Is Important to highlight that the nerves described in all lumbar/pelvic neuropathies may be also comprised and entrapped  at the level of the hip region,  hence the hip evaluation and treatment should be incorporated when dealing with patients with lumbar/pelvic  neurological complaint. 

Radiculopathies are generally accompanying with severe linear pain along the path of the compromised nerve in question (femoral, obturator, etc…)  Patients usually reports pain from the lower back down into the lower extremity associated with pins and needles, numbness, and weakness in the leg. Increased muscle contraction and intermittent lower back and buttocks spams may also develop.

Neuropathies and the corresponding spinal level of misalignment

Femoral Neuralgia is a condition that cause pain at the front of the thigh with associated muscles weakness due to the irritation of the femoral nerve roots at the spinal levels from L2 to L4.

Sciatica is a condition that cause pain at the back of the whole leg with associated muscles weakness due to the irritation of the sciatic nerve roots at the spinal levels from L4 to S3.

Obturator Neuralgia is a condition that cause pain at the inner thigh with associated muscle weakness due to the irritation of the obturator nerve roots at the spinal levels from L2 to L4.

Meralgia paresthetica is a condition that cause pain at the outside of the thigh with due to the irritation of lateral cutaneous nerve roots at the spinal levels L2 and L3.

Ilioinguinal and Genitofemoral Neuralgia is a condition that cause pain in the inner side of the thigh and groin the due to the irritation of ilioinguinal and genitofemoral nerve roots at the spinal level from T12 to L2.

Chronic injuries as seen in spinal degeneration may also narrow the nerve passage due to the scar/fibrotic tissue at the superficial fascia and by the osteophytic bone formation from the underlying bones.

Assessment

Neurological examination.

Spinal/Pelvic clinical assessment to identify the dysfunctional vertebral segments that contributed to this condition.

Xray analyses

Anteroposterior (AP) and Lateral spinal views are essential to accurately diagnosed and visualise the patterns of dysfunction responsible for compromising the never root.

MRI analysis

Important exam to verify the level of narrowing of the nerve passage and the exact point of irritation

Rule out any other condition; There are rare disorders that may create similar patterns of dysfunction, is advisable to rule out these conditions prior to the start of the treatment.

Treatment protocol

Specific spinal adjustment to relief the nerve root irritation

Low level laser application from the lower back following the path of the  never down the leg

Neuromobilization techniques is used once the direct compression of the nerve is reduced.

Specific therapeutic essential oils are applied to reduce nerve inflammation and enhance healing.

Depending on the level of nerve compromised and chronicity of the misalignment a minimum of 6 weeks up to 12 weeks of treatment care may be necessary to resolve this deformity.