Cruralgia and osteopathy
What is cruralgia?
Cruralgia is pain along the crural nerve. This nerve is also called the femoral nerve.
Here is the anatomical description of this nerve on the yellow card.
When the patient presents with cruralgia, he or she complains of pain in the lower back and/or the anterior and/or medial aspect of the thigh and/or the leg.
Cruralgia should not be confused with sciatica, which corresponds to the compression of the sciatic nerve and results in pain on the back of the thigh and leg, which can extend to the foot.
Symptoms of cruralgia
- Pain in the lower back (lumbar region)
- Pain:
- Anterior aspect of thigh
- And/or anterior and medial side of the knee,
- Anterior aspect of the leg
- Paresthesias (burning and tingling sensations) on the anterior aspect of the thigh and knee
- Loss of strength in the thigh and leg that can lead to paralysis
Causes of cruralgia
The most common causes of cruralgia are:
- Lumbar disc herniation which affects the crural nerve roots (L2, L3, L4)
- Lumbar stenosis or narrow lumbar canal: narrowing of the canal at the back of the vertebrae through which the spinal cord or the terminal film passes
- Lumbar osteoarthritis
- Spinal tumors: very rare
- Spinal deformity such as in cases of scoliosis
Complementary examinations
Complementary examinations are aimed at finding the cause of the cruralgia:
- Imaging:
- Radiography of the lumbar spine: profile and front view
- MRI or CT scan will reveal a possible compression of the crural nerve
- The electromyogram (EMG) is used to show the compression of the nerve by analyzing the quantity and quality of the nerve message.
Treatment of cruralgia
Drug treatment
Medications can be prescribed by the doctor to relieve the patient. These do not solve the cause but can relieve the patient or even remove the pain completely. The medications include
- Analgesics
- Anti-inflammatory drugs (NSAIDs)
- Muscle relaxants
- More rarely, corticosteroid therapy
Osteopathy
Osteopathy participates in the management of cruralgia.
Through specific tests, the osteopath will try to identify the cause of the cruralgia and, if necessary, will refer the patient to the doctor for further examination. Then, thanks to precise, painless and risk-free techniques, the osteopath will work on the lumbar vertebrae but also on the rest of the body. The goal is to relieve the crural nerve but also to treat all the repercussions that the cruralgia may have created in the rest of the body.
Osteopaths can treat cruralgia without any problem, whatever its cause. However, some techniques are not indicated, but your practitioner will adapt his practice to your pathology.
Infiltrations
Performed by a rheumatologist, radiologist or orthopedic surgeon, infiltrations of the spine can be performed in case of failure of the drug treatment.
physical therapy
When mobilization of the patient is possible, physical therapy can be considered.
The purpose of the sessions is to:
- Strengthen the back and abdominal muscles
- Mobilize the back
- Putting the patient back in motion
- Counseling to maintain physical fitness and thus prevent illness
Surgery
Surgery is considered in very rare cases such as advanced stages of herniated discs or narrow lumbar canal. It should only be performed when other treatments have failed and should never be performed as a first line of treatment.
Marie Messager
Osteopath D.O
78 - Versailles
