Jonathan Aarons M.D.

Tired of Chronic Pain?

Obturator Neuralgia

Obturator Neuralgia

Obturator Neuralgia is an uncommon painful condition of the inside of the thigh.  It is caused by injury or compression of the obturator nerve.  The obturator nerve originals from the L2, L3 and L4 nerve roots of the spine.  The obturator nerve descends through a hole called the obturator foramen in the pelvis and then divides into anterior (front) and posterior (back) branches.  This nerve ennervates the adductors of the thigh, the muscles that move the legs close together, as well as the skin of the inside of the thigh.  Patients with obturator neuralgia have pain in the groin and loss of sensation in the inner thigh.  Their gate is unsteady and wide due to muscle weakness.  The nerve is usually injured by trauma, tumor, hemorrhage or birth-related injuries.  It can also be injured during surgery to repair or replace a hip.  Diagnosis of Obturator Neuralgia is done with Electromyography (EMG) and Nerve Conduction Studies (NCV).  X-rays, MRI scans and CT scans are useful to exclude tumors or fractures.  Treatment of Obturator Neuralgia begins with physical therapy and non-steroidal anti-inflammatory agents.  Other medications can be tried such as anti-depressants ( notriptyline, duloxetine, and others) as well as gabapentin and pregabalin.  Injection of the nerve with a local anesthetic and a steroid can be helpful.  Where documented nerve entrapment is found, surgery to release the nerve may be useful as well.

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