MERALGIA PARESTHETICA

TYPES

• Intrinsic

The intrinsic types include obesity and pregnancy, which are likely the common reasons why there is more pressure on the nerve in the abdomen. 

• Extrinsic

This is common for people who wear tight jeans on a daily basis or those with belts as well. 

• Metabolic

People with Diabetes are most affected in terms of metabolic causes, having it themselves adds up the risk of having Meralgia Paresthetica. 

• Surgical problems

Orthopedic or abdominal surgeries can increase the risk of having Meralgia Paresthetica. One example of surgery is Hernia repair.

SYMPTOMS

If you have Meralgia Paresthetica, the most common symptoms of it are burning pain, buzzing sensations, coldness, or numbness in the thigh. These persist if you keep standing or walking long distances. 

DIAGNOSIS

• Pelvic Compression Test – this test is done where the pelvis is being pressed for about 45 seconds. This effective method will relieve pain.
• Tinel’s Test 
• Neurodynamic testing – this type of test determines whether you are diagnosed with the condition or not. It involves stretching the leg; if you feel any pain or discomfort, then it is positive.
• Diagnostic Nerve Block 
• MRI/NCS/EMG

TREATMENT

There are a variety of medications that can be used to treat Meralgia Paresthetica. Some people treat their meralgia paresthetica in just a few months. 

Here are the common treatments in easing the condition:

• Local injections of an Anesthetic +/- Steroids can be very useful. It is proven and tested. However, it’s essential also to note that three or four courses of these injections might be necessary.
• Ultrasonography-guidance is often a very useful tool to be able to deliver the injections to the right place and also to avoid any potential complications. 
• The usual selection of a variety of symptomatic relieving medications such as nonsteroidal for patients who may benefit from those and suitable for them, such as Tricyclic, antidepressants, Gabapentin, etc. 
• There is a variety of case reports in the literature of therapies, which can include topical things such as Capsaicin creams which can be helpful, TENS machines use, manual therapies, kinesiology, and acupuncture. However, none of these have ever really been tried or proven in larger groups. So, there isn’t really an evidence base for any of those treatments. 

In terms of operative measures, there is mixed literature in terms of the success rates of surgery. Sometimes it’s reported as 60%, but it can be as high as 99%.