Femoral nerve pain

by Rhonda
(Christiansburg va, usa)

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» Femoral nerve pain

My husband is 62 and recently diagnosed within the last year as diabetic type 2. Over the last couple of months he has right groin pain and since he is veteran, we go to the va hospital. They prescribed him gabapentin stating it is sciatic pain. It does not help much if at all, and makes him drowsy.

He also has sleep apnea which adds to this. The gabapentin affects his sex drive which really irritates him and neither of us believe it to be sciatic pain. Can you help us?

Hello Rhonda,
Yes, I think I may be able to contribute though for obvious reasons you need to take care placing anything you read on the net over your own doctor's advice. Your husband's doctors have been able to examine him; I haven't.

But you're quite right; this doesn't sound like sciatica at all and there's a real possibility of a completely wrong diagnosis.

Luckily it's really quite easy to test for sciatica. You can do it at home, though the interpretation of these tests can be very difficult.

1. Have your husband bend slowly forwards, then backwards, then to the side. What does he feel? Any back pain, any leg or groin pain?

2. Sitting in a normal kitchen chair, raise his left leg parallel to the ground. Lower it and now the naughty leg. Is there any pain or severe tightness at the back of the right thigh or calf? In the back?

3. Lying on his back, raise his straight left leg as far as it will go. Lower it, and now the right leg. Does he get pain or tightness in the back of the thigh or calf much sooner than the left leg?

If none of these tests are obviously positive, then it's unlikely he has sciatica.

More likely is a condition in the hip. Again have him lie on the bed and pull his left knee to the chest, then towards the opposite shoulder, and then make a circle. Repeat with the right leg. Is it obviously much stiffer and painful in the groin? A hip condition like an impingement syndrome, or arthritis.

Now look for Patrick's faber test at the link above.

A femoral nerve lesion is less likely, but possible. Depending on your answers to the above, we'll go into that. Have xrays been taken?

Let me have some answers, sticking to this thread, and we'll see if we can take this further. Please answer all of the above in full if you want a helpful answer.

When the treatment is worse than the disease, and particularly if it's not helping and has nasty side effects, you know what to do, right!

Dr B

» Femoral nerve pain

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Oct 14, 2015
Right femoral pain reply
by: Anonymous

On the tests you suggested.....the straight leg extension does not hurt. A little stuff on the right leg but no pain. Bending forward pulls in his groin and the third exercise he laughed at and said he couldn't do this before he was hurt.

And the sitting in the chair test. Like I said, if you want a helpful answer give me a detailed reply. I also don't understand the last sentence above. Full details, skimpy replies like this don't help.

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 have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is 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 is 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 pain-free. 

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 is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has 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 stroll 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; he has a short leg.

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. X-rays 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 few months 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 is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year 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 could not 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 should not be treating the elderly most medical sites state but that is so much bunkum.

Do you have a problem that is not getting better?

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Greetings, Dr B.

You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong. Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what a DC does.

The quickest and most interesting way is to read one of my eBooks of anecdotes. Described by a reader as gems, both funny and healthful from the life and work of a chiropractor, you will love them. Priced right at $2.99, though Kindle fiddles the amount without telling me.