Causes

Femoral nerve pain: symptoms, causes, treatment and exercises

The femoral nerve runs from the lower back through the groin to the front of the thigh. When it is damaged, the front of the thigh and the inner leg can hurt, tingle or go numb, and the thigh muscle that straightens the knee can weaken, so the knee may give way on stairs. Surgery and other medical procedures cause many cases, and many people recover over months.

Written by the Managing Neuropathy editorial team under the direction of Dr. Tom Biernacki, DPM, FACFAS · Clinical review pending · Last updated 5 October 2026

An older man in a brown jacket climbing a long flight of outdoor concrete steps between metal railings

The short answer. The femoral nerve comes from the second, third and fourth lumbar nerve roots, crosses the pelvis and enters the thigh in the groin. It powers the quadriceps, the thigh muscle that straightens the knee, and carries feeling from the front and inner thigh and, through its saphenous branch, from the inner side of the knee, shin and foot. Damage to it causes pain, burning, tingling or numbness in those areas and weakness straightening the knee, so the knee can buckle. As many as 60 percent of femoral nerve injuries are caused by surgery or another medical procedure; injuries, bleeding near the nerve and growths cause others, and diabetes can damage it as part of a wider nerve problem in the thigh. Treatment targets the cause, with pain relief, physical therapy and sometimes a knee brace, and recovery usually takes months. Sudden severe groin, belly or back pain with a weak or numb thigh, especially if you take a blood thinner, needs emergency care.

What the femoral nerve does

The femoral nerve forms from the second, third and fourth lumbar nerve roots (L2 to L4) in the lower back. It runs down through the psoas muscle, lies between the psoas and iliacus muscles inside the pelvis, and passes under the inguinal ligament in the groin, just outside the femoral artery, before it divides in the upper thigh.

Its muscle branches supply the quadriceps, the four-part muscle at the front of the thigh that straightens the knee, and the iliacus, sartorius and pectineus, which help bend the hip. Its skin branches carry feeling from the front and inner thigh. Its longest branch, the saphenous nerve, continues down the inner side of the knee and shin to the inner side of the foot.

Where femoral nerve symptoms are felt. The nerve also powers the quadriceps, which straightens the knee.

So a femoral nerve problem can weaken the knee as well as change how the skin feels. That sets it apart from meralgia paresthetica, a pinched skin nerve that makes the outer thigh burn or go numb but never weakens the leg.

Symptoms

Symptoms depend on where the nerve is damaged and how badly. The usual ones, on one side:

Pain, burning, tingling or numbness in the front and inner thigh, the inner side of the knee and the shin, sometimes reaching the inner side of the foot.
A weak knee. The thigh muscle can’t straighten the knee firmly, so the knee buckles or gives way, especially going down stairs.
Trouble with stairs, and falls when the knee gives way.
A weak or missing knee-jerk reflex, found on examination.
A shrinking thigh muscle if the weakness lasts.
Weak hip bending, when the damage is high up, inside the pelvis.

When bleeding inside the pelvis presses on the nerve, sudden pain in the groin, back or lower belly can come first. Numbness that starts in both feet and creeps upward is a different problem, usually peripheral neuropathy.

What causes it

A 2021 review, citing large earlier studies, reports that as many as 60 percent of femoral nerve injuries are caused by medical treatment, most often by stretching or pressing on the nerve. The main causes:

Surgery. Hip replacement: studies report femoral nerve injury after about 0.1 to 2.4 percent of total hip replacements, with large recent studies near the low end. Operations in the belly and pelvis, such as hysterectomy, bowel surgery, kidney transplant and hernia repair, where a retractor can press on the nerve, and urological surgery.
Lying with the hips bent and turned out for a long time, in the lithotomy position used for some operations and for childbirth. Nerve injuries follow about 0.3 to 2 percent of deliveries; the femoral nerve is affected slightly less often than the outer thigh nerve, the most common.
Procedures through the groin: a catheter placed in the femoral artery, for example for a heart procedure, and nerve blocks given for pain relief around surgery.
Bleeding near the nerve. A collection of blood in the psoas and iliacus muscles or behind the abdomen, a rare complication of blood thinners or of a catheter in the groin artery. When it affects a nerve, the femoral nerve is the one most often affected.
Injury, such as a broken pelvis.
Pressure from a growth or an abnormal blood vessel.
Diabetes, through a wider nerve problem in the thigh (next section).

Diabetes and thigh pain: diabetic amyotrophy

Diabetic amyotrophy, also called proximal diabetic neuropathy or diabetic lumbosacral radiculoplexus neuropathy, is not a femoral nerve problem alone. Inflammation of tiny blood vessels in the nerves is thought to damage the nerve roots and the network of nerves in the lower back and pelvis. It weakens the thigh muscles the femoral nerve supplies, and often other leg muscles too.

In a 2020 review of 115 published cases, 95 percent of people had type 2 diabetes. Their median age was 62, it began a median of 3 years after diabetes was diagnosed, and up to two-thirds lost weight, from about 10 to 120 pounds.

It typically starts with sudden, severe, deep pain in the hip, thigh or back, on one side in 70 percent of cases. Within weeks the thigh muscles weaken and shrink, and getting up from a chair becomes hard. In about half of people the other leg becomes involved too, typically within 6 months. Up to 20 percent have signs of damage to the automatic nerves that control things like blood pressure, such as dizziness on standing.

A Cochrane review found no usable evidence from randomized trials on whether immune treatments such as steroids or intravenous immunoglobulin help. Care centers on reviewing blood sugar control and treating the pain; pulses of intravenous methylprednisolone, a steroid, may help the pain if given within 2 to 3 months of the start. Recovery is slow and unpredictable: pain usually eases first, typically within a year, and strength returns more slowly. In one study that followed people for about 2 years, the number who needed a wheelchair fell from 16 to 3. If you have diabetes and new, severe thigh pain with weight loss or weakness, get checked promptly. More on diabetic neuropathy.

Is it the femoral nerve, or something else?

Several problems cause thigh pain or a weak knee. The clues that tell them apart:

Condition	Clues
Femoral neuropathy	Weak knee straightening, a weak or missing knee reflex, and numbness of the front and inner thigh and inner leg. Squeezing the knees together stays strong
A pinched nerve root in the lower back (lumbar radiculopathy)	Back pain, with pain, tingling or weakness spreading into the leg. On a needle EMG, the muscles beside the spine often show changes; they stay normal in a femoral nerve problem
Lumbar plexopathy, including diabetic amyotrophy	Severe hip or thigh pain, with weakness beyond the knee straighteners, such as in the muscles that pull the legs together; weight loss in diabetic amyotrophy
Meralgia paresthetica	A burning or numb patch on the front and outer thigh, stopping above the knee; no weakness
Hip arthritis	Pain mostly in the groin, sometimes spreading to the thigh, buttock or knee, with stiffness that makes walking or bending hard
A torn quadriceps tendon	A tearing or popping feeling at the knee, often after an awkward landing or a fall, a dent above the kneecap, and, if the tear is complete, a knee that can’t be straightened
Peripheral neuropathy	Starts in both feet, at the toes, and creeps upward over months or years

Radiculopathy or neuropathy: how to tell.

How it’s diagnosed

An examination does most of the work: testing the strength of knee straightening, hip bending and squeezing the knees together, checking the knee reflex, and mapping any numb skin. Tests confirm the problem and look for the cause:

A nerve conduction study and EMG show whether the femoral nerve is damaged and how badly, help tell a nerve problem from one in the spine or the nerve network in the pelvis, and help predict recovery.
Imaging: CT or MRI to look for bleeding, a growth or a spine problem. A CT scan can confirm bleeding behind the abdomen.
Blood tests, including blood sugar, to look for diabetes and other causes.

Treatment

Treatment depends on the cause and how weak the leg is. Mild cases often do well without surgery.

Treat the cause.
Take the pressure off the nerve. Bleeding near the nerve is managed in hospital: treatment ranges from close watching and stopping or reversing a blood thinner to surgery to drain it, which may be urgent when weakness is severe or getting worse. A growth pressing on the nerve may need surgery.

Control the pain.
Medicines used for nerve pain, such as amitriptyline, duloxetine, gabapentin or pregabalin. How nerve pain medicines compare.

Physical therapy.
Exercises to rebuild the thigh muscle and to walk safely, with a physical or occupational therapist.

A brace or splint.
A knee brace that keeps the knee from buckling while the muscle is weak, to prevent falls.

Track the recovery.
Repeat examinations, and nerve tests when needed, show how the nerve is healing.

Exercises for femoral nerve pain and weakness

A physical therapist sets the program around how strong the thigh is. The aim is to rebuild the quadriceps and walk without falling. Moves often used, on the weak side:

Seated leg extension. Sit up straight on a chair. Tighten your thigh muscle and slowly straighten the knee as far as you can. Hold for 5 seconds, then lower the foot to the floor. Repeat 10 times.
Sit to stand. From a sturdy chair with arms, stand up and sit down slowly, using your hands as much as you need. Repeat 5 to 10 times.
Straight-leg raise, once you can keep the knee straight. Lie on your back, propped on your elbows, with the other knee bent. Tighten the thigh of the weak leg and raise it 6 to 10 inches. Hold for 5 seconds and lower slowly.

Nerve glides. One version therapists teach: lie on your front with your forehead on your hands. Slowly bend the knee, bringing the heel toward your buttock, as you lift your head to look up. Stop before it hurts, then lower the knee and your head back to the start together. Move slowly, and repeat as often as your therapist suggests. We found no trials of nerve glides for femoral nerve damage, so treat them as optional, check with your therapist first, and stop if one makes pain or tingling spread or last longer.

None of these should hurt. If an exercise causes pain, stop and ask your therapist. On stairs, hold the handrail and remember “up with the good, down with the bad”: step up with the stronger leg first and down with the weaker leg first. If the knee buckles, ask about a brace before it causes a fall.

How long it lasts

It depends on the cause and how badly the nerve was hurt. Nerves that were stretched or pressed usually recover: in the 2021 review of injuries caused by medical treatment, movement and feeling usually came back within 6 to 12 months of rehabilitation. Some numbness can last; in one series of 36 people injured during hip replacement, 80 percent kept some change in feeling. A nerve that was cut recovers poorly.

After childbirth, nerve symptoms usually fade within weeks to months; in one study the median was 2 months. Diabetic amyotrophy is slower: pain usually eases within a year, and strength takes longer. MedlinePlus notes that full recovery is possible when the cause is found and treated, though some people are left with lasting weakness or numbness.

When to get help urgently

Go to an emergency department, or call 911, for sudden, severe pain in the groin, belly, side or back with a weak or numb thigh, especially if you take a blood thinner, recently had a procedure through the groin artery, or also feel faint or have a racing heart: possible bleeding near the nerve.
Go to an emergency department for numbness around the genitals or bottom, new bladder or bowel trouble, or weakness or numbness in both legs that is severe or getting worse: possible pressure on the nerves at the base of the spine.
Call 911 for sudden numbness or weakness of the face, an arm or a leg, especially on one side, or sudden trouble speaking: possible stroke.
Get seen the same day for new weakness in the leg, a knee that suddenly gives way, or a fall.
See a clinician soon for pain, tingling or numbness in the thigh or inner leg that doesn’t settle, or, if you have diabetes, severe thigh pain with weight loss.

Common questions

What does femoral nerve pain feel like?

Usually burning, aching, tingling or numbness over the front and inner thigh, sometimes running down the inner side of the knee and shin toward the inner foot. It often comes with a weak knee that buckles, especially on stairs. A burning patch on the outer thigh with normal strength is more likely meralgia paresthetica.

How long does femoral nerve damage take to heal?

Usually months. In a 2021 review of femoral nerve injuries caused by medical treatment, strength and feeling usually returned within 6 to 12 months of rehabilitation, though some numbness can remain. After childbirth, symptoms often fade within weeks to a few months. Diabetic amyotrophy is slower, and a nerve that was cut recovers poorly.

Can a pinched femoral nerve heal on its own?

Often, if the pressure is gone and the nerve wasn’t cut: most stretch and pressure injuries improve, though some numbness can last, and mild cases often do well without surgery. Ongoing pressure, such as from bleeding or a growth, needs treatment, so get the cause checked.

What exercises help femoral nerve pain?

Exercises that rebuild the thigh muscle, such as seated leg extensions, sit to stand from a chair and, once the knee stays straight, straight-leg raises, in a program set by a physical therapist. Gentle nerve glides are optional. None should hurt, and use the handrail on stairs.

Is femoral nerve pain the same as meralgia paresthetica?

No. Both cause thigh symptoms, but meralgia paresthetica affects the lateral femoral cutaneous nerve, which only carries feeling, so it causes burning or numbness on the outer thigh and never weakness. The femoral nerve also powers the quadriceps, so damage to it can weaken the knee, and its numbness is on the front and inner thigh and the inner leg.

A weak knee,
and numb feet too?

Femoral nerve problems are usually managed by a neurologist, a physical medicine and rehabilitation doctor, or the surgeon who did the operation. If your feet are also numb, burning or tingling, that is a separate problem worth an examination. Dr. Biernacki’s Michigan practice can start there.

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Dr. Tom Biernacki, DPM, FACFAS

Dr. Tom Biernacki, DPM, FACFAS is a double board-certified foot and ankle surgeon (ABFAS and ABPM) and a Fellow of the American College of Foot & Ankle Surgeons. He is the founder of Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, where peripheral neuropathy, diabetic foot risk and loss of protective sensation are part of his weekly clinic. His patient education videos have drawn more than 950,000 subscribers on YouTube. Managing Neuropathy is written by its editorial team under his direction, to put the explanation he gives in the exam room in front of the people who cannot get to one — including when a product is worth buying and when it is not.