Tuesday, September 30, 2014

Meralgia Paresthetica

Definition

A condition characterized by pain, paresthesia (abnormal sensation of burning, tingling, etc.) and numbness on the lateral surface of the thigh in the region supplied by the lateral femoral cutaneous nerve.

Description

The lateral femoral cutaneous nerve, a sensory nerve arising from the L2 and L3 roots, may be compressed or stretched in obese or diabetic patients and during pregnancy.

The nerve usually runs under the outer portion of the inguinal ligament to reach the thigh, but the ligament sometimes splits to enclose it. Hyperextension of the hip or increased lumbar lordosis (forward curvature of the lumbar spine), such as occurs during pregnancy, leads to nerve compression by the ligament. However, entrapment of the nerve at any point along its course may cause similar symptoms, and several other anatomic variations may damage the nerve during stretching.

Causes

The cause of the condition is ischemia (deficiency of blood due to constriction or obstruction) of the nerve caused by its entrapped position in the inguinal ligament. (Meralgia is pain in the thigh).

Symptoms

Pain, paresthesias (lack of sensation), or numbness occurs about the outer aspect of the thigh, usually on one side. It is sometimes relieved by sitting.

Physical exam by a physician shows no abnormalities, except in severe cases when sensation of the skin is impaired in the affected area.

Treatment

Symptoms are usually mild and commonly resolve spontaneously, so patients can be reassured about the benign nature of the disorder. Hydrocortisone injections often relieve symptoms temporarily, while nerve decompression may provide more lasting relief. In some cases, however, this condition lasts indefinitely.

Questions

What is causing the Meralgia Paresthetica?

If this is due to obesity or pregnancy and the weight is lost, will the condition subside or decrease?

What are the chances the nerve damage will become more severe or even permanent?

Would an exercise program with good back posture help relieve the symptoms?

If hydrocortisone injections are given, what are the possible side effects?

How often can an injection be given safely?