Femoral nerve pain shooting down front of thigh when mobilising

by jacqueline dick
(Glasgow,Scotland, uk)

ligthen up as you pass over the femoral nerve and artery.

ligthen up as you pass over the femoral nerve and artery.

I have a right labral tear, diagnosed 7 years ago by arthrogram.
Went on to develop classic paresthetica meralgia in left thigh. Now getting shooting nerve pain of sudden onset when walking which stops me in my tracks and can cause me to fall on occasion. Which leg? Thereafter painful limping for about 5 minutes and have to try and manipulate thigh to relieve nerve pain.
Unpredictable in onset. Can occur after a bout of sitting with first few steps or comes on suddenly after walking for some distance. Appears to be triggered by extension phase of walking but flexion of hip during exercise can also exacerbate. Frequent dull LBP at SIJ. Scan only shows labral tear and mild degenerative arthritic changes.

Orthopaedic consultant states that pain likely to be nerve impingement from poor hip stability and joint hyper mobile syndrome. Feels I will require hip replacement in approximately 10 years on right side. Has no advice on how to manage left nerve pain.

Causing great distress with pain, radiculopathy, particularly at night and fear of falling. Exacerbated by exercise and other activities of daily living. Worried about sustaining my employment as I work in orthopaedics as trained occupational therapist. Physiotherapy has not yielded any success in alleviating pain.

Hello Jacqueline,
It's not absolutely clear, but I'm presuming this is left anterior thigh pain; not classic for meralgia paresthetica by the way, as the Lateral Femoral Cutaneous Nerve supplies predominantly the lateral thigh.

Plus LFCN is sensory only. The big question is whether the falls are due to pain, or weakness in the quad. The knee jerk is normal? Springing on your knee reveals no weakness of the quad?

Lying prone, if your PT extends your hip with the knee bent, do you get much greater tightness or pain in the left ant thigh compared to the right?

Does lumbar flexion, extension, lateral flexion or Kemp's test provoke any anterior thigh pain, or mid lumbar pain?

Pulling your knee to the chest: do you get a pinch in the groin? Does the Fabere test provoke any groin/ hip pain when dropping the knee into the lotus position?

With a little oil on your thumb, beginning at the ASIS, is it very tender as you pass through the groin and particularly in the adductor magnus as you run down the medial thigh?

It's not clear in my mind from what you describe whether this is hip and capsular pain from a hypermobile hip (no signs of dysplasia, no sloping acetabulum, no unroofed femoral ball?) or a true femoral nerve condition. Try and answer the above as accurately as you can to get a more accurate diagnosis.

No family history of hip disease?

Could you try and send me a copy of your pelvic x-ray?

I hope this contributes to your conundrum. Give me some answers.

Dr B

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Aug 08, 2018
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Thank you for responding
by: Dd

Sir/mam

Yes sir. It is in my right thigh, almost a parellogram shape just above the knee slightly outer side. And yes it is being numb the past five six years and sensations are very different from my left side. It is acute. I suffered sleepless nights during April and May. But with the help of yoga, physical therapy and cycling, it is reduced a little bit that I can do household works with slight pain. Before therapies I couldn’t even walk or do chores.
Sorry if I ve missed anything kindly let me know.
Thank you again.

I'm getting a little confused, Dd. You've tacked onto Jacqueline's thread. Are you Jackie? I asked her to do a lot of tests and haven't heard the results.

If you are not Jackie they I suggest you start with your own thread at Chiropractic Help, giving me all the details.

Dr B

Aug 08, 2018
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Meralgia parasthetica
by: Dd

Hello sir/mam

I’m suffering with MP since my first pregnancy in 2013. I had it in my pregnancy and reduced drastically after delivery. The same happened in my second pregnancy also. But now I got my MP back this April and it or worst this time. Doing yoga and cycling both of which slightly helps. Now scared that it seems to happen in my other leg too. Any permanent cure for this in chiropractic doctor? I’m 32yrs and 66kg weight.
Thank you.

Like I said, do those tests I asked for, and let's see. I'm yet to be convinced this is meralgia paresthetica.

Take a needle and prick your thigh, all the way round, and compare with the other leg; is it different and if so map out exactly where with a koki and send it to me. Sharper or duller? And which leg is causing the drama?

Dr B

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