From the Guidelines
Obturator nerve entrapment symptoms typically present with medial thigh pain, sensory changes in the inner thigh, and weakness of hip adduction, as described in the context of lumbosacral plexopathy 1. The clinical presentation of obturator nerve entrapment can vary, but common symptoms include:
- Medial thigh pain that may radiate from the groin down the inner thigh
- Sensory changes such as numbness, tingling, or burning along the medial thigh
- Weakness of the adductor muscles, potentially causing difficulty bringing the legs together or maintaining stability during walking
- A clicking sensation in the groin with movement
- Night pain that disturbs sleep, which may be exacerbated by prolonged sitting These symptoms can result from various causes, including pelvic trauma, pelvic surgery, sports injuries involving the hip and groin, or compression from pelvic masses 1. Diagnosis of obturator nerve entrapment typically involves a clinical examination, including testing adductor strength and sensory function, along with specialized tests like the adductor squeeze test 1. Treatment usually begins conservatively with rest, physical therapy, and anti-inflammatory medications, while persistent cases may require nerve blocks, surgical decompression, or addressing underlying causes 1.
From the Research
Symptoms of Obturator Nerve Entrapment
- Medial thigh or groin pain, often exercise-induced and commencing in the region of the adductor muscle origin, radiating distally along the medial thigh 2, 3, 4
- Weakness with leg adduction, specifically adductor muscles weakness 2, 3, 4
- Sensory loss in the medial thigh of the affected side, including paresthesia in the cutaneous distribution of the medial thigh 2, 3, 4
- Post-exercise groin, lower abdominal, or medial thigh pain 2
Diagnostic Approaches
- Electromyography (EMG) to demonstrate denervation of the adductor muscles 2, 3, 4, 5
- Diagnostic local anaesthetic block to confirm the diagnosis 2, 3, 4, 5
- Radiographic imaging, such as MRI, may detect atrophy in the adductors of the leg but is limited in detecting nerve abnormalities 5
Treatment Options
- Surgical neurolysis to provide definitive cure of pain, with athletes returning to competition within several weeks of treatment 2, 3, 4
- Pharmacologic management of pain and physical therapy can be helpful in the acute phase of injury 5
- Surgical decompression of the nerve should be considered for lesions documented by EMG or local nerve block, for those with predisposing risk factors, and with prolonged or severe lesions 5