Cruralgia

Generality

Cruralgia is a painful condition that affects the anterior and / or inner side of the thigh, to be exact the area covered and innervated by the crural nerve.

The main causes of cruralgia are damage, compression or irritation of the crural nerve or its roots. Damage, compression or irritation of the crural nerve or crural nerve roots can result from a variety of conditions, including: herniated disc involving the crural nerve, presence of tumors or hematomas in the vicinity of the crural nerve, lumbar spinal stenosis and irregularity bone in the vertebrae.
In addition to pain, cruralgia can be characterized by a sense of numbness, tingling, burning and / or weakness in the affected limb.
The diagnosis of cruralgia is based on: the physical examination, the medical history, a neurological examination and a series of instrumental tests, such as CT, nuclear magnetic resonance and electromyography.
Treatment of cruralgia includes causal therapy - focused on treating the causes - and symptomatic therapy - the aim of which is to relieve symptoms.

What is cruralgia?

Cruralgia is the medical term that indicates the presence of pain along the anterior and / or inner side of the thigh, exactly in the area covered and innervated by the crural nerve.
Cruralgia is also known as crural neuralgia or frontal sciatica.

WHAT IS THE CRURAL NERVE?

Arising from the lumbar plexus, the crural nerve (or femoral nerve) is an important and bulky peripheral nerve of the lower limbs; along its path from the abdomen to the inner side of the foot, this nerve crosses the antero-medial part of the thigh and the medial aspect of the leg.
Having both a motor function and a sensory function, the crural nerve contains the nerve fibers of the spinal roots L2, L3 and L4 (N.B: the L indicates that the spinal roots emerge from the lumbar vertebrae number 2, number 3 and number 4).

Image modified from the site: Cursoenarm.net

Along its course, it gives rise to several branches (or branches): the so-called abdominal branches of the crural nerve, the so-called branches of the anterior division of the crural nerve and, finally, the so-called branches of the posterior division of the crural nerve.
At the motor level, the crural nerve controls the flexor muscles of the hip and the extensor muscles of the knee. At the sensory level, however, it controls the sensitivity of the antero-medial portion of the thigh, the medial side of the leg and the medial side of the foot.

EPIDEMIOLOGY

Cruralgia most commonly affects people over the age of 50.

Causes

Typically, cruralgia is the result of damage, compression or irritation of the crural nerve or of the roots of the crural nerve.
In most cases, crural nerve damage, compression, and irritation result from:

• Trauma directed to the nervous structure in question or its roots;
• A "herniated intervertebral disc at the level of the lumbar vertebrae L2, L3 or L4. It is one of the main causes of cruralgia;
• The presence, in the immediate vicinity of the crural nerve or its roots, of a tumor mass or a large hematoma.

More rarely, damage, compression and irritation depend on the presence of bone irregularities (secondary to vertebral fractures, osteoporosis, arthrosis with the formation of osteophytes, etc.) or on the presence of a narrowing of the vertebral canal (lumbar vertebral stenosis).

RISK FACTORS

For a human being, the following are risk factors for cruralgia:

• The presence of a "herniated intervertebral disc;
• Suffering from osteoarthritis and / osteoporosis;
• Being the victim of a vertebral fracture;
• Have lumbar spinal stenosis;
• Developing a tumor or hematoma near the crural nerve, near one of its branches or near its roots.