Meralgia Paresthetica, The Elusive Diagnosis

Abstract

Surgical management of meralgia paresthetica is a viable option for patients in whom medical management fails. Based on the published literature and the author's experience, a rationale is presented for determining the appropriate surgical management of these patients.

Meralgia Paresthetica in a Male Collegiate Lacrosse Player

“…Symptoms may be mild and spontaneously resolve or may be severe and limit patients for years. 1,2 Clinical Testing A few clinical tests may help with the diagnosis. In the pelvic compression test, the patient is side lying with the symptomatic side up; the examiner applies a downward compression force to the pelvis and holds for 45 s; if the symptoms alleviate, the test is positive (Figure 1).…”

“…1 Manual therapy, Kinesio Taping, and acupuncture may be effective in relieving symptoms. 2 The use of a warm-up before activity, ice treatment or a cold whirlpool after activity, and nonsteroidal anti-inflammatory drugs, were effective in maintaining the athlete's ability to continue playing.…”

“…1,2 The condition was first described by Hager in 1885, 3 reported on more extensively by Bernhardt in 1895, and eventually named by Roth in 1895 as meralgia, from the Greek words meros for thigh and algos for pain. 4 MP has also been referred to as Bernhardt-Roth syndrome or LCN (lateral cutaneous nerve) neuralgia.…”

“…[8][9][10][11][12] Symptoms typically include burning, coldness, lightning pain, deep muscle achiness, tingling, and anesthesia in the anterolateral thigh. 1 The LFCN supplies sensory innervation to the anterolateral aspect of the thigh 7 and is associated with the femoral nerve as they both pass deep to the inguinal ligament. 1 Mechanical factors such as obesity, pregnancy, tight garments, seat belts, direct trauma, muscle spasm, scoliosis, iliacus hematoma, and leg length changes can result in entrapment of the LFCN.…”

A manual therapy and exercise approach to meralgia paresthetica in pregnancy: a case report

“…Thus, following a trial of failed conservative management, adults with less than 1 year of symptoms and all pediatric patients undergo simple nerve decompression (a surgical procedure) and patients in the first group who have persistent or recurrent symptoms are considered for nerve resection. 17 In a study by Jones, 18 55 of 74 patients with MP had permanent relief of symptoms following 18 months of doctors reassuring patients that their symptoms did not represent signs of more permanent neurological disorders. While this represents a relatively high percentage of recovery, it requires lengthy time of patient suffering and disability compared to the results of this study.…”