Cruralgie: What to do?

She is a lower back pain radiating to the front of her thigh. This condition results from compression of the crural nerve by the intervertebral discs. the cruralgie, little known to the general public, however, hurts and silences many people of its atrocious impact. The physiotherapist Toussaint Azondekon proposes in this article, the causes, symptoms, the treatment of this evil which corrodes in so many households.

Cruralgia is the medical term for pain that starts in the lower back and spreads to the thigh, even knee. This condition according to Toussaint Azondekon results from inflammation of the crural nerve (or femoral nerve, this is the motor and sensory nerve of the anterior aspect of the thigh) mostly caused by a herniated disc: “The diagnosis of cruralgia is clinical. It can be confirmed by imaging tests such as X-rays or CT scans. Treatment is based on symptom relief : painkillers, anti-inflammatories, physiotherapy, etc… »

The causes

According to the physiotherapist, Toussaint Azondedkon, herniated disc is the most common cause of cruralgia. " Over time, the intervertebral disc collapses and becomes less flexible. It loses its role as a shock absorber. Thus acute or even chronic lumbar pain can be triggered., he explained. In the event of serious deterioration, he continues, "Le nucleus pulposus (gelatinous substance located in the heart of the intervertebral disc which acts as a shock absorber and ensures the movement of the vertebrae) can enter the spinal canal causing a herniated disc whose volume is very variable”. However, term, the hernia can pinch nerves : “When it compresses the nerve located between the third and fourth lumbar vertebra (or crural nerve), we are talking about cruralgia”. "A vertebral compression : it may be due to osteoporosis (most common in postmenopausal women) or trauma (accident, chute…) ". "Lumbar osteoarthritis, i.e. chronic lower back pain caused by the progressive degeneration of the intervertebral discs. These pains can be related to age or wear and tear.. “A psoas hematoma. It can be spontaneous, Posttraumatic (surgery, chute, accident) or linked to an overdose of an anticoagulant treatment (anti-vitamin K) ». “An infection during “infectious spondylodiscitis” when a microbe migrates between two vertebrae”.  He specifies: “A herniated disc is not always accompanied by cruralgia”.

Symptoms

According to Professor Vincent Goeb, rheumatologist quoted by the specialist, the cruralgie (nevralgia crurale) is manifested by "lumbar pain that descends into the buttocks, hip, the front of the thigh and sometimes radiates to the calf or to the ankle. This pain is latent (even if the intensity is variable from one patient to another) ». In case of impingement between an intervertebral disc and a nerve root, evokes the physiotherapist “the pain is exacerbated with the effort and increases during the abdominal pressure (What can increase pain when coughing, sneezing or defecation) ». We also note, he will say: “Tingling sensations, tingling (paresthesias), electric shocks in the lower limb ; areas of skin that are painful on palpation”.

Can cruralgia be cured? ?

To this question, physiotherapist Toussaint Azondekon answers in the affirmative. However, for some patients, he informs "It's not enough. Because cruralgia is resistant to treatment ». To relieve them, “Surgical intervention may be offered to them in order to excise the herniated disc. A treatment that relieves more than 8 patients out of 10 ».

How to relieve and treat cruralgia ?

"To ease the pain, it is useful to place warm (a reusable hot pack is ideal), on the lumbar region, in order to relax the paravertebral musculature”, advises Toussaint Azondekon, adding "A period of rest must be observed, but it should not extend beyond 2 days. Prolonged inactivity can disrupt recovery and delay it”. “Your doctor may also prescribe anti-inflammatories., that you should only take as recommended. But beware (self-medication should be avoided) », he insists.

Treatment to be followed after cruralgia ?

“You need physical activity, especially muscle work. The ideal remains the practice of abdominal sheathing. Because it not only relieves pain but also strengthens the musculature of the abdominal-dorsal strap and the stabilizers of the pelvis », says physiotherapist Toussaint Azondekon. “Sheathing can prevent a possible relapse and treat cruralgia more effectively. In this case, stretching the psoas muscles can also help relieve and treat your cruralgia,” he recalls..

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