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Old 12-04-2014, 02:20 PM #1
zygopetalum zygopetalum is offline
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Smile meralgia paresthetica

I hope I spelled that right. I know someone who could really use some help with that and I can't figure out how to direct her. Is there a forum I am not seeing? I found a thread on page 2 of General Health conditions and Rare Disorders and on it Lara posted a link to what looked like a forum for MP?

Thanks,

Judi
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Old 12-04-2014, 03:01 PM #2
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Hi there Judi!

It's hiding in Other Diseases & Concerns. There's a whole groups of forums in there.

Other Diseases & Concerns Subforums

Meralgia Paresthetica Forum

Hope that helps.
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Old 12-04-2014, 04:25 PM #3
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Thank you, I will try to get her here. She is really having a hard time.

judi
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Old 12-04-2014, 05:43 PM #4
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Lightbulb

I had this for several years following a C-section.

I have posted on that forum my experiences.... with Lidoderm patches.

But every cause of MP is different. And sometimes it is even misdiagnosed. (the femoral nerve being affected, instead of the lateral femoral cutaneous nerve).

So patients should research this problem carefully. Damage to the spine where the nerve exits the spine and enters the abdomen, is one cause. Damage there will give MP symptoms.
Also damage when it exits the abdomen or in the abdomen itself are other causes. Placement of the Lidoderm patches therefore is critical depending on the trigger and anatomy.

Damage can come from wearing tight blue jeans, or girdles.
Wearing tight belts or other clothing. For males, sitting on their wallets in the back trouser pockets, diabetic neuropathies. Falling on your back/buttocks, having a bone marrow biopsy, or donating marrow...places the needle in that area and may damage the nerve. All sorts of things can be triggers.

Mine was surgical. But even though I have a remission of sorts, it will flare if I sit in hot water for any bathing, or steam room, or use a heating pad. This will flare even today, but it is a much smaller issue that before. So I would caution to avoid heat stimulation to the nerve. That forum has the link to AAFP:
http://www.aafp.org/afp/2000/0401/p2109.html

Figure 2B shows the proper nerve distribution. (the femoral nerve is shown also in a different placement closer to the midline of the groin.)

MP can be confused with bursitis in the hip, also.
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Old 12-04-2014, 08:13 PM #5
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She was diagnosed by an MD and is seeing an neurologist. I hope she does come, I told her you guys know everything about neurological issues...you do.

judi
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Old 12-05-2014, 11:18 AM #6
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Hi Judi,

To add to mrs D's comments. MP can be a temporary problem that may resolve on its own or in some cases become a life-long problem. I happen to fall into the life-long category. It can also be intermittent or constant.

I have heard of many cases that were undiagnosed and/or misdiagnosed, also.

Please have your friend tell us some more about her symptoms, longevity, etc. if she is willing to share that information with us.

This condition affects ONLY the sensory nerve of the skin in the thigh region only. If any other part of her leg is affected or if there is any muscle involvement, it is not MP.

Please do not misunderstand when I say "ONLY" sensory because that can be extremely painful even though it does not affect muscles. The person is "capable" of movement but will resist certain positions like standing or walking due to the pain produced by those activities.

This condition can come and go throughout the day or become constant. Sometimes the pain can happen only occasionally for a short time and go away for weeks.

Severity and longevity vary. Treatments for MP also differ and are some times dependent upon the nature, cause. and extent of damage to the LFCN. (lateral femoral cutaneous nerve)

The good news is that many prior sufferers are no longer posting on NT as they have recovered. There are just a few of us left that continue in the life-long category.

I will be happy to discuss MP further with you or your friend if desired.
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Old 12-06-2014, 12:48 AM #7
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Thanks Hopeless. She is someone from a COPD forum, I hope she comes. I think she said she got it during pulmonary rehab riding a stationary bike. It seems like it has been going on awhile and if I remember correctly the pain is on the outside of her thigh. They just started her on Gabapentin. I should probably wait and let her post, that's all I know anyway.

You guys know everything about nerve stuff.

judi
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Old 12-06-2014, 06:47 AM #8
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Quote:
Originally Posted by zygopetalum View Post
Thanks Hopeless. She is someone from a COPD forum, I hope she comes. I think she said she got it during pulmonary rehab riding a stationary bike. It seems like it has been going on awhile and if I remember correctly the pain is on the outside of her thigh. They just started her on Gabapentin. I should probably wait and let her post, that's all I know anyway.

You guys know everything about nerve stuff.

judi
Hi Judi,

Thanks for the response. It sure does sound like MP. Riding the bike could certainly be the aggravating factor of the LFCN and Gabapentin is often a treatment offered. Also, the location of the pain is definitely the area for MP.

Whether your friend decides to post on the MP forum of NT or not, please be sure to extend my best wishes to her for a speedy recovery or remission from the pain of MP.

In my opinion, since it appears the bike is what irritated the LFCN, there is a good possibility that avoidance of that activity combined with some time for the nerve to calm down from the irritation, she may have a spontaneous resolution. In some cases, physical therapy is beneficial but in other cases PT may further aggravate the nerve.

Many times various treatment modalities are attempted to find what will work for a particular case of MP.

Thanks for contacting us. Wishing your friend a spontaneous resolution.
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Old 12-06-2014, 08:55 AM #9
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Lightbulb

This person is also a candidate for trochanteric bursitis...which is often treated with a steroid injection.

If NSAIDs or aspirin make the issue better, it may be that and not really MP.

Upright bicycles also place strain and compression in the seat area, and can lead to all sorts of pelvic generated pain.

The lateral femoral nerve does not go down the buttocks to get compressed. It goes thru the abdomen. But the sciatic nerve does go thru those muscles in the buttocks.

The pain of MP is usually shooting and stabbing and can vary from numbness (in between stabs), to searing pain if a lightning shot stab persists. If there is no numbness at all in the front of the thigh, and only pain along the sides, I'd get evaluated for trochanteric bursitis. My MP did not present down the side....it was all in front with the worst pain in FRONT and only a bit
reaching the side. Prior to the worst of it, it began with a sensation of water running down my leg. The severe pain developed later, and the water sensation stopped and was replaced by numbness. Today the numbness is not really there but occasionally I do get a bit of it. This is a warning to me to avoid heat stimulation of any kind.
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Old 12-06-2014, 08:10 PM #10
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MP can present in various manners. Several people have been diagnosed with MP and come to the forum for support. Many have been misdiagnosed and that became evident when they further described their symptoms stating things like the pain runs down into my lower leg and calf area. That is a flag that MP was an incorrect diagnosis as MP would not cause pain in their calf area. Another poster diagnosed with MP stated weakness in their leg. Another flag for mis-diagnosis as MP does not affect muscle and does not cause "weakness".

MP can show up on the side of the thigh or front of the thigh or both. Symptoms could include burning pain like a hot poker, ice cold like a block of ice being held on the thigh, numbness, electrical shocks like being hit by a bolt of lightning or a stun gun, and a few other symptoms. The person may experience only one symptom or many symptoms. Another symptom is feeling extreme sensitivity in the affected area. The slightest touch of something on the area will produce painful sensations.

Many times, the ligament over the iliac crest will rub against the LFCN, irritating it and be the cause of MP. Compression of the LFCN at any point along its course may result in MP.

If any of the symptoms appear in areas other than the anterior or lateral thigh, it is not MP. (Unless the patient has MP AND another neuropathy simultaneously.) I am guessing that a person could be afflicted with both MP and another "leg" neuropathy such as sciatica which produces pain in the buttock area and back of leg.

Just out of curiosity, does the person engage in any particular activity that will precipitate an episode of pain? Standing was my first precipitating activity. Then walking became one. Sitting would resolve the pain in the first few years but as the LFCN became more damaged, it did not take any precipitating activity and sitting was no longer a resolution. With continual damage to the LFCN, it became constant even when sleeping.

There are a few "key" symptoms that would direct a physician toward a diagnosis of MP, but there are also many symptoms that would also rule it out.

Many physicians have failed to diagnose MP and many have also provided a diagnosis of MP incorrectly. I have also encountered physicians that have never heard of Meralgia Paresthetica.

There is also no one size fits all treatment for MP. If the gabapentin does not work for your friend, please have her seek alternative modalities of treatment until she finds one that will provide relief. There are several options including physical therapy, TENS unit, Lidoderm pain patches, oral medications, nerve blocks, radio frequency ablation, modifications of aggravating factors, and as a very last resort surgery. And spontaneous resolution is always a possibility.

Thanks for trying to help your friend. MP can be very painful.
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