Hi all, newbie here.
I stumbled onto this site and a thread by mrsB on Lidoderm patch placement(can't post the link with less than 10 posts), while Internet searching for info on Meralgia Paresthetica, and possible treatments such as Lidoderm patches. (Thanks mrsD, that thread is most informative).

A little background on my condition:
I had problems with my right leg for at least 10 years.
Initially thought to be a probable case of sciatica, a full pelvic X-ray 2 years ago revealed the true problem to be a very advanced case of osteo arthritis in the right hip. The ultimate solution occured on April 13 this year with a total hip replacement.

While my new hip works like a million bucks, the surgery has left me with bi-lateral MP. This first evidenced itself about a week post-op with the cessation of Lyrica/Celebrex combo therapy, which apparantly is part of the program given to joint replacement patients at the place I had this done.
At it's worst, I've awaken in the morning to level 10 pain - severe stabbing pain in the thighs, bad enough to make me shout out involuntarily. This has happened only a few times though, and not happened since I started sleeping in a recliner rather than a bed.
Most of the time it feels like I have abrasions on the top of my thighs, or put another way - like the inside of my pants are lined with sandpaper, I would deem level 2 -4 pain, which is bearable but annoying.

I am considering trying the Lidoderm patches and found the tips in mrsD's thread to be very informative.
I have a question though - in reading product info on Lidoderm it lists beta-blockers ( I take 5 mg Atenolol 1 X Day) as a possible concern - does not seem to forbid using both but states must use caution. If anyone reading this uses both a beta-blocker and lidoderm patches, I would like to hear of your experiences.

Lidocaine can affect the heart. Since beta blockers slow the heart down, this may be more of a concern for those patients.

I think you should discuss this with your doctor who prescribed the beta blocker. If you take the beta blocker for blood pressure, then switching to an ACE inhibitor might be an option.

Your doctor may recommend using 1/2 patch to start. To see if you tolerate it. I certainly myself would not use the max of 3, as suggested. I've never used more than one at a time.

MP pain can be horrific... stabbing intense, etc. I never had sandpaper sensations, I had a feeling of water running down my thigh instead. Mostly numb alternating with sharp pain, later.

I wonder why you have MP in both hips. Did the surgeon offer any clues?

My MP rarely affected me at night. Extending the leg, walking, would trigger it. Bikes would trigger it. Heat would trigger it. etc. Standing at work was very difficult at times.

Alot of things can happen to people during surgery. Sometimes nerves get compressed by the position they put you in. I think having the MP in the non-surgical hip is odd. Did you have a spinal for your anesthesia? This might be traceable to that part of the procedure.

I am heartened that my post brought you here. I hope it helps others the same way.

You won't know if Lidoderms will work for you unless you try them. But discuss it carefully with your doctor first. I know they have "saved" me great discomfort. I had that MP for almost 20 yrs, and the last 5 of them were horrific (as it got worse and worse). I still have it, but it has been quiet for a while now. Every once in a while when I get in the car, and stretch that leg, I get a twinge, but it does not last, thank goodness.

Thanks for the response mrsD,

My apology for the slow follow up to your comments and questions,
I had attempted a rather long post to follow up and something happened to make me lose the work when I went to preview post, I was out of time and had to give up, and haven't managed to get back until now.

Anyhow...
RE the bi-lateral MP,
My surgeon hasn't had much to say on this, other than acknowledging it's less common. My own theory has to do with being overweight. This was an issue before surgery, when it was evident I wasn't going to fix this (I was gaining rather than losing - my advanced hip arthritis left me unable to exercise much, which I rely on) he agreed to do the surgery with the understanding that complications would be a greater possibility than with a procedure on someone at their ideal weight.
I think it's possible a nerve got compressed on the side I was supported on while the operation took place, and the operated side (the incision - 42 staples! is almost opposite of where I must have been supported) feels like a big knot where I was cut. So I'm sure there may be some compression there as well.

RE Spinal anesthesia,
They attempted to do a spinal on me (as they say they like to do with most cases) for quite a while and failed. They eventually gave up and I was given general anesthesia. Whether the failed attempts could have had an effect on the MP I don't know - but I suppose it's also a possibility.

In more recent times, the MP has been rather stable but constant, with a general sense that it is VERY slowly improving. I have now moved back into a bed for sleeping at night, and have not had any more of the intense stabbing. But I have noticed the sensation of water trickling as you mention, I feel this mostly at night as I try to lay still, and it's quite annoying (and deprives me of some sleep). In the daytime the abrasion-like soreness in the thighs is still there, but at a low enough level that I am able to put it out of my mind as long as I'm busy.

My last follow-up with the surgeon, he agreed that Lidoderm patches might be helpful and gave me a prescription. ( I was shocked at the cost!)
I have since also had follow up visits with my GP, and the cardiologist (who had to give a stress test for clearance for the surgery) - and I explained about the caution suggested in manufacturer info. Neither one deemed the combination of using a beta-blocker and Lidoderm patches to be much of a concern, so I started using them (with an antennae up for possible reaction, of course).
I started with one, cut in half and placed on each side. They didn't seem to either harm or help that much. So I started trying different placements, and have moved to 2 patches total.
I have a relative who is an RN who advised me to keep using them, and I might see better results over time. So, the last few days I've been placing them right on the sides (where I would have been supported, and opposite side right over the incision site). I do not notice any sort of immediate relief - but seem to notice an improvement in later hours after they're off - don't know if this is a placebo affect or a real affect, but I do have a sense that I am improving (very slowly) as I said.

Hopefully others who have had any of these kind of issues may see this topic and chime in, would be interested to hear of others experiences. I'll post if anything changes with me, for better or worse. Thanks to this forum for giving me a chance to chat on this.

Typically Lidoderms don't work over incision sites, or where one feels the pain. They have to go higher, to intercept the signals before they get to the spine. I cut mine in half and put each half on the thigh where the groin ends and thigh begins. One to the side in front (lengthwise) and the other near the center of the body where the other nerve exits. I don't know where your incision is?
Figure 2B at this link:
http://www.aafp.org/afp/20000401/2109.html
Shows the two nerves coming out of the abdomen. And the spinal exits too. This should make placement easier, if it is really MP and not some other issue like bursitis, etc.

I put mine in my groin on that side where the nerve exits the abdomen. You might have to go up near the L4 where the nerve comes out of the spine.

If you lose posts due to timing out, there is a fix for that.
When you log in there is a little box called "remember me" next to where you type in your userid. Check that box.
Sometimes people use preview post and then forget to hit
SUBMIT after that. That is another way to lose a post.
If preview is confusing you, just submit it. You can edit any time up to 24hrs as you need to. I never use preview. But I do edit alot fixing spelling and grammar!

"Typically Lidoderms don't work over incision sites, or where one feels the pain."

I understand the basic gist of what you're saying here, but I seem to be just a little confused about the exact placement. When you say groin, it makes me think more towards the inner thigh, the 2B illustration seems like the lateral femoral cutaneous nerve is located more towards the outer part of the thigh?
I wasn't sure if the places I have tried were going in the best place, and they probably weren't.
My insision site is partly across the buttock and extends to the very outside top of the thigh, just about where one might be bearing weight if sleeping on their side, and not too far off from the way I see the illustrated nerve (If I'm reading it right), just a little lower and more to the outside. I need to keep working on this, and I think I'd also like to try the L-4 area next, which I haven't tried yet.

Since these worked for you, I was wondering how long after a patch was placed did it provide noticeable relief?

I suppose I should also consider the possibility of the condition being other than MP, but from everthing I've searched thus far, the descriptions of MP match very well with what I'm experiencing - which has varied from starting out as tingling, numbness, and itching - to the stabbing pains - sensitivity to light touch - and recently to the water trickling sensation - all in the front and outside areas of both thighs.

Also appreciate the tip on "remember me?"
Didn't realize you could time out.
Last post I copied with right click before I hit anything - glad I did - because I must have timed out like the last time - as soon as I hit preview post I got a message saying I wasn't logged in, and all was gone. I was able log in and paste it back right away. Heh - I'll get this place figured out eventually!

I used the Lidoderms every day for 2 weeks...it was about then that the trouble started abating.. I used them for a bit longer, but not a whole month, to see what would happen.

It is possible there is complex nerve damage in your hip area.
So one location may not be the solution to the surgical side.

But the other side should be different in some ways.

I only get little twinges now... I haven't had to use them for MP for over a year now. Heat is very bad and will activate it. No steam rooms and no heating pad for me!

I use the Lidoderms for other things too.. my bad knee, and my tendon injury in the other leg. But not really that often. I've used 1/2 patch on the top of my feet but they don't really work well for PN I have found. Mostly for my arthritis and MP they have been very effective.

You have to be willing to experiment with them. On my Lidoderm thread I have a link to a 3D anatomy graphic to help you with placement ideas. Don't be afraid to move them around for best results for your specific problem. It might be you need them on your back at L4 since the surgery may have upset the nerve higher on YOU than was the case for me, which was abdominal/ C-section surgery. Not all MP is the same for everyone. Each has their own trigger and compression site.

Hi mrsD. Do I understand you correctly that the lidoderm patches don't help PN? I've been thinking all this time that PN is what you were saying to use them for, and have been really frustrated with trying them on various spots with no results. Are you saying that I'm wasting my time if all I want is PN relief (burning, stabbing in feet)?

I don't use them on my feet typically.

I use them when one nerve is acting up. And for those with
targeted nerves, they may help. But the all over burning is all over, and hard to find the right spot to apply. I've tried them on the tops of my feet a few times, when I was desperate, but they didn't work well for burning.

But when the left ankle starts up, I get a sharp pain along the inner bone, I sometimes put a Lidoderm there.

For pain emanating from the spine, you can intercept the nerves on the lower back. I've used mine for my knees (behind the knee), for a tendon groin injury, and the MP in my right thigh.

When people come on here and state their EMGs have targeted a specific nerve, that is when Lidoderm patches may have a target to work on. They are very expensive, so you want to place them in the best position to get results.

I have a thread that shows the nerve distributions in the body, which may help illustrate this problem.
http://neurotalk.psychcentral.com/sh...light=Lidoderm

Some people try putting them on the bottoms of the feet, but I don't think that is a very useful location. The feet are tough to deal with patch-wise.

Thanks mrsD. I have a supply of the patches, and have tried and tried using them for the burning on the bottoms of my feet, tips of toes, and just under my ankles, which are the spots where the burning is sometimes unbearable. Never even put a dent in the pain. I also have the burning on various parts of my legs all the way up, but not as bad, so I never bothered targeting them.

So far I've also tried pretty much all the supplements mentioned here, Biofreeze, Capsaicin, Salonpas, and various pharmaceuticals that we've all talked about. But the only thing that has reliably given me relief is Ambien, which I can't be taking in the daytime for obvious reasons. Just wish they could make it with the pain killing part but not the sleepy part.

Try the patches in the lower sacral area, if you have some left.
That seems to be the only spot not on your list. The fact the alot of the legs is affected, might be that intercepting the nerves in the lower back may help. Give the patches at least 3 days to get going too.

When I hurt the tendons in my left leg from a fall, the lower back placement gave me some relief. Not 100% but at least I could move and roll over in bed, which at that time was impossible.
That injury was the "most painful thing" I've every had!