What is Meralgia Paresthetica?
Meralgia Paresthetica is a painful compressive neuropathy of the lateral femoral cutaneous nerve (LFCN), which causes a “burning” pain and altered sensation in the thigh (1-3).
Who is most likely to get Meralgia paresthetica?
Meralgia paresthetica can happen at any age, but is most common in middle-aged adults (5,6). Diabetics have a 6X risk of developing the condition (7-9). The condition affects men up to three times more frequently than women (8,10-12), which is thought to be due to increased belt use-carpentry, police belts, etc.
Can Meralgia paresthetica happen on both legs?
It can happen in either the dominant or non-dominant leg (10). The condition is presenting both legs in 20-25% of cases. (5,10-12).
What causes Meralgia paresthetica?
Excessive compression stretch of the LFCN is a primary cause of meralgia paresethetica (1,3). Other known sources of compression include excessively tight clothing (especially jeans or belts), pregnancy, and obesity (10,16-21). Recent weight gain often precedes the condition. In fact, 8 percent of new cases report recent weight gains over 15 pounds (10,22). Seat belt compression has also been found to be a contributing factor (23-25). Excess periods of laying on one's stomach can also contribute (26). Athletes who are in gymnastics, baseball, soccer, bodybuilding, or strenuous exercise may be predisposed (27-31).
What are the symptoms of meralgia paresthetica?
The typical symptoms of meralgia paresthetica are isolated pain or paresthesia on the outside of their thigh (1,3). The pain is variable and patients may feel dull, aching, itching, buzzing or burning and may range from mildly uncomfortable to disabling (3,34-40). Symptoms may prevent proper function and sleep (3,41). Complaints are often provoked by walking and alleviated when sitting- as sitting can decrease tension on the inguinal ligament (11,12,41,42).
Do I need X-rays or imaging for meralgia paresthetica?
The clinical syndrome of meralgia parasthetica is well defined, and diagnostic studies may be unnecessary (1,42).
What are the best treatment options for meralgia paresthetica?
Conservative management is the frontline treatment for meralgia paresthetica and is successful in up to 91% of cases (16,52,53).
The goal of treatment is to remove any cause of excessive compression (16,52). In some cases, simply wearing looser clothing may alleviate the complaint. Other considerations include selective rest from an aggravating activity, weight loss, or carrying a toolbox instead of wearing a tool belt. Wearing high heels should be avoided as this causes excessive anterior pelvic tilt, which may be linked to the problem (32).
Myofascial release and stretching may be appropriate for tightness in the muscles around the hip. (52-57)
Stabilization exercises are recommended for the core and pelvis (53-57).
One small study demonstrated significant improvement in meralgia paresthetica symptoms following the application of therapeutic exercise tape. (60,61).
What other treatment options are there?
Patients may consider ice, over-the-counter analgesic creams, and NSAIDs for symptomatic relief (62).
Severe cases may benefit from anesthetic block or local steroid injection (63-65).
Surgery should be reserved for those who fail all other forms of conservative treatments (62).
At Creekside Chiropractic & Performance Center, we are highly trained to treat each of these conditions. We are the only inter-disciplinary clinic providing services to Sheboygan, Sheboygan Falls, Plymouth, and Oostburg including chiropractic, manual therapy, myofascial release, ART (Active Release Technique), massage therapy, acupuncture, physiotherapy, rehabilitative exercise, nutritional counseling, personal training, and golf performance training under one roof. Utilizing these different services, we can help patients and clients reach the best outcomes and the best versions of themselves. Voted Best Chiropractor in Sheboygan by the Sheboygan Press.
Evidence Based-Patient Centered-Outcome Focused
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