Femoral neuropathy

[Zentraf]

I have femoral nerve damage the doctor says the nerve was stretched. This happened in July of last year & I had MRI, EMG/NCT etc done. At first I had a hard time walking and getting up, but now I can lift up my leg while laying down & I can kick my leg out almost straight while sitting down. I have severe quad atrophy & the doc says it will be about a year for the nerve to heal at 1inch per month.  I am still numb on the inside of my leg above & below my right knee & of course I have the tingling & shooting pains. My knee is still a little wobbly because the muscles are still pretty weak & numb around it. It is not as bad as it was & not as sensitive. At the beginning it hurt to barely touch my skin or if anything rubbed against it it was excruciating. I still can't do leg extensions because my leg is not strong enough & I have to do stairs one at a time. I have a cane for stuff like that. My doctor doesn't want to retest me until a year is up. My questions are will the atrophy go away if the nerve regenerates after a year? & if it doesn't am I screwed & left w a skinny leg?

[philnoir]

Decompression surgery is premature at this point, and may not be appropriate.

You'll have to ask your doc it you have a circulation problem in that leg. If your femoral nerve was pinched in the groin, then you may have reduced circulation through the femoral artery. Again, ask your doc.

Pain, in general, starts with nociceptors in the peripheral nervous system that release chemicals when under pressure, heat, cold, or other stimulus. Nerve endings sensitive to these chemicals depolarize and cause an pulsed electric wave to pass up a set of nerves into the spinal cord, where they synapse to nerve pathways leading up to the brain. That's the simple answer.

Be careful on the ice -- it has been treacherous around here.

[Zentraf]

I guess I'm freaking out because I've read that after 1-1.5 years the muscle starts to turn into scar tissue and what you see is what you get. Not even surgery can fix it. Then you are stuck w a skinny leg. I guess im asking when should I start to panick?

How would I know if I have a circulation issue w my leg?

I was considering trying back decompression since my L4 & L5 have disk narrowing. Any thoughts on that?

Thanks again for the info especially on the nerve regeneration process. I guess I'm anxious cause all the into I read about stretched femoral nerves indicated a 3-4 month recovery so I just assume I'm not recovering like I should be since it's been right at 6 months . So I will try to be more patient. It's a little easier these days since the pain has gone down significantly, thank God. I did slip & fall last week like a dork while exercising so I know I kinda tweaked my knee & it has caused some soreness. Most if my leg is numb so in this instance it's prob a good thing :)

I've read that the pain is caused by nerves misfiring. Some say that means it is healing and others say that when the pain stops it is healing??

[philnoir]

The "one inch per month" figure is an approximation. Nerves don't grow in a straight line, so you cannot use a tape measure to estimate a date of healing.

With mononeuropathy, some time is required for glial cells to clean up the old, damaged tissue before growth can proceed. If circulation is restricted, growth takes longer.

Atrophy is to be expected. You've had an injury and now you must wait for your body to heal.

The good news is that you are making progress. Be patient and keep exercising as well as you can manage.

Best wishes.

[Zentraf]

Thanks for your response. I'm not sure how healthy the nerve is at this point but my leg is still pretty weak especially at around the knee area. I guess the nerve is doing something since I can do more with my leg than I could at first but It seems like the atrophy is getting worse to me which is why I was pushing for another emg/ Ncs at the 6 month mark instead of a year. The EMG I had done last year was not very specific on the type or extent of my injury.  I start back on physical therapy this Wednesday. I've been exercising at home or the gym &  I'm going back to the doctor for another follow up on the 20th. I still can't extend my leg all the way straight while sitting down. I guess I will just have to hurry up & wait in regards to the nerves regenerating. I wanted to get a second opinion but I'm not having much luck finding a doctor with femoral nerve experience in my area. Not sure if orthopedic doctors mainly handle this type of injury of if there is another specialist . I also have disk narrowing between L4 & L5 but my doc says that has nothing to do with it but that's where the femoral nerve starts.

Just don't want time or my options to run out. Seems to me at one inch per month from my pelvis the nerve regeneration should be almost at the middle of my thigh in another month or so & I thought I would be noticing more muscle returning or strength. That's why the atrophy is so concerning to me. But thanks for your response.

[philnoir]

Yes, you can rebuild the muscles in your if there is no circulatory deficit to the leg. I'm going to assume that since your nerve is now healthy and growing, your femoral artery is also flowing without restriction.

Once the damaged nerves regenerate, you'll be better able control that quadriceps muscle on the top of your upper leg. With control comes the ability to exercise which can rebuild both muscle mass and muscle tone. Building muscle requires proper nutrients that comes to the quads via the femoral artery.

So, first things first -- the nerve has to heal before you can effectively build up the thigh muscles. However, don't let the leg dangle. Any exercise that you are able to do while the nerve is growing will help preserve muscle tone.

A physical therapist can help in this process with exercises that will isolate and eventually reverse muscle atrophy due to your neuropathy.