The lateral cutaneous nerve of the thigh in the human body leaves the pelvic cavity through the channel under the external lobe of the inguinal ligament, which connects the iliac crest with the protrusion of the pubic structure. It is located very superficially, branches in the skin of the outer surface of the thigh.
Features
The lateral cutaneous nerve of the thigh in its composition has only sensitive fiber, it does not innervate the muscles, therefore, no movement will be impaired during the lesion. The main complaint made by patients is pain and a violation of the sensitivity of the thigh surface in its upper part. Discomfort may be persistent or occurs periodically. The pains are severe, and are sometimes accompanied by a feeling of intense burning, which causes considerable discomfort.
Increased pain when walking
The pain usually intensifies when standing upright or while walking, due to skin tension on the front of the thighs, where the nerve actually branches. Some patients have almost no discomfort in the innervation area, but there are complaints of numbness, goosebumps, and skin tightening in the area. Sometimes pains appear or intensify as the pathology progresses, but can also be almost absent. With a prolonged course of neuropathy of the external cutaneous nerve of the thigh, a decrease in sensitivity often develops in a certain area of the body.
Neuropathy - a description of the disease
According to ICD 10, this pathology is assigned class VI - diseases of the nervous system (codes G50-G99).
Such neuropathy usually occurs near the superior anterior spine of the ilium, where the nerve pierces bundles of the inguinal ligaments. In addition, the disease may appear due to pinching at the site of passage of the impulse fiber through the wide fascia of the thigh. Most often, this pathology is formed in men in retirement age due to fibrosis of the inguinal ligament. A deviation by numbness, paresthesia on the outer surface is manifested, usually when walking it can give burning pain.
Hip extension can aggravate pain, and flexion, on the contrary, reduces. Over time, a decrease in tactile, temperature, and then pain sensitivity in this area is likely. Weight loss sometimes reduces the manifestation of the disease. Such an ailment is rarely observed in women. And if it does occur, then it happens during pregnancy, which is accompanied by late toxicosis. The disease can also have an infectious toxic origin, in particular with diabetes, against the background of typhoid fever, vitamin deficiency and so on.
Causes of pathology
Among the triggers that can cause pathologies of the lateral cutaneous nerve of the thigh, the most frequent factors are those that cause compression of the fibers in the inguinal region. These include wearing a corset, tight belts or too tight underwear along with obesity, pregnancy, curvature of the spine (we are talking about scoliosis, lordosis), injuries of the hip joint and bone fractures.
In addition, the following factors are the causes of the disease: muscle tonic and reflex changes that occur during illness and spinal injury (lumbar radiculitis, osteochondrosis, discogenic myelopathy, fractures of the lumbar sector, and so on). All of the above reasons lead to a change in the relative position of the anatomical structure of the region of the inguinal ligament, which causes friction of the nerve against the ligament or spine of the iliac bones when bending forward and against the background of hip movements. Next, find out how the disease is currently being treated.
Treatment
Effective therapy of pathologies of the lateral cutaneous nerve of the thigh is a combination of drug and reflex therapeutic methods. Such treatment is carried out, usually by a neurologist. A special role is played by the elimination of triggers that encourage the development of neuropathy. For example, weight loss along with the removal of tumors, treatment of pathologies of the hip joint, and correction of vertebral disorders.
Relief of pain is carried out by the appointment of anti-inflammatory drugs and analgesics, such as Nemisulide along with Ketorolac and Ibuprofen. In more complex cases, local administration of local anesthetics, such as Lidocaine, Novocaine, or glucocorticoids (Hydrocortisone, Diprospan) are used. Improving the trophism of the affected structure is achieved through the use of vasoactive drugs (nicotinic acid, Pentoxifylline) and metabolic pharmaceutical preparations like Cyanocobalamin, Thiamine, Pyridoxine, and combinations thereof.
Physiotherapy
Physiotherapeutic treatment is prescribed after consultation with a doctor. It may include, for example, darsonvalization along with mud therapy, hydrogen sulfide or radon baths, massage and so on. Acupuncture or electroacupuncture is possible. True, the effectiveness of reflexology depends largely on the professionalism of the treating specialist.
In some cases, against the background of the lack of the desired effect of conservative therapy and in the presence of intense pain, they raise the question of performing surgery in the area of the inguinal ligaments. In this situation, the goal is decompression of the nerve.
Now consider the syndrome of the cutaneous external femoral nerve.
Neuropathy of the external cutaneous nerve of the thigh: causes and symptoms
Neuropathy of this nerve of the thigh was described in the last century by the Russian neurologist Roth. It is observed mainly in men who are over the age of fifty. It is worth noting that men from fifty to sixty years old make up seventy-five percent of cases. Such a pathology occurs in pregnant women, mainly in the last trimester, which is directly related to the ongoing change in the position of the pelvis.
In most medical cases, the syndrome of the external cutaneous nerve of the thigh is one-sided. Bilateral lesions make up about twenty percent. Family examples of such neuropathy are known, which are probably due to genetic determinate features in the structure of this element and its surrounding anatomical structure.
Ultrasound
Ultrasound examination of the lumbar plexus nerve was first used for the diagnosis of pathologies in the late nineties. With the beginning of using such a technique, it became clear its undeniable advantage in comparison with other methods of diagnosis. Electrophysiological techniques like electromyography and neuromyography are traditionally recognized as a kind of gold standard designed to detect diseases of the peripheral nervous system.
However, it must be emphasized that the information that was obtained during the above examinations does not give an idea of the state of the surrounding tissue, nor does it indicate the nature and causes of damage to the nerve trunks, and it does not always accurately reflect the localization of the change. At the same time, it is precisely such information that helps the doctor determine the tactics of surgical or conservative treatment.
Femoral neuropathy - what is this pathology?
Neuropathy of the lateral cutaneous nerve and femoral nerve at the iliac lumbar level is often caused by compression as a result of muscle cramps or hemorrhage in the lumbar muscle, which occurs during overload or during trauma. Less commonly, femoral nerve neuropathy is caused by a retroperitoneal hematoma or tumor, such as sarcoma, lymphoma. A hematoma can form in the presence of hemophilia and thrombocytopenia.
In addition, one of the factors in the development of this kind of neuropathy of the posterior cutaneous nerve of the thigh is the complication of anticoagulant treatment used for thromboembolism and thrombosis, especially among patients with abdominal aortic aneurysms. Also described in medicine are cases of femoral neuropathy that were caused by nerve damage as a result of appendectomy, surgery on the kidneys or ureters, as well as bursitis and an abscess of the ileum lumbar muscle.
The cause of compression of the femoral nerves in the region of the inguinal ligaments may be lymphogranulomatosis along with a hernia. Damage to structures is possible, among other things, during surgery on the hip joints, in the case of surgical treatment of inguinal hernias, etc.