Hip / Groin / Leg

Femoral Neuropathy

Definition

Femoral neuropathy is a neurological disorder due to lesions or dysfunction of this nerve and is accompanied by pain and neurological deficits in region of the femoral nerve.

Aetiology

There are many causes for femoral neuropathy, but it is most frequently seen (2%) after hip surgery. In addition, diabetes, iliac haematoma, radiation, prostrate surgery, gynaecological exploratory surgery and tumours are also related to femoral neuropathy.

Signs and symptoms

The symptoms in femoral neuralgia usually consist of an unpleasant painful feeling in the front of the upper leg.

Patients complain of a characteristic burning, stabbing pain in the ventral side of the upper leg, together with a tingling sensation. Allodynia can be present. In addition, patients sometimes complain of a loss of strength that mainly occurs when using the stairs.

Diagnostics

Physical Examination

Neurological examination, particularly in the region of the femoral nerve, can confirm the diagnosis.

Additional Somatic Diagnostics

  • Diabetes must be excluded.
  • EMG of the femoral nerve.
  • Referral, when there is suspicion of other aetiology.

 

Additional Psycho-cognitive Diagnostics

  • RAND-36 (quality of life)
  • VAS Pain (maximal, minimal, actual, average/week)
  • PCS (catastrophising)
  • HADS (fear and depression)

Multidisciplinary Treatment

Whether or not somatic treatment is indicated is based on the pain diagnosis. Based on the findings of the pain questionnaires, additional diagnostics and/or multidisciplinary treatment comprising various non-somatic treatments may be necessary.

Non-somatic Treatment

Somatic Treatment

Pharmacological treatment:

  • Tricyclic antidepressants
  • Anticonvulsives: carbamazepine, oxcarbazepine, gabapentine and pregabaline.

Interventional Pain Treatment