Femoral nerve dysfunction
Femoral nerve dysfunction is a loss of movement or sensation in parts of the legs due to damage to the femoral nerve.
See also: Peripheral neuropathy; Mononeuropathy; Mononeuritis multiplex
Neuropathy - femoral nerve; Femoral neuropathy
The femoral nerve is located in the leg. It helps the muscles move the hip and straighten the leg. It provides feeling (sensation) to the front of the thigh and part of the lower leg.
A nerve is made up of many fibers, called axons, surrounded by insulation, called the myelin sheath.
Damage to a nerve, such as the femoral nerve, is called mononeuropathy. Mononeuropathy usually means there is a local cause of damage to a single nerve. Disorders that involve the entire body (systemic disorders) can also cause isolated nerve damage (such as occurs with mononeuritis multiplex).
More common causes of femoral nerve dysfunction are:
- Direct injury (trauma)
- Prolonged pressure on the nerve
- Compression or entrapment of the nerve by nearby parts of the body or disease-related structures (such as a tumor or abnormal blood vessel)
Prolonged pressure on the nerve decreases blood flow in the area. This can lead to further complications.
The femoral nerve can be also be damaged if you have:
- A broken pelvis bone
- A catheter placed into the femoral artery in the groin
- Diabetes, which can cause widespread nerve damage
- Internal bleeding in the pelvis or belly area (abdomen)
One common risk factor is lying on the back with the thighs and legs flexed and turned ("lithotomy" position) during surgery or diagnostic procedures. Branches of the femoral nerve can be compressed by tight or heavy waist belts. People who lose or gain a lot of weight may be at greater risk of femoral nerve injury. Also, people who have more widespread nerve damage from medical or hereditary causes may be more prone to injury to the femoral nerve with any pressure. In some cases, no cause can be found.
- Sensation changes in the thigh, knee, or leg, such as decreased sensation, numbness, tingling, burning, or pain
- Weakness of the knee or leg, including difficulty going up and down stairs -- especially down, with a feeling of the knee "giving way" or buckling
Exams and Tests
The doctor or nurse will obtain a history from you and examine you. This will include an exam of the nerves and muscles in your legs.
The exam may show:
- You might have weakness when you straighten the knee or bend at the hip
- Sensation changes located on the front of the thigh or in the foreleg
- You may have an abnormal knee reflex
- The quadriceps muscles on the front of the thigh may be smaller than normal
Tests that may be done include:
- Electromyography (EMG)
- Nerve conduction tests (NCV), usually done at the same time as an EMG
- MRI to check for masses or tumors
Your doctor may order additional tests, depending on your medical history and symptoms. Tests may include blood tests, x-rays, and other imaging tests.
Your doctor will try to identify and treat the cause of the nerve damage. Your doctor will treat any medical problems (such as diabetes or bleeding in the pelvis) thought to be causing the nerve damage. In some cases, the nerve will heal with treatment of the underlying medical problem.
Other treatments include:
- Some people might benefit from surgical removal of tumors or other growths that press on the nerve.
- Pain medication, if necessary. Various other medications can reduce the stabbing pains that some people experience. The benefits of medications should be weighed against any possible side effects.
- Weight loss and change in lifestyle may be suggested if it is thought that diabetes or excess weight are contributing to the nerve damage.
In some cases, no treatment is required and you'll recover on your own. In that case, any treatment, such as physical therapy, is aimed at increasing mobility, maintaining muscle strength and independence while you recover. Orthopedic appliances such as braces or splints may help in walking. Your health care provider might recommend vocational counseling, occupational therapy, job changes or retraining, or similar interventions.
If the cause of the femoral nerve dysfunction can be identified and successfully treated, it is possible to recover fully. In some cases, there may be partial or complete loss of movement or sensation resulting in some degree of permanent disability.
Nerve pain may be quite uncomfortable and can continue for a long time. Injury to the femoral area may also injure the femoral artery or vein, which can cause bleeding and other problems.
When there is a loss of feeling (sensation), a potential complication is repeated and unnoticed injury to the leg. When there is muscle weakness, falls and related injuries may occur.
When to Contact a Medical Professional
Call your health care provider if you develop symptoms of femoral nerve dysfunction.
Prevention depends on the cause of the nerve damage.
Felice, KJ. Focal neuropathies of the femoral, obturator, lateral femoral cutaneous and other nerves of the thigh and pelvis. In: Bromberg MB, Smith GA, eds. Handbook of Peripheral Neuropathy. Boca Raton, Fl: Taylor and Francis; 2005:chap 31.
Misulis KE. Lower back and lower limb pain. In: Bradley WG, Daroff RB, Fenichel GM, Jakovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann; 2008:chap 33.
Reviewed By:Joseph V. Campellone, M.D., Department of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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