THE SPINAL COLUMN

Dr Sunil Rama

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25 Jun 0 Comment

A numbness on the front of my leg-MERALGIA PARESTHETICA


A common finding in practice.

The chief presenting complaint here is a numbess or a funny feeling on the front and side of the quadriceps muscle (the front thigh muscle). The discomfort is usually constant and does seem worsen when the patient walks but is common upon sitting too

The nerve roots from the lumbar plexus/lumbar spine at L2/L3 branch off a sensory nerve called the lateral femoral cutaneous nerve  which lies on the hip flexor in the groin area that supplies sensation to the front of the thigh (see attached image).

We see this condition in cyclists, pregnancy, sudden weight gain over the abdomen and in patients that wear tight fitting garments or holsters that may interrupt or irritate the superficial nerve. Other cases are trauma and spasm of the muscles in front of the thigh/groin.

We diagnose this by checking sensation with touch and pin-prick of the affected leg and comparing it to the unaffected leg, often with the patients eyes closed. If there is a loss of sensation on the affected leg, it usually points to this diagnosis. The muscle strength should not be affected, i.e no weakness of power in the leg should be present

However, I always will examine the lumbar spine and pelvis to ensure no restriction or joint pathology exists that can cause the patients symptoms. This i nevertheless treat to ensure that the origin of the nerve (L2/L3) is functioning optimally.

I advise streching of the affected leg (20 secs to be done thrice daily) and avoiding tight garments, gun holsters or any restrictive items over the waistline

If symptoms persist, further tests are warranted.

Dr Sunil Rama

The anatomy of the nerve affected

 

 

Dr Sunil Rama meralgia paresthetica

The affected site over the nerve distribution

 

 

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