numbness in anterior calf with quad muscle weakness

by Sarah
(SF, CA)

Indeed quite likely the L4 root.

Indeed quite likely the L4 root.

Numbness in anterior calf with quad muscle weakness is associated with femoral nerve damage.

My journey all started with a neck pain brought on from sleeping funny; the kind that lasts for 3 days or so. Then it moved to a stiff/tired feeling in the lumbar area, and a sharp pain when bending over suddenly ramped up the problem. Lower back pain increased and strong leg cramps began in the upper front part of my leg; TFL and quads.

After 5 nights of lumbar pain and crippling leg cramps, throbbing pain in the hip joint and numbness in the front of my leg, I moved to heavy duty muscle relaxer and pain meds, began seeing a Chiro/DO(4xs) who prescribed 3 days bedrest, an elastic back brace for a slipped disc, they also did some spine/neck gentle manipulations.

Pain finally subsided but has left the lingering numbness in my anterior calf that anatomy books say is brought on by L4, and a weakness in my leg that prevents me from fully supporting my own body weight on it.

I also have difficulty flexing the knee fully because of a tight swollen feeling, and the fibular collateral ligament(or something right next to it) is extremely tender after Chiro #2 massaged some psoas and a tendon very nearly running the length of my IT band. Chiro #2 says it is a Sacroiliac joint dysfunction and gave supplements and asked for an MRI.


Part 1: why is my leg still numb? I feel it mostly right over my patella, dead center, and then it travels down my leg on the inside side of my anterior calf and stops just above the ankle. Toes and dorsiflexion seem normal. It has felt this way for around 4 weeks. It is a light numbness, but will not go away.

Part 2: why is my leg weak? I have difficulty flexing from the hip joint(like when you put on pants or lift a foot to tie a shoe), and also climbing stairs I cannot support my own body weight on affected leg, my glutes and hamstrings feel weak and kind of asleep.

Are these nerves that need to come back from being pressed? Thank you for your help!

Hello Sarah,
Obviously I've not had the opportunity to examine you, so don't treat this as gospel. Perhaps with a pinch of salt!

I very much doubt this is primarily a SI dysfunction; that wouldn't cause the sensory and motor changes you are getting.

This sounds far more like a L4 nerve root impingement, as you've been told causing inner shin numbness and quad weakness; that's why your knee is giving.

Do you know if the knee jerk is diminished on that side?

Has anyone done a femoral nerve stretch; pulling your upper leg posteriorally with the knee bent?

That MRI is definitely indicated.

I've had this exact injury myself, so I know precisely what you're talking about; plus I've treated hundreds. You can read about it at femoral nerve damage.

Four treatments won't fix this unless you're very lucky. It took about 15 in my case, and I'm fine.

Let me know what the MRI shows and we'll take this further.

Dr B

» numbness in anterior calf with quad muscle weakness

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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.

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