Meralgia Paresthetica?
 

My neurologist says that is what I may have. She is running a bunch of blood work to rule out diabetes and other possible conditions.

I have severe burning on the outside of my left leg from my hip to my knee. I also have constant numbness in the same area. I have had an EMG on my back and the nerves are fine there. I have not had an MRI yet. I also have tarsal tunnel in both feet. So my neurologist was also thinking I have have phepheral neuropathy but I don't think so.

For the Meralgia Paresthetica, I don't wear tight clothes or anything so it must be a compression or entrapment of the nerve somewhere.

Does anyone have any experience with this? I have tried to research it but I am having a little trouble finding good sites that explain it well.

Thanks in advance for the replies!

MP involves the front of the thigh mostly, but some side pain may occur too. I never had the side pain, myself, only the front of the thigh.

Side pain, along the side of the upper thigh may be connected to trochanteric bursitis. This is typically treated with an injection of steroid into the bursa of the hip.

This link shows the distribution of the lateral femoral nerve. It is
Figure 2b.

If your pain is more in the knee area, that could be an inflamed meniscal ligament or nerve. One diagnostic sign of meniscal nerve inflammation is pressing a point on the lateral side of the knee. (I had that test when my knee dislocated).

I found Lidoderm patches just about curative for my MP.

My experience is here:
http://neurotalk.psychcentral.com/thread124259.html

This is our MP forum:
http://neurotalk.psychcentral.com/forum76.html
many different experiences there.

Thank you for the information. As it turns out, I do have a lot of pain in my left hip. I am a runner and the more I run the worse the hip pain gets. So I am down to only being about to run 2 miles and still walk. I never connected it bursitis but that is a good idea. I can't believe I have 3 doctors working on this and none of them can come up with anything!

Only 3 doctors? That's not too bad...heheheheheh.

At PN people go to many more than that.

So read that link...I think it is very helpful. My MP came following a C-section. I had a shot of Phenergan/demerol in that thigh in recovery, and I think that is what damaged the nerve.
(later legal wranglings have found Phenergan damaging when injected.)

I can still feel it when I over stretch that leg...so I don't. Also heat activates it so I avoid (can't do a steam room anymore).
But the searing pain and stabbing attacks stopped when I used the Lidoderms every day for 14 days, in the upper thigh area where the nerve exits the abdomen.

You can test your pain, by taking Aleve... 2 at a time, or any other RX NSAID...if you get some relief...that would point more to bursitis. The nerve pain of MP however is highly resistant to most oral meds IMO.

If you have good insurance I'd try the Lidoderms...put them high on the thigh, not where you "feel" the pain. Catching the nerve higher up works better. (doctors don't know how to use or apply Lidoderms either).

I have the Lidoderm patches but haven't tried them yet. I will try them today over the hip area because that seems to be where it starts. I also take Neurotin 400mg three times a day which helps a little.

The worst is when I lay flat on my back with my legs straight out. If I bend my knees up it gets a little better. And wow, I thought it was crazy to have 3 doctors working on this!

Does anyone have experience with the cortisone shots? I was wondering if they worked for the nerves or not. I came across it in my research but it wasn't very clear as to whether it worked or not.

When my knee was terrible about 8 yrs ago, after all the MRI and Xray business, the "suspected" tumor the Ortho thought I had was not there. So he gave me a Steroid+ Marcaine (like lidocaine) injection into the top of the knee on the femur side.

It did stop all my pain for a while.

The steroid shots work in joints acutely and last a month or 2.
If the problem resolves, that is nice. But if whatever is causing the problem continues, well, then they wear off. My knee shot fixed my severe pain back then. That did not come back. It was some kind synovitis inflamed from the knee strain when it dislocated.

That link I gave you shows where the bursae are in the hip.
It is also possible, if you have had a fall on the hip or have taken prednisone orally in the past, that you have some necrosis of the bone going on. I had a patient who fell on her hip playing tennis, and it started a cascade of hip bone loss and she had to have a hip replacement at 45! People can get this slow necrosis also from steroids. It is a rare but potential risk.
People with asthma, or other allergic things, get those Medrol dospaks, and may later get hip deterioration. Not common but it does happen. If you have low bone density, it can also be a risk in younger patients. (this is called osteopenia).

But most things are bursitis, or strain from running. If it were me? I'd give up the running for a while until you heal up.

I don't think steroid shots work at all for MP. That is a nerve malfunction, or compression, not inflammation.

Thank you so much for all the information you have given me. I have stopped running and the pain in the hip is going away. It seems whenever I try to increase my exercise the hip starts to hurt. I did take a steroid pack and it didn't do anything. I have never injured the hip that I can remember. I am 34 and would hate to think I have arthritis already but that is a possibility. I did check out both links and will post in the MP forum as well. Again thank you so much for all your help!

You are welcome.

Also you may have some tendonitis there. The hip is pretty complex with lots of ligaments holding it together.

Some antibiotics called fluoroquinolones (Cipro and Levaquin, Avelox) can cause tendon injuries or ruptures even long after use.
Up to a year! People get bronchitis etc, take Cipro or Levaquin and rupture Achilles tendons doing nothing extreme months later. Any tendon can rupture with these drugs!

If you had MP, you would have pain even after stopping the running. MP does NOT stop hurting when activity level changes.
There are studies with Lidoderm and pain relief in the knee. Those studies found results comparable to Celebrex RX NSAID.
So the Lidoderm may work for you. I am not sure it can penetrate to the deep bursae in the hip though.

If you have any problems with the Lidoderms, you can PM me anytime, as well.

treatment for MP
 

Skully,

As you know meralgia paresthetica (compression of the lateral femoral or lateral femoral cutaneous nerve) is a condition which results in a lot of anterior and lateral thigh (sometimes buttock) pain. What most people do not know is that this condition can be very successfully treated with decompression surgery (just like carpal tunnel syndrome) and is a procedure I have performed very successfuly on more than one occasion.

A nerve block in my hands is only meant to numb the nerve as the local will obviously wear off in a few hours. Thus, for me it is a diagnostic test, not a treatment modality. In other words, if a person has a good history and physical exam consistent for MP and a good result with the nerve block, they are a candidate for the decompression procedure which could possibly provide them with permanent relief (just like in carpal tunnel syndrome). This procedure is done as an outpatient and takes less than two hours in the majority of cases. People retrun to their daily lives right away with the only restriction being that they refrain from strenuous activity for about one month. 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.
drp.

Barry
 

Hi Scully,

Have you considered TFL / ITB hypertonicity +/- tendinopathy of TFL ?
What is you gait like? Do you have technique challanges with your running? How do your shoes wear?

I feel you would find it worthwhile to get a consultation from a sports Chiropractor before surgery. Prefferably one that also is a runner.
Surgery is your last resort. It may be a combination of poor technique with under-lying limbo-pelvic dysfunction.

Keep asking questions until you are satisfied and gain understanding.

Cheers, Barry.