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.

Question...

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!
Sarah

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



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