You Ask , They Answer
Q
: What is meralgia paresthetica ?
A
: The nerves in the body send information to the brain about the environment in the form of sensory nerves , while motor nerves convey messages from the brain to activate muscles . To do this , nerves must pass over , under , around and through your joints , bones and muscles . Usually , there is enough room to permit easy passage .
Swelling , trauma , or pressure , however , can narrow these openings and squeeze the nerve . When that happens , pain , paralysis , or other dysfunction may result .
A painful , burning sensation on the outer side of the thigh may mean that one of the large sensory nerves in the legs , the lateral femoral cutaneous nerve , is being compressed . This condition is known as meralgia paresthetica .
Specifically , symptoms include pain on the outer side of the thigh , occasionally extending to the outer side of the knee , and a burning sensation , tingling , or numbness in the same area . Occasionally , there may be aching in the groin area or pain spreading across the buttocks . This usually happens on only one side of the body . The affected area is often more sensitive to light touch than to firm pressure .
Q
: How is it diagnosed ?
A
: During a physical examination , I would ask about recent surgeries , injury to the hip , or repetitive activities that could irritate the nerve . I would also check for any sensory differences between the affected leg and the other leg . To verify the site of the burning pain , I would put some pressure on the nerve to reproduce the sensation . The patient might need both an abdominal and a pelvic examination to exclude any problems in those areas .
X-rays will help identify any bone abnormalities that might be putting pressure on the nerve . If I suspect that a growth , such as a tumour , is the source of the pressure , I might ask for an MRI or CT scan . In rare cases , a nerve conduction study may be advised .
Q
: How can it be treated ?
A
: Restrictive clothing and weight gain are two common reasons for pressure on a nerve , so I might ask the patient if they wear a heavy tool belt at work or if they consistently wear a tight corset or girdle . Another cause might be a seatbelt injury from a motor vehicle accident . I might also recommend a weight loss programme .
Treatments will vary , depending on the source of the pressure . It may take time for the burning pain to stop and , in some cases , numbness will persist despite treatment . The goal is to remove the cause of the compression . This may mean resting from an aggravating activity , losing weight , wearing loose clothing , or using a toolbox instead of wearing a tool belt . In more severe cases , I may give the patient an injection of a corticosteroid preparation to reduce inflammation . This generally relieves the symptoms for some time . In some cases , surgery is needed to release the nerve .
Dr Prem Pillay
Dr Prem Pillay is the director of the Singapore Brain Spine Nerves Center and a specialist in neurosurgery and spine surgery .
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8 AUGUST 2021 GlobalHealthAsiaPacific . com