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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