is what I call taking charge of my life !

Hello again Garry,
what I like most about your story is your grim determination to get better against all odds. You just keep going, going, taking control of your own life, and hey it works.

Thanks so much for contributing, there are many others who will be inspired by your story.

Dr B

Jan 27, 2014
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I Have the Solution - Part 1
by: Anonymous

After trying many things to fix my Neuro-Muscular Problems, with symptoms of muscle pain on a systemic basis (legs, back, shoulders, arms, everywhere), I finally found a solution. I want to share my findings with all those who read the ChiropracticHelp.com web site, and I recommend they do their own investigations into what I found as a solution to my problems to see if it helps them.

How it all began: Initially, my left Psoas muscle went in knots with much pain, accompanied by immediate loss of use of the left leg (quads, hamstrings, knee, IT band, etc.) I tried the traditional exercises of pelvic tilts, and hip hikes, which all helped by about 5-10%, but no more. Then I tried the Intra Muscular Stimulation (acupuncture needles stuck directly into the knots within the muscles) and that treatment got my left leg working again, with about 20-30% improvement, but no more.

Then I tried the IronMan ATIS-4000 Inversion Table, where I hung upside down for 10 minutes, and after the first session, I could walk with almost no pain for 2 hours. This led me to the conclusion that being inverted slowly stretched the knotted muscles (Psoas, and QL, and other core muscles) so they no longer pulled the lower back joints together. Now I knew the problem and I had the solution: The knotted core muscles were compressing the lumbar spine joints and putting pressure on the nerve roots where they exit the spine. In my case the L1 and L3 joints were the most significant. After the first successful inversion treatment, I started hanging like a bat three times per day, which kept me functional and mobile again. Overall, I estimate that the inversion table three times per day gave me about 50% improvement, and I could walk again without limping, but I could not yet run again.

The next part of my fix, was to spend 2 months in Hawaii have special Lomi-Lomi Fusion massage sessions from Jan Walker (JanWalkerLMT@gmail.com), a lady who has 10+ years experience in treatment of conditions such as mine, and I have to report that she is by far the best massage therapist I have encountered (and I have tried 20 or more people before I found Jan). For this Hawaii solution, I pre-purchased a portable Inversion Table called the IronMan Gravity-1000 for about $140 from amazon.com and had it shipped to the hotel in Waikiki before I arrived there. I used the inversion 3 times per day in the hotel room, walked 1 hour round trip from the hotel to Jan’s massage centre every second day, and walked 1 hour every other day along the beach and around the Kapiolani Park, combined with swimming in the ocean to force the shoulder muscles to work again. Jan suggested using 3-6 Advil per day to reduce inflammation and manage pain.

Garry Anderson

Hello Garry,
This is great news. Inversion traction is indeed very helpful, but remember stretches your spine as well as the muscles.

Keep at it!

Dr B

Nov 02, 2012
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MRI Test Results of Lumbar Spine
by: Garry Anderson

Today (Nov 1, 2012) I had a Lumbar Spine MRI performed on my back. Afterwards, I reviewed the results with Dr. Raj Attariwala, and looked at the images with him. The images show some compression between L4-L5, and L5-S1, with a very slight bulge in both places. The Dr. theorizes that the bulge is caused by compression of the spine by the tight QL and Erector muscles. The L1 through L3 region is very straight, without a natural curve, and the Dr. thinks that the muscle compression is responsible for that too. The Dr. sees a restricted nerve hole in L4 and thinks that is where the problems begin. He concurs with the theory that once a nerve distress begins, then other muscles go into cramp, further pinching the nerve. The Dr. thinks that I need more IMS treatments along the entire spine from L1 through S1 to break the loop.

My MRI CD Image is available for download at https://www.onlinefilefolder.com/2sTvxHMEdXpiAZ

The CD Image is in CDR format, which is Master Format created by the Mac Disk Utility. When the CDR file is burned to a CD, both Windows and Mac can read the DICOM images from the CD. I use the Free OsiriX viewer for Mac, and it works very well.

Anybody who wants to view the MRI and post any comments, same would be much appreciated.

Hello Garry,
Unfortunately a very large folder, takes two hours to download. Perhaps if you gave the option of a few selected images.

There comes a time when one has to honestly ask the question: is this treatment helping. Am I any further forward than three months ago? It applies whether you are having medical, or complementary treatment.

If the honest answer is an unequivocal NO, then it's time to think of alternatives.

Dr B

Oct 30, 2012
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IntraMuscular Stimulation Provides Temporary Relief
by: Garry Anderson

Here are my updates and comments for today, October 30, 2012:

Yesterday I underwent some intensive IMS on my lower back problem areas. Dr. Lam from iSTOP inserted four needles into the QL muscle which grabbed and created pain in my lower back QL region. Then, he inserted a very long needle into the Psoas muscle from the back, which grabbed and intensified the pain to include the inner groin area and the leg. Finally, he inserted a needle into the L1 region (I think it might have been Psoas connection point) from the back, which grabbed then intensified the pain to be about five times what I experience in the "resting" state. So, with all these points activated, I now lay in pain for 45 minutes waiting for the grabbing to stop and the knots to release, which they did not. After the needles were removed, I could not move my left leg for about 1 minute, then finally I could move it quite freely. For the next 3-4 hours, I had good mobility and could climb stairs easily. Also, my general body pain and muscle weakness everywhere else, also disappeared. I was able to do some Yoga stretches, which I have been unable to do since August. Later on, the benefits of this IMS treatment went away as the Psoas and QL muscles tightened again.

Dr. Lam theorized that L1 was the beginning of the problem, which affected the Femerol nerve, and that then caused the Psoas to tighten, which in turn pinched the Nerve in a secondary location within the Psoas muscle itself. It appears that there are two links to be broken: The L1 activation point, and the Psoas muscle pinching the nerve creating the feedback loop.

Slowly we are getting closer to finding a solution. Any comments would be greatly appreciated.

Hello Garry,
I do some acupuncture but your doc is obviously in a different league. Naturally the risks also increase. You have to decide: is it really helping, or simply symptom treatment?

There are other ways of treating psoas spasm. Pressing deeply into the gut, that too with potential problems as one has to go through the colon. Regular stretching of the psoas?

Obviously you have a nasty case, so I won't offer a simplistic solution. There isn't one. But do keep up the exercises.

Good luck, keep in touch.

Dr B


Oct 28, 2012
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Further Contact Information
by: Garry Anderson

Dr. Barrie:

Sorry about the 3000 character limit on the site.

My email is GarryAnderson@shaw.ca

I don't mind allowing my email to become public.

Garry.

Oct 27, 2012
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Ankle Jerk & Femoral Nerve Stretch Okay
by: Garry Anderson

Dr Barrie:

As requested, I had the other tests performed today.

The Ankle Jerk test performed normally on both legs.

The Femoral Nerve Stretch was done on both legs, and was negative for any nerve pain or activation. What was interesting, however, was the amount of movement before restriction occurred. The right leg (the good one) would not stretch back as far as the left leg (the bad one). The Chiropractor theorized that the right stretch pulls the spine to the right side, and the spine's movement in that direction is being limited by the knotted Psoas Muscle on the left side.

Today, I underwent some more IntraMuscular Stimulation (IMS) with Dr. Allan Lam from the iSTOP institute. He worked on my left QL Muscle (with regular needles) and he put a very long needle into my left Psoas Muscle from the rear side (coming in from the back, instead of through the intestines). The interesting thing was that as the needle was going through all the normal tissue and muscle there was no reaction or pain until it hit the Psoas Muscle, at which point the Psoas Muscle started to grab the needle then stopped a short time later. Same grabbing occurred on the QL muscle but with a shorter needle. The doctor isolated the "core" spot, which creates the internal pain I feel, to be near the left side of L3, and when those spots were activated with needles or palpation, what I felt internally was an intense pain like an amplified version of what I experience all day.

After the IMS treatment (20 minutes), I could walk around with much greater mobility for 6-8 hours, until bed time at least.

Dr. Lam theorized that the Femoral Nerve goes through the Psoas Muscle, and when the Psoas is in contraction (as it is now) the Nerve is pinched, and when the nerve is pinched, it causes the Muscle to go into contraction (a positive feedback loop). He agreed that we need to break the feedback loop somehow.

Since IMS only releases a muscle in a small area near the needle prick, and since the Psoas is over 15 cm long, we need some other technique to release the whole muscle at the same time. Dr. Lam also tried a magnetic pulser which causes muscles to contract, however, its effective range was not deep enough to reach the Psoas. It certainly worked on shallow muscles (like abs) but did not reach the Psoas.

I have been thinking about some sort of injected muscle relaxant (like cyclopentolate, which is used to dilate the eye's pupils for 12 hours) to break the feedback loop, however, I am not sure that it is the best way to proceed at the moment and I don't know what damage may result if the Psoas Muscle is not working at all to support the spine for 12 hours.

Also, I have been considering traction, however I don't know how that would create a permanent solution since it may end up pulling against the knotted Psoas muscle and create more internal compression.


This site limits the length of letters, so no room for my answer, send me your email.

Dr B


Oct 24, 2012
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Results of Leg Tests
by: Garry Anderson

Dear Barrie:

Thank you for the post, and for your comments. Here are the answers to your questions:

1. The knee jerk reflex test (with the rubber mallet) works normally, same on both knees.

2. I have weakness when bouncing on the left leg. The knee is swollen and running a little hot. I feel pressure in the knee area from the swelling, but I also feel pain in the Quadricepts and Hamstring from the bouncing.

3. I cannot find out how to do the Femoral Nerve Stretch test, so please direct me to the page/video, then I will perform the test.

4. Some massage has been done on the Iliacus muscle, and occasionally the LFCN becomes more aggravated when pressure is applied to both the upper and lower regions of the Iliacus. I can press and trigger it myself. I presume your reference to where the LFCN escapes form the pelivs is where the LFCN goes under the Inguinal Ligament. I will have the ART practitioner do some work there this week.

5. I have started doing the Pelvic Tilt (simple and enhanced) exercises, as well as the Hip Hike in the mornings before I get out of bed. I think there may be a slight improvement, but not significant. I will continue with these exercises and see what happens

New Information:

I forgot to mention that I have almost now power to pull my left heel towards my butt. The Hamstring muscles are not working very well. After the GunnIMS treatment in my left leg muscles (except Hamstrings and Calf muscles) the power in my left leg has improved. Later this week, I get the Hamstrings and Calf muscles treated with GunnIMS.

Every morning, after sleeping, my QL muscles are so tight that my back does not have a very large range of motion. I have my wife massage the QL with her elbow, alternating with hot water bottles, which seems to help a little bit.

Hope these comments help.

Garry.

This suggests that the weakness in the quad is more related to a knee condition, unrelated to your back. The gastroc and soleus raise your heel. Is the achilles knee jerk also Ok?
It's not likely related to your bed, but sometimes morning pain is simply the bed. Try another.
The Fem n. stretch is difficult. You can't do it yourself, like a sciatic n. stretch. Get your chiro to do it.
You've done your homework, yes I'm interested in what you feel where the LFCN escapes under the inguinal lig. May be VERY painful.

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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