Meralgia paraesthetica

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Meralgia paresthetica or paraesthetica (or Bernhardt-Roth syndrome ), is numbness or pain in the external thigh that is not caused by injury to the thigh, but because of a nerve injury extending from the spine to the thigh.

This chronic neurological disorder involves a single nerve - the lateral cutaneous cord of the thigh, also called the lateral femoral nerve cyst (and therefore the lateral cutaneous cutaneous cutaneous syndrome ). The term "meralgia paraesthetica" combines four Greek roots meaning "thigh pain with anomalous perception". This disorder is also dubbed skinny underwear syndrome , referring to an increase in teens wearing tight pants.

Video Meralgia paraesthetica

Signs and symptoms

• The pain on the outside of the thigh, sometimes extending to the outer side of the knee, is usually constant.
• Burning sensation, tingling, or numbness in the same area
• Many stings such as pain in the affected area
• Occasionally, pain in the groin or pain area spreads across the ass
• Usually more sensitive to light touch than strong pressure
• Hyper sensitivity to heat (warm water from the shower feels like a burning area)
• Occasionally, patients may complain of itching or disturbing sensations rather than pain in the affected area.

The entire distribution of nerves is rarely affected. Typically, unpleasant sensation (s) affect only the part of the skin provided by the nerves.

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Cause

The lateral femoral nerve cutaneous most often becomes injured by entrapment or compression in which it passes between the upper frontal hip (ilium) and inguinal ligaments near the attachment of the anterior superior iliac spine (hip top point). Less commonly, nerves may be trapped by other anatomical or abnormal structures, or damaged by diabetes or other neuropathies or trauma such as from a seatbelt injury in an accident.

The nerves may become painful over a period of time because weight gain makes the underwear, belting or waist pants gradually exert a higher pressure level. Pain can be acute and radiate to the ribs, and to the groin, thighs, and knees. Alternately, weight loss or aging can remove the protective layer of fat under the skin, so the nerves can suppress the underwear, outerwear, and - most often - by belting. Long standing or foot exercises that increase tension in inguinal ligaments can also cause pressure.

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Diagnosis

Diagnosis is largely based on patient description and relevant details about recent surgery, hip injury, or repetitive activity that may irritate the nerves. Examination of the examination for sensory differences between the affected foot and the other leg. Accurate diagnosis may require examination of the abdomen and pelvis to exclude problems in the area.

Electrocardiographic conduction studies (EMG) may be required. X-rays may be needed to exclude bone abnormalities that may put pressure on the nerves; as well as CT or MRI scans to exclude the causes of soft tissue such as tumors.

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Treatment

Treatment varies. In most cases, the best treatment is to eliminate the cause of compression by modifying the patient's behavior, in combination with medical treatment to relieve inflammation and pain. Whatever the cause, typical treatment takes several weeks to months - depending on the extent of nerve damage. Common treatment options include:

• Active Release Removal Techniques (ART)
• Wear more lax clothes and suspenders than belts
• Weight loss if obesity is
• Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammatory pain if pain levels limit motion and prevent sleep
• Reduces physical activity in relation to pain level. Acute pain may require total rest
• Deep tissue massage to reduce tension in gluteal muscles, most often maximus gluteus. The tensor fasciae latae may also be involved.

The lateral cutaneous cord of the thigh may occasionally be damaged during the repair of laparoscopic hernia, or scarring of the surgery may cause meralgia paraesthetica.

For lower pain levels, treatment may involve the patient:

• Look for the right physical therapy, such as stretching and massage, which plays a major role in pain management
• Learn to perform inguinal ligaments that stretch (from a physical therapist) that can quickly relieve symptoms
• Use break time to interrupt long periods of standing, walking, cycling, or other incriminating activities
• Lose weight, and exercise to strengthen abdominal muscles
• Wear loose clothing in the upper hips area
• Apply heat, ice, or electrical stimulation
• Take nonsteroidal antiinflammatory drugs for 7-10 days
• Remove hair in the affected area (shaved)
• Lidocaine patch (must be shaved first)
• Titanium dioxide patch to interfere with the electrostatic effects of nerves on the skin surface

Pain may require significant time (weeks) to stop and, in some cases, numbness persists even after it has been treated. In severe cases, doctors may perform local nerve blocks in inguinal ligaments, using a combination of local anesthesia (lidocaine) and corticosteroids to provide help that can last several weeks. Pain-converting drugs for neuralgic pain (such as amitriptyline, carbamazepine or gabapentin) can be tried, but often do not help in most patients.

A persistent and severe case may require surgery to decipher nerves or, as a last resort, to resolve the nerves. The last treatment left a permanent numbness in the area.

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See also

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References

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External links

• Meralgia Paresthetica by eMedicine.com

Source of the article : Wikipedia