Hello everyone! I am new to this resource and I hope that I can get some feedback on how to approach my Meralgia Paresthetica issues.

Here is my brief background:
- Diagnosed with Meralgia Paresthetica about 3 or 4 years ago. I am not overweight, in fact, I am normal weight (or a few pounds underweight)
- I was struck by lightning about 2 years ago, which made my MP worse
- I have tried many meds, including: dopa, neurontin, lyrica, and a few others. I ultimately ended-up using Exalgo, which did the trick.

I also have RLS (Restless Leg), which I have tried everything and ended up using 10mg of Methadon nightly... this is working perfectly.

My pain decreased in the Summer of 2013 and I got off the Exalgo, decreasing to Norco 10mg. I have since stopped using that full-time, but only using it when I travel or when it is way too cold outside (cold makes the MP much worse).

I am seeing my Neurologist next week and want to make some suggestions to help.

Recently, in the past 1.5 months, the pain has returned, moving from a constant 3 (I can deal with without meds) to a 5 or 6. I would like to NOT take norco, but it helps.

Any suggestions on what I should discuss with my doc next week about the increase in pain? Should I go back on a constant pain killer? When I was, I felt great. Should I have Norco all the time with Perc. when needed?

Any help is much appreciated.

Thanks!

I have had MP for decades. I have tried almost everything. Lidoderm patches would drop the pain intensity one or two levels at times but not very often. Using a TENS unit did not provide relief. Physical therapy was of no help. When the MP was constant, 24/7, my pain mgt. doc suggested direct nerve block into the LFCN. First one was great for the first few hours but the pain returned. Second injection helped- reduced my pain levels to 6 and 7. Third injection proved extremely helpful. Will be scheduling my next injection very soon.

Different treatments work differently on different people. Maybe pain patches, physical therapy, TENS unit, may be beneficial to you. Might be worth a try.

Let us know what you and your doctor decide and how you are doing.

Please search this forum: Lidoderm

Placement of Lidoderm patches is very important for success.

If your compression is in the lumbar area, placing them there would be the best. If not, and you have an abdominal compression, placing at the top of the thigh near the inguinal ligament would be best.

Placing where you "feel" the pain, will not work, I have discovered.
You have to intercept the nerve axons themselves, and not the dendrites in the periphery.

I have threads here with links to diagrams if you search the word
"Lidoderm" . The search function is at the top right of the first page of this forum.

You need to find your trigger... perhaps tight clothing is the culprit. Mine was a C-section with exploratory in the abdomen looking for an ovarian tumor. I had it for many years, and finally when Lidoderms came out, I tried them and they put me into a remission after 14 days of consecutive use. I can still be triggered by heat. So if you are using HEAT on your MP, please stop as it tends to stimulate nerve firing, which you want to decrease.

Good luck.

How to talk to your doctor about chronic pain

Those are the kinds of questions that may/should come up in the conversation with your doctor. No-one can feel your pain or how it affects you, one person's "7" can be another person's "3", and all that.... Is the pain constant 24/7, necessitating constant medication? The big potential downside with opioids (IMO) is, of course, ever-increasing tolerance.

I agree with identifying & avoiding/eliminating triggers, and adopting anti-inflammatory lifestyle changes as much as possible.

Chronic pain can be cyclical. The fact that you've gone through a period of reduced pain is encouraging if you can figure out why and make use of that.

Doc

Thanks for everyone's help. I have tried tens device with no success. Same with the patches mentioned. I still has some left but it doesn't do anything.

I was thinking of talking to the doc about increasing the methadone. Since I use 10 mg for rls nightly, I wouldn't have to move to another med. Maybe this could pull double duty for rls and the pain... Just not sure how much more is needed.

As a side note, I function fine when I am on meds... No side effects from the methadone.

I was doing some research and was even considering asking about the fent patches... If I moved to this, it would also work for rls, meaning no methadone needed.

Thoughts?

IMO, choice of medication(s) and/or dosage/increases are best left to your doctor for a variety of reasons. If methadone is working for you, does not cause intolerable side effects, and you are being monitored for cardiac arrhythmia/prolonged QTc interval, it may be the best choice for you (i.e. meralgia paresthetica).

* Fentanyl also binds primarily to the μ (mu) receptors.

Also...
Methadone does, however, have a longer half-life than other opioids, which must be understood and considered in order to avoid accidental overdose.

Aside from fentanyl's inherent risks, it is far more expensive (than methadone) and its delivery system (the patches) poses further complications/inconvenience; a pill is (IMO) just less hassle/mess.

Doc

Thanks... great info. I have my appointment tomorrow and will let you know what my doc decides.

Thanks!