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Sciatica and cruralgia : what are the differences ?

cruralgia, sciatica

Sciatica and cruralgia : what are the differences ?

We all know somebody or even yourself who have been struggling with sciatica. But we know less about cruralgia.

Both of them are related to the lower back.

The sciatica is a pain starting from the back and going down the lower limb’s back or side while the cruralgia has the same start but is going down the lower limb’s front. This is a very short summary but it is the principal idea.

Cruralgia : ‘the thigh pain’

It is a pain along the crural nerve (or femoral nerve). It is due to a compression of the root L3 (between L3 and L4) or in most cases the root L4 (between L4 and L5).
To better understand see below some anatomy regarding the femoral nerve:

  • origins is in the abdomen, at the level of the muscle large psoas.
  • largest branch of the lumbar plexus.
  • derived from the nerve roots L2, L3 and L4.

The femoral nerve supplies the motricity of the anterior thigh’s muscle: Hip flexors and Knee extensors.

It also supplies the skin sensitivity of the anteromedial thigh, the knee, the medial leg and foot.

What are the symptom ?

  • Painful sensations felt on the path of one of the nerve roots of the femoral nerve such as tensions, burning, electricity, tingling, numbness.
  • Possible to feel pain in the buttock (outer side), the groin, the inner side of the thigh and the leg.
  • May be accompanied by pain in the lumbar region, which is called lumbocruralgia.
  • Depending on the severity, we can find sensitivity disorders (tingling, burning sensations) in the regions innervated by the femoral nerve but also the loss of muscles strenght in the most serious cases.

What are the causes?

Multiples causes:

  • Herniated disc compressing the root nerve.
  • Degenerative disc.
  • Narrow lumbar canal (spinal stenosis).
  • Conflict between a muscle (psoas, iliac) and the roots nerve.
  • In most serious cases, tumor compression (neuroma), bone metastasis on a lumbar vertebra or hematoma of the psoas.

Sciatica: ‘the buttocks pain’

The sciatica refers to a pain that radiates along the path of the sciatic nerve. The pain is felt in the buttock, back of the thigh and leg and in the foot. This pain is well defined.

The sciatic nerve is the widest and longest nerve of the human body, issue of the lumbosacral plexus and derived from the roots nerve L4, L5, S1 and S2. It begins in the pelvis and runs through the buttocks and down the posterior side of the lower limb.
It ensures motor and sensitivity of the posterior part of the lower limb.

Symptom of the sciatica

  • Painful sensations felt on the path of one of the nerve roots of the sciatic nerve, such as tensions, burning, electricity, tingling, numbness usually only affects one leg.
  • The pains are located on the posterior aspect of the buttock, the thigh, the leg, under and on the side of the foot.
  • These conditions can be accompanied by pain in the lumbar region, so called lumbosciatica.
  • Depending on the severity, it is possible to experience a loss of strength of the muscles innervated by nerve (in the most serious cases). The patient will have a difficulty to go on his/her tiptoe.

What are the causes?

As from the cruralgia, there is multiple cause for the sciatica :

  • Herniated disc.
  • Narrow lumbar canal (spinal stenosis).
  • Piriformis syndrome.
  • Sacroiliitis (inflammation of one or both of the sacroiliac joint).
  • Muscle inflammation, infection or injury that irritates or compresses the sciatic nerve.
  • Spinal tumor.

Osteopathic treatment

First of all, the osteopath will eliminate any medical cause as tumor, fracture, oedema…

He will try to find the root cause of your cruralgia or sciatica.  Because osteopathy is a holistic therapy, your osteopath is not going to be focus on the painful area.
He will release all the compression zones on the nerve path.

For exemple, the osteopath will bring back the lumbar mobility where the sciatic or crural nerve are emerging by releasing the muscle tension. He might also proceed on a visceral work or even being working on an old sprain if he thinks that these problems can disturb your postural balance.

He can also recommend to see a physiotherapist to proceed in a lumbar and abdominal rehabilitation or even to do a podiatry assessment.

If you are experiencing back pain due to a bad posture feel free to call us (416) 931-7686 or to request an appointment online.