Femoral neuropathy (in ICD-10: G56-G57) is manifested by inflammation or damage to its myelin sheaths, which leads to impaired impulse conduction. The basis of this disease is most often compression of the nerve trunk. Next, we find out what are the causes of the development of femoral neuropathy, and, in addition, find out what symptoms accompany this disease, and how its treatment is currently being carried out. In addition, we will talk about such an ailment as compression-ischemic neuropathy.
Causes of the disease
The development of neuropathy of the femoral nerve undergoes anatomical formations with a superficial location, as well as those that pass in narrow bony, ligamentous and muscle channels. The femoral nerve is also related to these anatomical formations. Its part is located between the lumbar muscles, and then it lies under the inguinal ligament. This arrangement determines its frequent exposure to pathological processes. The causes of femoral nerve neuropathy are as follows:
- Injuries to the muscles of the lower back along with its spasms can cause compression of the femoral nerve.
- Compression is also exerted by abscesses, hematomas and tumors of the retroperitoneal space.
- Neuropathy of the left femoral nerve may develop if it is damaged during an operation on the left kidney. Injuries to the right femoral nerve occur during appendectomy.
- Nerve compression occurs in women with a prolonged lithotomy position in childbirth.
- Due to metabolic disorders in diabetes.
- Against the background of long-term alcohol intoxication.
How does compression-ischemic neuropathy of the femoral nerve manifest itself? About it further.
The main symptoms of pathology
Against the background of a lesion of the femoral nerve, people experience the following symptoms:
- The weakness in the leg may gradually increase, which at the same time ceases to obey the person and bends.
- The occurrence of pain in the groin with its spread on the inner and front surface of the thigh.
- Violation of pain and temperature sensitivity of the anterior-inner surface of the leg.
- Violation of flexion of the leg at the knee. At the same time, running and walking can be difficult, and, in addition, climbing and descending stairs is very difficult.
- Impaired gait.
Symptoms of femoral nerve neuropathy should not go unnoticed.
As part of a neurological examination, specialists identify signs of nerve damage. At the same time, attention is drawn to soreness in the region of the inguinal ligament, muscle atrophy, decreased and inhibited reflexes.
The causes and symptoms of femoral neuropathy are interrelated.
Diagnostics
The diagnosis of femoral neuropathy is usually based on complaints, and, in addition, on the patient’s medical history and neurological status. To clarify the degree of damage, electroneuromyography, which is a study of a nerve impulse, is performed. This technique allows you to determine the type of damage and makes it possible to control the dynamics of therapy. Differential diagnosis of neuropathy is carried out with a stroke, Raynaud's syndrome and multiple sclerosis.
Features of the treatment
The treatment of femoral neuropathy is determined by the causes that caused it. In the event that the ailment appeared from squeezing with a hematoma or a tumor, then surgical intervention cannot be dispensed with, since compression must be eliminated. Against the background of neuropathy of a diabetic or alcohol type, therapy of the underlying disease is necessary.
The main methods of treatment for the treatment of neuropathy include the following methods of therapy:
- Treatment with non-steroidal anti-inflammatory drugs, for example, in this case, funds are used in the form of “Meloxicam”, “Diclofenac”, “Ketorolac”, “Xefocam” and so on. They relieve pain, eliminate swelling and inflammation.
- The use of a complex of vitamins from group "B" in order to restore myelin sheaths. What else is used in the treatment of femoral neuropathy?
- The use of tools to improve the conductivity of the pulse. For these purposes, "Proserinum" and "Neuromidinum" are suitable.
- Medications to improve the circulatory system are Trental and Pentoxifylline.
- The use of antioxidants and antihypoxants in the form of “Berlition”, “Espa-lipon” and “Thiogamma”.
Physiotherapy
In the treatment complex, various physiotherapeutic procedures produce a good effect. They are selected by the doctor, depending on the stage of the pathological process, taking into account possible contraindications for this or that patient. Recovery, as a rule, is facilitated by electrophoresis with Dibazolum and Eufillin, as well as electroanalgesia along with magnetotherapy, laser treatment, ultrasound and electromyostimulation.
Other methods
At the stage of rehabilitation therapy in the treatment of femoral neuropathy, physiotherapy exercises, acupuncture and massage are ideal. When conservative treatment does not bring effect, doctors usually resort to neurosurgical care. Usually, surgery is prescribed for traumatic injuries. In such cases, the earlier the operation is performed, the more favorable will be the prognosis for the restoration of limb functionality.
With compression-ischemic neuropathy of the femoral nerve, massage and gymnastics are also important.
The benefits of massage
Carrying out a special acupressure helps to relieve pain and corrects violations of the motor system. With femoral neuropathy, massages very effectively help recover as part of a comprehensive treatment.
It is also possible to perform can massage, which no less effectively helps with neuropathy. Thanks to this method, blood circulation is activated, and, in addition, the saturation of cells with nutrients and active oxygen is stimulated, which favors the improvement of the functioning of nerve fibers.
Gymnastics
Physical education also plays an important role in the treatment of femoral neuropathy. As part of the gymnastic course, the following exercises can be used (performed while lying down):
- It is necessary to bend the legs alternately in the knee joints, performing a sliding motion with the heels on the floor. In this case, the knee joints must be fully extended. Perform the exercise eight to ten times.
- First you need to turn your legs to the inside of the thigh, then return to its original position, then turn the feet apart. Repeat the exercise eight times.
- Then take the starting position, hands - on the belt. Then spread legs to the sides and slide on the floor with heels, then return to the starting position. Repeat the exercise eight times.
- Lying on his stomach, behind his fingers, clasp his fingers in the lock. Then raise the head and shoulders and hold them in this state for two seconds, and then return to their original position. Performing this exercise, it is impossible to bend sharply in any case. Repeat six times.
- Lie on your stomach, keep your hands clasped in the castle on your buttocks. Alternately raise straightened legs. Perform the exercise six times.
- Lie down on your stomach again. Lift the upper part of the body, making 2-3 swimming movements with your hands (move them apart). Repeat the exercise six times.
- As part of the final exercise, lie on a healthy side, support the head with a hand bent at the elbow. Then raise up the sore limb. When a person lowers his leg, he must relax his muscles. Repeat the exercise eight times.
Many are interested in how to treat compression-ischemic neuropathy of the femoral nerve.
Compression Ischemic Neuropathy
In another way, this ailment is also called tunnel syndrome. This phenomenon is one of the most frequently observed variations among diseases of the peripheral nerves. Such pathologies are very common in 45% of patients whose professional activity is directly related to the prolonged tension of certain muscle groups.
In the human body there are areas of excessive vulnerability of peripheral nerves, which pass through special tunnels, which are formed by bones, ligaments, muscles and fasciae. Against the background of pathological changes in the tissues that form the walls of the tunnel, nerve irritation and compression are formed.
Compression ischemic neuropathy and its causes
The causes of compression syndrome include the following factors:
- Exposure to professional or domestic muscle loads, that is, against the background of chronic microtraumatization.
- The presence of traumatic lesions of soft tissues and bones.
- The presence of anomalies in the structure of tissues.
- The presence of systemic diseases in the form of endocrinopathy and polyarthritis of a rheumatic nature, which may be accompanied by morphological changes.
In the early period of the disease, the correct diagnosis of the development of tunnel damage is very rare. Many may have neuropathy of the femoral-genital nerve on the map. It branches and forms the femoral and inguinal branches.
Symptomatology
As a rule, the clinical picture of this syndrome consists of the following manifestations:
- The presence of paresthesia, that is, frequent tingling, and, in addition, a feeling of creeping creeps in the area of innervation of a sick nerve. Often a phenomenon such as paresthesia occurs at night, which is directly related to the development of venous stasis in the distal limb during sleep. In turn, venous congestion contributes to impaired blood circulation in the area of tunnel nerve damage.
- The presence of spontaneous pain, which is also typical for the development of a tunnel lesion. In medical practice, there is a wide range of the nature and intensity of pain, ranging from mild dull pain in the area of the tunnel to acute manifestations that do not allow even a small amount of movement to be performed in joints adjacent to the tunnel. Irradiation of pain in the area of nerve innervation is also characteristic.
- In the vast majority of patients, a sensitivity disorder is detected in the form of areas of hypesthesia (that is, decreased sensitivity) and hypalgesia (reduced pain sensitivity) in the area of innervation of the corresponding nerve. Sites of hyperalgesia and hyperpathy may be much less common. The occurrence of a sensitivity disorder in the late stage of the disease is explained by a slow increase in tissue pressure in the area of the tunnel. In the event that acute nerve damage occurs due to compression by the structures that form the tunnel, then sensitivity disorder develops relatively quickly due to motor disorders.
How to prevent compression-ischemic neuropathy of the femoral nerve?
Prophylaxis
To prevent neuropathy, people should not drink alcohol first. In addition, it is necessary to take protective preparations in case of work with toxic substances. In addition, it is very useful in the prevention of such diseases to eat fresh products, when buying, you must check the expiration date with the date of manufacture in order not to subsequently be poisoned.
It is very important during the treatment of a disease to observe the dosage of drugs, but it is best not to drink them without an urgent need. It is necessary to treat sinusitis, flu, sinusitis and other infections in a timely manner. In no case should such diseases be carried on the feet.
Everyone should do swimming, dancing, jogging or fitness. This is very useful, since almost any kind of sports will significantly improve blood circulation. It is equally important to avoid injuries and burns. It is very useful to regularly perform foot baths for fifteen minutes. Among other things, you should only walk in comfortable shoes and do not wear heels above five centimeters.
We examined the symptoms and treatment of femoral neuropathy.