Femoral Nerve Neuropathy

Femoral neuropathy, or femoral nerve dysfunction, refers to any disorder that results from damage to the femoral nerve. The peripheral nervous system is the network of nerves that reside outside of the central nervous system (spinal cord and brain). It includes different types of nerves that are responsible for functions like:

• Sensory nerves – responsible for transmitting sensations, such as pain, temperature and touch.

• Motor nerves – responsible for controlling muscles.

• Autonomic nerves – control organs to regulate activities that people do not control consciously, such as breathing, digesting food, and heart and gland functions.

The femoral nerve is one of the largest nerves in the body. It begins in the pelvis and separates into several smaller branches (shown above). These nerve branches control the movements of various leg muscles. The femoral nerve itself mainly controls the thigh muscles for sensation and motor function. It is responsible for hip bending and knee extension. The femoral nerve also receives messages from the skin when there is pressure on the thigh or inner calf.

• Numbness and tingling in the feet or hands.

• Burning, stabbing or shooting pain in the affected areas – more than likely the thigh.

• Loss of balance and co-ordination.

• Muscle weakness, especially in the high or flexing the hip.

The exact symptoms of peripheral neuropathy vary, depending on the exact location and the extent of the nerve damage. Caution should be taken if you suddenly develop considerable weakness in the leg, this would warrant urgent advice from your GP who may recommend attending A&E.

A patient with femoral neuropathy has pain that radiates into the anterior thigh and midcalf and is associated with weakness of the quadriceps muscle. This weakness can result in significant functional deficit, with the patient unable to extend the knee fully, which can allow the knee to buckle. A patient with femoral neuropathy also may experience weakness of the hip flexors, making walking up the stairs quite difficult. If you were unable to lift the thigh up at all or use your leg you should see immediate medical attention. If you develop unusual swelling in the leg, or if your leg is hot or red around the area of pain, you should seek assessment as soon as possible.

• Compression i.e swelling or a herniated disc.

• Over stretching of the nerve through an injury.

• Direct injury or trauma to the nerve.

• A viral infection such as shingles.

• Reduced blood supply to the nerve such as if you have peripheral vascular disease.

• A side effect of certain medicine or drinking too much.

People can also develop femoral neuropathy as a complication of other medical conditions, such as:

• Diabetes/metabolic disorders/autoimmune disorders and vascular disorders.

• Obesity.

• A fractured pelvis/femur.

• Herniated spinal disc.

• Vitamin deficiency.

• Exposure to toxic substances.

• Infection-related inflammation.

At Pure, your Physio will take a detailed history of your symptoms followed by a thorough clinical examination to establish a diagnosis. A fast and accurate diagnosis will mean that the most effective treatment and management plan can be implemented straight away, helping to achieve optimal outcomes. Your Physiotherapist will want to know how your condition is effecting you day to day so that your treatment can be tailored to your needs and will mean personalised goals can be established. Regular re-assessment will ascertain if your are making progress towards your goals and will allow adjustments to your treatment to be made.

Your Physiotherapist will educate you on your condition and will offer strategies that will help you manage your symptoms and support recovery. This may include activity modification, advice on suitable exercises, avoiding aggravating activities and methods to ease symptoms. Neuropathic pain medications and anti-inflammatories may also be prescribed by your doctor to help ease your symptoms, helping you to return to a level of function which is manageable. Your Physio may liaise with your GP to discuss this. They may also recommended using heat therapy which may help to relieve symptoms and make you more comfortable.

Your Physio can provide you with a bespoke home exercise plan designed to mitigate symptoms and help you to progressively return to your normal activities. Your Physiotherapist may use hands on treatment techniques to help alleviate your symptoms and will demonstrate and help you perform specific stretches and exercises which will yield positive changes in your symptoms and function. You will be provided with ongoing advice and support so that you can confidently manage your symptoms and prevent re-occurrence.