Most of the time, the general practitioner is able to diagnose and treat cruralgia.

Among the specialists taking charge of this disease, it is necessary to cite above all rheumatologists, neurologists and rehabilitation physicians (MPR). Some radiologists can also sometimes perform a therapeutic gesture.

Surgical emergencies are handled by neurosurgeons or orthopedic surgeons.

Some cases of very painful cruralgia may require consultation in a pain relief center.

What exams do we do?

In classical cruralgia, the symptoms are so typical that physical examination is sufficient. The tensioning of the nerve by a maneuver intended to find an inverted Lasègue sign or Leri sign (prone, extension behind the leg) causes an increase in pain. A small motor deficit and decreased sensitivity corresponding to the area of ​​the crural nerve may also help confirm the diagnosis. When it is the L3 lumbar root which is compressed, the painful path concerns the buttock, the anterior aspect of the thigh and the internal aspect of the knee and the muscular insufficiency concerns the quadriceps and the anterior tibial muscle of the leg (flexion of the leg. foot). When it is the L4 root that is compressed, the painful path goes from the buttock to the anterior and inner face of the leg, passing through the outer face of the thigh and the anterior and inner face of the leg.

Increased pain with coughing, sneezing, or defecation are classic signs of pain due to compression of a nerve root. In principle, the pain subsides at rest, but there may be nighttime upsurges.

The other examinations are only done if there is any doubt about the origin of the cruralgia or the ineffectiveness of the treatment, or even aggravation: x-rays of the spine, blood test, CT scan, MRI. However, in Western countries, these examinations are often performed more or less systematically. They then make it possible to visualize the compression of the nerve roots. Other explorations may, more rarely, be necessary such as an electromyogram, for example.