Meralgia Parasthetica

Meralgia paresthetica, also called Bernhardt-Roth syndrome, is a neurological condition that causes numbness, tingling, and sometimes pain in the outer thigh. It’s usually not serious.

Meralgia paresthetica happens when a nerve, known as the lateral femoral cutaneous nerve, becomes compressed. Any of the following can trigger the condition:

• pregnancy
• tight clothing
• hip surgery
• obesity
• standing or walking for long periods of time

Typically, meralgia paresthetica goes away in a few months on its own or with conservative treatment, like wearing loose-fitting clothing or losing weight. Pregnant women with the condition usually experience relief after giving birth. More severe cases may require medications or surgery.

What are the symptoms?

Meralgia paresthetica affects the skin on the outer thigh. Symptoms most commonly occur on one side of the body. They may worsen after standing or walking for a long period of time.

Symptoms include:

• pain
• burning
• tingling
• partial loss of sensation
• aching in the groin area

The skin on the outer thigh is usually more sensitive to light touch than to firm pressure. The muscles of the thigh aren’t affected.

Causes

The condition occurs when a nerve called the lateral femoral cutaneous nerve is compressed, trapped, or pinched. This nerve starts in the lower spine and leaves the pelvis underneath a ligament called the inguinal ligament.

Nerves are responsible for sending information about the environment back to the brain and also for sending messages from the brain to the muscles. You have many nerves throughout your body. They pass over, under, and in between your joints, bones, ligaments, and muscles, usually with ease.

If the nerve is pinched or squeezed when passing through a joint, bone, ligament, or muscle, it can cause pain, loss of sensation, or other symptoms.

Some of the ways that your lateral femoral cutaneous nerve can become compressed include:

• wearing tight clothing or belts
• walking, running, biking, or standing for a long period of time
• surgery or trauma to the hip or back
• pregnancy
• obesity

Meralgia paresthetica during pregnancy

For pregnant women, a growing stomach and weight gain can put pressure on the groin. This added pressure can compress the lateral femoral cutaneous nerve, leading to meralgia paresthetica.

Symptoms of meralgia paresthetica may get worse as the pregnancy continues, but usually go away after giving birth. Meralgia paresthetica won’t cause complications with your pregnancy or affect your baby.

• are pregnant
• are obese or overweight
• recently had surgery to the hip or back
• have diabetes (people with diabetes are over seven times more likely to develop meralgia paresthetica, which can be caused by a diabetes-related nerve injury)
• are between the ages of 30 and 60
• wear a heavy tool belt for work

How it’s diagnosed

To diagnose meralgia paresthetica, a doctor will ask you questions about your symptoms and conduct a physical exam. You may be asked questions about your medical history, including any other conditions you may have, medications you’re taking, and if you’ve had a recent surgery.

Your doctor might also ask you questions about your lifestyle, such as if you wear a heavy tool belt for your job, or if you often wear tight corsets or stockings.

During a physical exam, your doctor may test the sensation on your thigh and ask you to pinpoint the spot on the thigh that is painful or numb.

If a doctor is unable to confirm a diagnosis based on your symptoms and medical history alone, they may also recommend the following tests:

• imaging tests, like an X-ray or MRI, to create images of your hip and pelvis
• nerve conduction velocity tests, which use electrical impulses to look for damaged nerves
• electromyography (EMG) to help measure the electrical discharges of surrounding muscles
• nerve blockade, where an anesthetic is injected into the thigh at the location where the lateral femoral cutaneous nerve passes into it (if you have meralgia paresthetica, your pain will go away immediately after the anesthetic is injected and the pain relief will last for 30 to 40 minutes)

Since symptoms typically subside on their own in a few months, medical treatment usually isn’t necessary.

The goal of treatment is to remove whatever is compressing the nerve. To help ease your symptoms, your doctor may suggest:

• wearing loose clothing
• resting
• losing weight
• taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen (Advil), or pain medications like acetaminophen (Tylenol)
• deep tissue massage

There are also exercises you can do to help relieve the pressure on the groin area and improve flexibility and strength in the pelvis, hip, and core. from your doctor

Medical treatment is usually only recommended if your symptoms continue for more than two to three months or you consider the pain severe.

Your doctor might recommend:

• corticosteroid injections to help relieve inflammation and pain
• tricyclic antidepressant medications, which have been shown to relieve this type of pain
• medications used to treat seizures, such as gabapentin (Neurontin) or pregabalin (Lyrica)
• nerve decompression surgery (rare)

The outlook for meralgia paresthetica is usually very good. Most cases resolve on their own without further complications. For pregnant women diagnosed with meralgia paresthetica, the condition will likely resolve right after delivery. In a small number of cases, the numbness, burning, and pain will persist despite treatment.

If you’ve been diagnosed with meralgia paresthetica, make sure you’re taking steps to reduce the nerve compression that causes it. This could mean wearing loose clothing, losing weight, or doing exercises and stretches. For mild pain, you can take over-the-counter pain medications, like ibuprofen (Advil) or aspirin. Be sure to read the product labels carefully.

If your pain becomes severe or hasn’t gone away after two months, visit your doctor to discuss treatment options.

Sourse :

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