Meralgia paresthetica, also called Bernhardt-Roth syndrome, is caused when one of the large sensory nerves (lateral femoral cutaneous nerve) to one of the legs is being compressed. This compression results in a terrible burning sensation felt in the outer thigh. It is characterized by tingling, numbness, and burning pain in the outer side of the thigh.
The femoral nerve is a part of the lumbar plexus nerve network. The femoral nerve works to provide nerve innervations to the flexor muscles of the hip and the extensor muscles of the leg. It provides sensation to the anterior (front) of the thigh.
The lateral femoral cutaneous nerve is part of the lumbar plexus nerve network. It provides sensation to the antero-lateral aspect of the thigh and has some overlap in sensation with the femoral nerve. As a pure sensory nerve, it does not operate any muscles.
Nerve compression can arise from swelling, injury, tight clothing, weight gain, and certain types of physical activity. In most cases, addressing the cause of the meralgia paresthetica will prevent any complications. Left untreated, however, meralgia paresthetica may lead to serious pain or paralysis.
Usually, meralgia paresthetica will resolve itself spontaneously or with lifestyle modifications such as wearing loose clothing. In cases in which meralgia paresthetica is painful, antiseizure or antidepressant medications that target the nervous system may be used. In extreme cases of meralgia paresthetica, surgical intervention may be necessary to release the compressed nerve.
Causes
Meralgia paresthetica is caused by nerve entrapment. The lateral femoral cutaneous nerve running through your pelvis, groin and into the thighs becomes compressed. This can be caused by swelling, trauma, or pressure narrowing these openings and squeezing the nerve.
Common causes of meralgia paresthetica may include –
- Repetitive motion of the legs
- Recent injuries to the hip
- Wearing tight clothing
- Weight gain
Risk Factors
The following conditions may increase your risk of meralgia paresthetica –
- Extra weight – Being overweight or obese may increase the pressure on the lateral femoral cutaneous nerve.
- Pregnancy – A growing belly puts added pressure on the groin, through which the lateral femoral cutaneous nerve passes.
- Diabetes – Diabetes-related nerve injury can lead to meralgia paresthetica.
- Age – People between the ages of 30 and 60 are at a higher risk.
Symptoms
A painful, burning sensation on the outer side of the thigh may mean that one of the large sensory nerves to your legs–the lateral femoral cutaneous nerve is being compressed. This condition is known as meralgia paresthetica.
- Pain on the outer side of the thigh, occasionally extending to the outer side of the knee
- A burning sensation, tingling, or numbness in the same area
- Occasionally, aching in the groin area or pain spreading across the buttocks
- Usually only on one side of the body
- Usually more sensitive to light touch than to firm pressure
Treatment
Conservative treatment is effective for most of the patients and helps in getting rid of the pain within a few weeks to months. Conservative measures include –
- Wearing loose clothing
- Losing excess weight
Over-the-counter pain killers such as acetaminophen (Tylenol) ibuprofen (Advil, Motrin) or aspirin help in relieving pain.
Corticosteroid injections are given in severe cases, where the symptoms persist despite conservative treatment. These injections help in reducing pain and inflammation. Side effects of corticosteroid injections include pain and whitening of skin around the site of injection, infection of the joint and nerve damage.
Tricyclic antidepressants also help in pain relief. Side effects include dry mouth, drowsiness, constipation and impaired sexual functioning.
Anti-seizure medications such as gabapentin (Neurontin) or pregabalin (Lyrica) also help in alleviating symptoms of pain. Side effects include nausea, dizziness, constipation, drowsiness and lightheadedness.
Surgery – Rarely surgery is required in severe cases where the patient has persistent symptoms for a long time. Surgery is done in order to decompress the nerve.
Lifestyle changes such as avoiding tight clothing, avoiding standing or walking for prolonged periods of time, maintaining a healthy weight and losing excess weight helps in preventing and relieving meralgia paresthetica.
Alternative Treatment
Vitamin B12 supplements help in reducing burning and tingling sensation. Increase the intake of meat, egg and poultry products.
Physical therapy is considered useful in relieving the nerve entrapment. Physical therapy attempts to strengthen the muscles of the thigh and inner hip region to reduce the entrapment.
Obese individuals are at a higher risk of developing this condition and hence weight management is considered very important. Regular exercise coupled with dietary modifications like reducing the intake of processed foods, oily and starchy foods and increasing the intake of dietary fiber is very useful.
Electrotherapy is also considered beneficial in reducing the nerve blockage and alleviating the symptoms. Electrotherapy focuses on stimulating the nerve tissue and alleviating the symptoms associated with the condition.
Alfalfa is a nerve tonic and helps in alleviating the symptoms associated with the condition.
Reference –
http://www.brainfacts.org/diseases-disorders/diseases-a-to-z-from-ninds/meralgia-paresthetica/
http://curingmeralgiaparesthetica.com/mp-book-long-landing-page
http://www.fpnotebook.com/ortho/neuro/MrlgPrsthtc.htm
http://www.healthline.com/health/fitness-exercise/meralgia-paresthetica-exercises
http://orthopedics.about.com/od/hipinjuries/a/meralgia.htm
http://emedicine.medscape.com/article/1141848-overview