Femoral neuropathy, or femoral nerve dysfunction, refers to any disorder that results from damage to the femoral nerve. It can lead to pain, numbness, weakness, and possibly paralysis in the legs.

The femoral nerve is one of the largest nerves in the body. It begins in the pelvis and separates into several smaller branches. These nerve branches control the movements of various leg muscles.

The femoral nerve mainly controls the thigh muscles and is responsible for hip bending and knee extension. It also receives messages from the skin when there is pressure on the thigh or inner calf.

While health researchers consider femoral neuropathy uncommon, damage to the femoral nerve can occur during hip replacement surgery. It can also be a complication of diabetes and other health issues.

In this article, we discuss the causes, symptoms, and treatments associated with femoral neuropathy.

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Direct trauma to the femoral nerve can cause femoral neuropathy. This trauma can occur from an injury or a surgical procedure that involves the hip or abdomen, and in rare cases, it can result from spinal surgery.

People can also develop femoral neuropathy as a complication of another medical condition, such as:

  • diabetes
  • pressure on the femoral nerve, for example, due to a hematoma or tumor
  • a fractured pelvis
  • bleeding in the abdomen
  • holding the leg flexed and turned outward for an extended time, such as in childbirth

Trauma to the pelvic area can lead to both femoral neuropathy and meralgia paresthetica, which causes tingling, numbness, and burning pain.

The specific symptoms of peripheral neuropathy vary depending on the exact location and the extent of the nerve damage.

Signs and symptoms of femoral neuropathy can include:

Symptoms can affect the thigh and may occur in the knee, the lower leg, and as far as the foot.

If a person does not receive treatment for femoral neuropathy, it can lead to:

  • permanent nerve damage
  • risk of experiencing an unnoticeable leg injury due to loss of sensation
  • a loss of flexibility
  • muscle wasting

To assess for femoral neuropathy, a doctor will most likely:

  • ask about symptoms
  • carry out a physical examination, which will include checking knee reflexes
  • ask about the person’s medical history, including recent injuries, recent surgeries, and lifestyle risk factors

They may then refer the person to a neurologist or recommend further testing to confirm the diagnosis and determine how much nerve damage is present.

Tests for femoral neuropathy

Various tests can help diagnose femoral neuropathy.

Electromyography can record the electrical activity of muscles and determine how the nerve is functioning. Nerve conduction velocity tests measure how quickly electrical signals move through nerves.

Other tests can help diagnose trauma, hematoma, and other contributing factors.

Neuromuscular ultrasound can diagnose and guide treatment for conditions that affect the nerves and muscles. It can help identify changes in the nerve’s shape.

Healthcare professionals may also recommend an MRI or CT scan, which generates images of the body’s internal structures.

Treatment for femoral neuropathy varies depending on the cause and extent of the nerve damage. These approaches aim to address the underlying cause of the nerve damage and relieve symptoms.

If pressure on the nerve is causing neuropathy, treatment will focus on reducing pressure on the nerve. Sometimes, femoral neuropathy resolves on its own without treatment.

Treating an underlying cause, such as diabetes, may also help relieve symptoms and prevent neuropathy from worsening.

Some treatments of femoral neuropathy include:

Medication

A doctor may recommend a nerve block, a local anesthetic that interrupts, or “turns off,” the pain signals that travel along a certain nerve.

They may also recommend corticosteroids to reduce inflammation and swelling. Over-the-counter or prescription pain medications can help relieve painful and uncomfortable symptoms.

Surgery

A doctor might recommend surgery if less invasive treatment has not helped or if a growth or tumor is compressing the femoral nerve.

Femoral decompression is a type of surgery that can help relieve symptoms. It focuses on reducing pressure on the femoral nerve.

Lifestyle remedies

In some cases, making lifestyle changes can help manage the symptoms of femoral neuropathy.

Lifestyle changes can include:

  • avoiding activities that can put pressure on the femoral nerve for extended periods
  • managing diabetes
  • discussing with a doctor the risk of femoral neuropathy when considering hip replacement surgery

Manual therapy

Manual therapy is a type of massage.

A therapist will use specific strokes that aim to:

  • increase range of motion and flexibility
  • reduce pain and swelling
  • improve muscle performance

They will manipulate the soft muscle to reduce the impact of scarring and stimulate the growth of new tissue.

Physical therapy

Stretching and strengthening exercises can help improve mobility and muscle strength. Stretching aims to relieve nerve compression by lengthening muscles that have become shortened.

Some common physical therapy exercises that help improve symptoms of femoral neuropathy include:

  • hip abduction
  • hip rotation
  • kneeling hip flexor stretch

These exercises aim to help symptoms by mobilizing the sciatic nerve deep in the gluteal region. However, there is little evidence that they have this effect.

A person can do stretching exercises at home, but they should first work with a physical therapist. The therapist will teach them to stretch in a slow, controlled way and how to progress to more strenuous exercises.

Other exercise types that may help include:

Where appropriate, a doctor may recommend a brace to support the knee or lower leg.

Cognitive behavioral therapy

Cognitive behavioral therapy is a type of counseling that involves learning coping mechanisms to help a person approach problems in new ways. This may be helpful for people living with chronic, or persistent, femoral neuropathy.

Learning more about why the pain occurs may help the individual feel more in control of the discomfort.

It is not always possible to prevent femoral neuropathy, but some tips that may help include managing diabetes and following professional guidance when exercising.

People should seek medical advice if they experience new or worsening symptoms of femoral neuropathy.

Anyone who has recently undergone hip surgery or another intervention in the pelvic area may wish to contact the doctor who treated them if they develop this complication.

Here are some questions people often ask about femoral neuropathy:

What are the symptoms of femoral nerve damage?

Common symptoms include pain, numbness, weakness, and tingling in the thigh that may extend to the knee and as far as the foot. In some cases, it can affect mobility.

What is the treatment for femoral neuropathy?

Treatment options include medication and physical and manual therapy. In some cases, a person may need surgery.

Is femoral neuropathy permanent?

In most cases, symptoms will improve over time, although some people may have permanent nerve damage. In some cases, a person will need surgery.

Femoral neuropathy is a broad term that refers to any medical condition that causes femoral nerve damage. Common symptoms include numbness, weakness, or paralysis of the legs.

Femoral neuropathy can develop as a result of an injury, surgical procedures involving the hip or abdomen, or as a complication of another medical condition, such as diabetes.

Treatment can help reduce or manage symptoms.