Numbness in Leg May Be Due to Nerve Damage

by on Apr.19, 2012, under Aches and Pains

Q.My 78-year-old mother is having trouble with her right leg. It’s numb just below the knee and in the calf. After an EMG, the doctor said there was little circulation in the leg, but knowing that doesn’t take the numbness away. She had X-rays on her hips and thighs, but they showed nothing. This has been going on for months and her doctor hasn’t given her information on how to improve it. She says she had to give up walking because her leg got so tired. Any help would be appreciated. – J.M.

A. Mobility is a tough thing to give up at any age. I’m sorry to hear of your mother’s condition. It sounds like she may have chronic compressive peripheral mononeuropathy.

Let me explain those terms. “Peripheral neuropathy” is damage, by disease or injury, of nerve tissue outside the brain and spinal cord. “Mono-” refers to a single nerve; “polyneuropathy,” on the other hand, would be damage to a number of peripheral nerves throughout the body, usually caused by systemwide infection, disease or toxic agents (including some drugs).

Peripheral mononeuropathy is usually caused by localized injury and sometimes disease. That physical injury is often prolonged pressure on a nerve that runs alongside a bone. Bending or stretching a nerve can also cause problems.

Strenuous activity, trauma, infection, heat or cold exposure, radiation therapy and, on rare occasions, tumors, are associated with mononeuropathy.

The peroneal nerve in the calf of the leg is one of the peripheral nerves often injured or compressed because of its vulnerable location, close to the surface of the skin at the back of the knee. For example, peroneal compression is regularly seen in thin people who cross their legs a lot.

Femoral or sciatic nerves may also be affected.

Of course, treatment begins with verifying the diagnosis, and identifying and treating underlying factors, if any, such as infection. If the neuropathy is due to compression or other physical problem, the next step is to locate the site and determine the appropriate treatment.

Neurologists or orthopedic specialists are the health care providers best qualified to diagnose your mother’s problem and recommend treatment. That doctor can also point out what activities would aggravate the situation and thus should be avoided.

Steroids injected directly in or around the damaged area can sometimes reduce swelling and inflammation of the nerve and relieve the pain; it is the method of treatment usually tried first. Surgery to relieve the compression is recommended if the steroids aren’t effective.

Electromyograms (EMGs) measure the electrical activity of muscle. And it’s true that some peripheral disorders can cause abnormal readings. X-rays can often show bone spurs or other problems causing nerve inflammation.

However, to verify the diagnosis of mononeuropathy or rule it out, your mother probably needs to have nerve conduction studies done to measure the speed of nerve impulse conduction; an MRI may also be needed.

Accompany your mother the next time goes to her doctor and let him or her know you’re concerned that she gets information on her condition.

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