Hello, I have just joined this site to get some info for my daughter, she is 16 and has MP diagnosed since 12. She also has apophysitis of pelvis which appears to be slow to settle despite her being 16.5 years old now. The combined problem has led to her stopping all sports since diagnosis and is severely affecting her life, we were told at initial diagnosis that it would go away as soon as her growth plates were formed but that's not the case at all. She has always described her pain as being consistent with MP and had a positive nerve block aged 12 also. At this stage, I'm no longer happy to accept this reduced quality of life for her, it stops her taking part on days out, holidays, trips away and anything which involves lots of walking/standing or impact activities. She is not happy to take medication and I can understand why, she initially was on the gabas and older TCA's and had all the horrible side effects too, her consultant is still treating it conservatively but I don't think this is okay at this stage in terms of her quality of life. My question is, is nerve decompression suitable at this stage and is that the same as severing the nerve ( I understand this is also an option as it's a superficial/ sensory nerve) and is this usually carried out by a neurologist or an orthopaedic surgeon? Thanks in advance.
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Originally Posted by drp.
I recently read your post regarding a nerve block for meralgia paresthetica. I am a Harvard-trained plastic and peripheral nerve surgeon and also use nerve blocks to help in the diagnosis of this condition. However, in my hands, the nerve block is as diagnostic test, not a treatment modality. In other words, if the physical exam suggests MP and there is a positive Tinel sign on physical exam, that to me is a sign of peripheral nerve compression (just like carpal tunnel syndrome). If the patient responds positively to a nerve block they are a candidate for a decompression procedure to hopefully give them more permanent relief. This procedure is done as an outpatient and often takes less than two hours. As you know, meralgia paresthetica (compression of the lateral femoral or lateral femoral cutaneous nerves is a condition which results in a lot of anterior and lateral thigh (sometimes buttock) pain. Most people do no know this it can be very successfully treated with decompression surgery. It is a procedure I have performed on more than one occasion. In fact, I presented my results with this very procedure at the California Society of Plastic Surgeons Meeting last May. In that series of patients, the pre-operative pain intensity score was 9.4/10 and post-op was only 1/10.
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