If you have irritating outer thigh so you should know about this

Meralgia Paresthetica is a neurological condition which is caused by compression of the lateral femoral cutaneous nerve. It is also known as Bernhardt Roth syndrome.

Anatomy involved The lateral femoral cutaneous nerve is a part of lumbar plexus arises from L2 and L3 vertebra. It emerges at psoas muscle at the lateral edge and passes beneath inguinal ligament.

What are the causes?

There are some causes of compression of the lateral femoral nerve. These causes can lead to an increase in compression and characteristic features in the groin area on inguinal ligament i.e. obesity, tight clothing, tight belts, corsets tight jeans or pants, wearing a heavy tool belt, pregnancy. However, Meralgia Paresthetica also caused due to scar tissue near inguinal ligament due to injury, trauma and diabetes. Meralgia Paresthetica can occur at any age but mostly found in 30 to 40 years old. Also seen in children treated for Osteoid Osteoma. The entrapment can have an idiopathic or iatrogenic cause.

Symptoms:-

Burning, aching, tingling, stabbing or numbness in the thigh (one side). Pain occurs at lateral or outer thigh which may extend down to the lateral side of the knee. Pain worsens when thigh touched lightly and also in walking or standing for a long period of time.

Diagnosis

Diagnosis can be based on symptoms, physical examination and other tests like nerve conduction test of lateral femoral cutaneous nerve. MRI or ultrasound performed when the cause is a pelvic tumour or herniated disc. Painful inguinal ligament area where nerve crosses is found in physical examination and hair loss in areas of LFCN because they constantly rub this area.

Management

Medical management includes conservative treatment in which patients are advised to lose weight, wearing loose clothing and cold packs can be applied in painful areas. Medical management includes corticosteroids injections analgesic anti- inflammatory medication.Surgery is the last option which includes decompression and neurectomy.

Physiotherapy management includes various techniques which includes:-

  1. TENS (Transcutaneous Electrical Nerve Stimulation) is effective in painful neuropathy. Low-frequency TENS are used which activates the central mechanism to provide analgesic effects.
  2. Kinesio Taping which improves vascular and lymphatic flow, increase muscle function by decreasing pain and improves proprioception.
  3. Dry needling and Neurostimulation techniques are also used according to some researches.
  4. 30 minutes of daily exercise is found effective which helps in improving chronic pain and to increase endurance, stability, strength and flexibility.
  5. Weight loss advice in obese patients.
  6. Aerobic exercise, isometric exercise balance, manual techniques and mobilization.