Meralgia Post-Surgery Video

Here’s a Meralgia Post-Surgery Video

The last resort for meralgia sufferers is usually surgery (which is pretty thoroughly discussed in Curing Meralgia Paresthetica) so here’s a conversation between a surgeon and patient after the surgery:

Dr. Williams: We are now approximately 6 months from a removal of the left lateral femoral cutaneous nerve. And the lateral femoral cutaneous nerve effects the outside of the thigh here. Can you tell me what kind of pain you are having prior to this operation?

Male: It’s almost impossible to tell you how severe the pain was. I’ve never experienced anything like it.

Dr. Williams: And what was the cause of that pain, do you remember?

Male: My belief is it got damaged during surgery when they replaced my left hip.

Dr. Williams: Okay.

Male: And the doctor never admitted to that, but it doesn’t matter, I just had to get the pain. And to be honest, Dr. Williams, I’ve told you this several times, if it weren’t for you, I don’t think I’d be alive today. I couldn’t take the pain.

Dr. Williams: Okay, so your pain was pretty bad?

Male: The worst I’ve ever felt in my entire life.

Dr. Williams: And give me an example. Were you able to wear pants or touch your leg or anything.

Male: No it was like my leg, like somebody poured lighter fluid on my leg and light it. It was like intense heat.

Dr. Williams: Okay.

Male: And I couldn’t even put a wet washcloth on it for any length of time because the weight of the washcloth hurt the nerves and I would take the washcloth off and the pain would come back. There was no hope. There was nothing.

Dr. Williams: Okay.

Male: Until I really came to see you.

Dr. Williams: And 6 months ago we removed that nerve and what differences did you notice?

Male: When I came out of anesthesia, after you removed that nerve, I could tell that the pain was gone. There were still some residual effects that have been aggravated but it was immediate.

Dr. Williams: And compared to before surgery, what level of pain do you have now?

Male: Zero.

Dr. Williams: Zero pain?

Male: It’s unbelievable.

Dr. Williams: And we do remove a nerve, so do you have a lot of numbness in your leg or was it already numb before surgery too?

Male: No, I don’t have as much as numbness as you told me I would have.

Dr. Williams: Okay.

Male: I don’t know, I still feel pressure fine. Heat and cold to some degree. It doesn’t bother me at all.

Dr. Williams: Very good.

Male: So it’s better than I anticipated.

Dr. Williams: Alright, very well, thank you so much.
Male: Thank you.

Meralgia Paresthetica Surgery

Is Meralgia Paresthetica Surgery For You?

Surgery for meralgia is a last-ditch strategy. When all else fails, people start giving serious thought to having their LFCN cut. Here’s a video and transcript of a post-surgery meralgia patient and his doctor:

and here’s the transcript:

Dr. Williams: We are now approximately 6 months from a removal of the left lateral femoral cutaneous nerve. And the lateral femoral cutaneous nerve effects the outside of the thigh here. Can you tell me what kind of pain you are having prior to this operation?

Male: It’s almost impossible to tell you how severe the pain was. I’ve never experienced anything like it.

Dr. Williams: And what was the cause of that pain, do you remember?

Male: My belief is it got damaged during surgery when they replaced my left hip.

Dr. Williams: Okay.

Male: And the doctor never admitted to that, but it doesn’t matter, I just had to get the pain. And to be honest, Dr. Williams, I’ve told you this several times, if it weren’t for you, I don’t think I’d be alive today. I couldn’t take the pain.

Dr. Williams: Okay, so your pain was pretty bad?

Male: The worst I’ve ever felt in my entire life.

Dr. Williams: And give me an example. Were you able to wear pants or touch your leg or anything.

Male: No it was like my leg, like somebody poured lighter fluid on my leg and light it. It was like intense heat.

Dr. Williams: Okay.

Male: And I couldn’t even put a wet washcloth on it for any length of time because the weight of the washcloth hurt the nerves and I would take the washcloth off and the pain would come back. There was no hope. There was nothing.

Dr. Williams: Okay.

Male: Until I really came to see you.

Dr. Williams: And 6 months ago we removed that nerve and what differences did you notice?

Male: When I came out of anesthesia, after you removed that nerve, I could tell that the pain was gone.

There were still some residual effects that have been aggravated but it was immediate.

Dr. Williams: And compared to before surgery, what level of pain do you have now?

Male: Zero.

Dr. Williams: Zero pain?

Male: It’s unbelievable.

Dr. Williams: And we do remove a nerve, so do you have a lot of numbness in your leg or was it already numb before surgery too?

Male: No, I don’t have as much as numbness as you told me I would have.

Dr. Williams: Okay.

Male: I don’t know, I still feel pressure fine. Heat and cold to some degree. It doesn’t bother me at all.

Dr. Williams: Very good.

Male: So it’s better than I anticipated.

Dr. Williams: Alright, very well, thank you so much.

Male: Thank you.

Meralgia and Yoga

Why Meralgia and Yoga Go Together

When we surveyed our 700+ subscribers we were amazed to find that they voted yoga #1 for granting relief from meralgia paresthetica symptoms. Why? Read on…

Meralgia symptoms are caused by a compression (and damage) to the lateral femoral cutaneous nerve (LFCN). I damaged mine – paradoxically – doing a yoga pose called Marichasana B. I was 72 and had lost a lot of weight during a long, tropical summer so my normal subcutaneous fat layer had melted away and was not deep enough to protect the nerve from compression  The lovely woman is doing the pose correctly but I crushed my LFCN when I bent forward to touch my forehead to my toe.

The further forward I bent, the deeper the blade (outer edge) of my foot dug into my inner thigh until, eventually –you guessed it – it hit my LFCN and crushed it. I paid for that mistake with months in bed and years of rehab. And my rehab consisted mostly of – you saw this coming! – yoga!

So let’s look at a simple sequence that starts to decompress the lumbar spine. Why start at the lumbar spine? Because that’s where the LFCN exits the spinal column and that’s where some people have damaged LFCNs. This is a series called The Decompression Project and it’s developer, Ruthie Fraser, provides a series of videos that are an ideal way to begin to…graaaadually…take pressure off your lumbar, hip and thigh regions. Here’s the first of Ruthie’s series:

Meralgia and Inversion Tables

Meralgia and Inversion Tables: Can Inversion Tables Help?

Inversion tables are designed to decompress our joints so, since meralgia paresthetica is often caused by a compressed lateral femoral cutaneous nerve (LFCN), it may be worth trying inversion. But don’t rush out and buy a table yet. Read the rest of this post and watch all the videos before you spend hundreds of dollars. First, here’s a video about the potential benefits of inversion tables.

Want to try it? Learn how to use the inversion table correctly:

If you don’t know anyone with an inversion table you can try or borrow, I recommend this one, the Innova ITM 4800 for several reasons:

  1. It allows you to control your angle of inclination easily. Most inversion tables don’t, which means you’re either upright or upside down!
  2. It allows you to warm your lower back muscles before you invert. Warmth relaxes them and relaxation allows the joints to separate more easily.
  3. It allows you to massage your lower back. A feature you might enjoy.
  4. It’s sturdy.
  5. It’s the best combination of price, quality and features I’ve found.

Before you go, though, watch one more video about the downside of inversion tables – just to be sure you’re making an informed choice and know how to avoid stressing your muscles:

Finally, if you’re getting good results from inversion, consider combining it with medical marijuana. It’s a natural analgesic and also an anti-inflammatory. Read more about marijuana and meralgia in this post.

 

Marijuana and Meralgia

Marijuana and Meralgia:

Can Medical Marijuana Treat Meralgia Paresthetica?

I’d suffered from meralgia paresthetica pain for a year before visiting a friend in California who suggested medical marijuana. He said marijuana has two potentially helpful actions: it’s an analgesic and an anti-inflammatory. I knew that marijuana is non-toxic and…this was California – so what could go wrong? My friend baked up a batch of brownies (he’s against smoking of any kind and says that you need to ingest all the parts of the plant to get the full benefits) and gave me half of his ‘standard’ brownie. Within 30 minutes I’d not only lost track of time, I’d also lost consciousness of my chronic pain. Eureka! At last I’d found a natural alternative to my favorite pharmaceutical, gabapentin. (I also understood why pharmaceutical companies fight so hard to ban marijuana!).

Marijuana’s action as an analgesic (pain killer) removed my pain symptoms while its anti-inflammatory action soothed my inflamed lateral femoral cutaneous nerve (or LFCN: the nerve that, when compressed and irritated, gives rise to meralgia symptoms).

Since that happy day I’ve been able to give up pharmaceuticals completely. Better yet, I’ve been able to begin the exercise routine in the book: I feel so relaxed when I stretch that I sometimes hold the posture just for the pleasure of it.

Here’s Dr. D.I. Abrams talking about his research with marijuana and neuropathy (nerve pain):

Worth Reading: In the video above, Dr Abrams talks about publishing his research. Here’s the research in published form: Cannabis in painful HIV-associated sensory neuropathy A randomized placebo-controlled trial.

What is Meralgia Paresthetica?

What on Earth is Meralgia Paresthetica?

What exactly is meralgia paresthetica? Also called 20120112-145152.jpgBernhardt-Roth syndrome, Meralgia Parasthetica, Neuralgia Paraesthetica, femoral cutaneous nerve syndrome, LFCN syndrome, or burning thigh syndrome–is caused not by injury to the thigh, but by injury to a nerve that extends from the thigh to the spinal column: the lateral femoral cutaneous nerve, or LFCN. The term Meralgia Paraesthetica comprises four Greek roots, which together denote “thigh pain with anomalous perception”. In other words, you perceive the pain not at the point of injury to the nerve, but somewhere else: where the nerve ends.

The nerve root comes out of your spinal cord between the lowest (or twelfth) thoracic vertebra and the highest (or first) lumbar vertebra, usually abbreviated (T12) and (L1) and comes close to the skin when it exits from under the inguinal ligament. (See illustration)

SYMPTOMS

  • pain can be experienced anywhere from your hip to your knee
  • pain tends to move around
  • pain is strongest at night and diminishes by day
  • usually involves weakness in the affected leg and numbness and/or tingling.
  • numbness and/or pain in the outer thigh
  • abnormal or heightened sensitivity to touch in the outer thigh.
  • burning pain
  • pain may extend to the knees, groin, or buttocks
  • in 80% of cases, symptoms occur on only one side of the body.

DURATION
Though many people suffer from long term and chronic meralgia, MP typically lasts about 6-12 weeks. This can be reduced to 3-4 weeks using the treatments described here.

OCCURRENCE, FREQUENCY
World wide, Meralgia Parasthetica newly afflicts about 10,000 people every day.

So now you know what is Meralgia Paresthetica is. The rest of this site tells you what you can do to relieve its symptoms.

You can download Curing Meralgia Paresthetica here.

 

 

godfree@thailandretirementhelpers.com

Relieve Meralgia Symptoms at Night

THIS evening regime will help you get 6-8 hours sleep and not wake up feeling “dopey”:20120112-160247.jpg

FIRST NIGHT:
1. Take one Sandoz 300 mg. Gabapentin (or equivalent) 8 hours before bedtime

2. Take another 300 mg. Gabapentin 4 hours before bedtime

3. Take another 300 mg Gabapentin just before you lie down, along with 3 Neofenac (diclofenac sodium) 25 mg. (more, if your doctor recommends it).

4. Get down on the floor and do the Finger-Walking Child’s Pose exercise (see Exercises)

5. Just before you tuck yourself in, apply Capsaicin cream, as directed, to you inguinal region.

SECOND NIGHT
1. If the first night worked well, consider taking just two Gabapentin on the second night. One 4 hours before bedtime, and the other plus two Neofenac painkillers as you go to sleep.

2. Get down on the floor and do the Finger-Walking Child’s Pose exercise (see Exercises)

3. Just before you tuck yourself in, apply your Capsaicin cream, as directed, to you inguinal region.

4. This second-night drug regime can be safely maintained thereafter.

IN BED
1. Do the Yoga “Bridge”, (see the Exercises page) while lying on your back in bed.

2. Do a 360-degree rotation of your tailbone while keeping your spine and buttocks still. Start out slowly tracing tiny circles with the tip of your tailbone–barely visible to an observer–and work your way up to larger circles. Always moving slowly and deliberately.

3. Sleep (on your side) with a pillow between your legs. This keeps your knees apart and reduces tension on your hip.

4. As soon as you wake up, sit up as directed above, get up, and apply your capsaicin cream, and do the Yoga Child’s Pose + Finger Walk (see the Exercises page). This helps dispel any residual night pain and allows you to start your day without more drugs. If you stay in bed, for some reason the pain seems to get worse. So swing your legs over the side of the bed and sit up.

MIDNIGHT TRICKS
1. If you wake up in pain during the night, don’t just lie there focusing on your pain

2. Sit upright on the edge of your bed (that really helps).

3. Take another painkiller if it’s 3-4 hours since the last one.

4. Wrap some ice in a washcloth or hand towel and apply it to your inguinal region, your T12/L1 region, and the region where you are currently feeling pain. That will do two things: diminish the pain and distract you from focusing on the pain, which is almost as good.

5. Do the the same with a hot cloth. Alternating between cold and hot compresses can be most effective.

6. Drink a soothing soporific like hot milk or Valerian tea with honey.

7. Use the Buddha Machine (Apple iTunes app) or any soothing noise generator.

MORNING ROUTINE: WHEN YOU WAKE UP

20120114-113542.jpg1. When you wake up in the morning, move around slowly and carefully.

2. Make yourself a large cup of strong Irish Breakfast tea with milk and sugar (coffee’s fine, too, but harder on your tummy). You’ll find that it lifts your spirits and that, in itself, will diminish your perception of pain.

3. While your tea or coffee is brewing, get down on the floor and do the Get down on the floor and do the Finger-Walking Child’s Pose exercise SLOWLY, GENTLY, AND COMPLETELY.

Relieve Meralgia Symptoms at night by following the instructions above and you’ll soon be on the mend!

You can download Curing Meralgia Paresthetica here.

godfree@thailandretirementhelpers.com

Meralgia Paresthetica Natural Treatments

Meralgia Paresthetica Natural Treatments to Help You

1. Icing

Experiment with icing T12/L1, and also with icing your inguinal region: Wrap some crushed ice in a thick hand towel and apply it gently and repeatedly to your spine. You can also try icing the area where the lateral femoral cutaneous nerve comes close to your skin as it exits from behind the inguinal ligament.

2. Heating
A hot, moist towel applied to the T12/L1 region and the inguinal region: apply it gently and repeatedly to your spine. You can also apply it to your inguinal region and to the painful area of your hip, thigh, or leg.

3. Epsom Salts Bath20120112-144141.jpg
Epsom salts is a common mineral salt called magnesium sulfate. When magnesium sulfate is absorbed through the skin, such as in a bath, it draws toxins from the body, sedates the nervous system, reduces swelling, relaxes muscles, is a natural emollient, exfoliator, and much more. Take an Epsom Salt bath with a follow-through of icing the T12/L1: Soak in a tub of warm water with 2 cups of Epsom salt.

Capsaicin
Capsaicin is the active component of chili peppers, plants belonging to the genus Capsicum. It is an irritant for mammals, including humans, and can produce a sensation of burning when applied to the skin. But, when applied topically (to your skin) it, for reasons still unknown, RELIEVES PAIN. Yay!20120112-144220.jpg

But first, a few warnings: Before using capsaicin, tell your doctor about:

  • broken skin
  • skin irritation
  • previous allergic reactions to capsaicin, hot peppers
  • breastfeeding
  • pregnancy or current attempts to become pregnant

Buy a tube of capsaicin cream over the counter and follow the directions by rubbing a small amount into your skin where the nerve exits below the inguinal ligament, and at the T12/L1 joint area. Keep a soapy wash cloth handy in case you’re supersensitive. Otherwise, in 5 minutes you’ll start feeling relief which will last up to 4 hours. If your relief is not sufficient try a stronger concentration cream. You won’t develop a tolerance to it, so you can use it night and day.

Carry a tube of capsaicin cream with you everywhere and apply it when your pain reminds you to. When puzzled friends see you frantically fumbling in your crotch, just say brightly, “I’m applying capsaicin to my inguinal region” and they’ll never ask again.

Acupuncture

20120112-144337.jpgFind a Chinese acupuncturist–they usually have offices in Chinese herb shops–show him these pages and describe your symptoms. Acupuncture can provide remarkable relief and should b included in everyone’s regimen. Ignore the fearful nonsense about acupuncture being painful, etc. The little pinpricks are nothing compared to what you’re suffering! In fact, they’ll probably feel good because they immediately move your energy. Ask your TCM (traditional Chinese Medicine) practitioner if there is a herbal prescription that might help. Chinese herbs are inexpensive and very effective.

Pain Management
There are pain management clinics in every major city. Before you spend the money, consider learning some pain management tricks yourself. An excellent textbook is Bonica’s Management of Pain [Hardcover]. Buy a used copy at Amazon ($20) and educate yourself.

Weight Loss
If you’re over your optimum weight then change your diet and eating habits and get regular exercise. And any extra weight complicates and delays your recovery. The quickest, easiest, safest way to shed pounds is a juice fast: fresh, organic, raw fruit and vegetable juices for 30 days. If you don’t one a juicer and can’t borrow one, buy a Panasonic centrifugal juicer. Quick and, most important, EASY TO CLEN–the secret to successful juicing!.

Massage
Massage from a knowledgeable masseuse can be remarkably effective. Before your session take time to show them the anatomy illustration above, talk about the T12/L1 junction, and discuss your symptoms. A qualified Thai masseuse can do wonders to relieve your symptoms!

Walking up Stairs
Avoid walking as much as possible. Above all, don’t make the mistake I did: you’re feeling pretty good. All the things you’ve been doing are paying off: you feel no pain! So you climb the stairs like a normal person, taking great delight in being able to push off the stairs with your bad leg. Big mistake. That night will be agonizing, possibly the worst night since your symptoms started. For some reason, pushing off like that, and lifting your whole body weight by extending the ball of your foot exacerbates the problem. Be warned!

And, Finally
If you have any tips to help relieve the symptoms of meralgia paraesthetica, please email me and I will add them to the list. Between us, we can do a great deal to help others sufferers–and ourselves!

You can download Curing Meralgia Paresthetica here.

godfree@thailandretirementhelpers.com

REFERENCES
Mayo Clinic: Meralgia Paresthetica
Dr. Joseph Hayes: Treating Meralgia Paresthetica During Pregnancy
Shaw Chiropractic: Exam Glossary
“Journal of Chiropractic Medicine”: A Manual Therapy and Exercise Approach to Meralgia Paresthetica in Pregnancy: A Case Report; C. D. Skaggs, et al.; 2006
“Archives of Physical Medicine and Rehabilitation”: Myofascial Pain: Relief by Post-Isometric Relaxation; K. Lewit and D. G. Simons; August 1984
Mayo Clinic: Meralgia Paresthetica, Lifestyle and Home Remedies
Article reviewed by Nancy Jacoby Last updated on: Jun 14, 2011

Drugs for Meralgia Parasthetica

PAINKILLERS

20120112-154109.jpg

Medications for treatment of meralgia paresthetica (MP) pain include nonsteroidal anti-inflammatory drugs (NSAIDs), narcotics, and other agents like amitriptyline, Neurontin, and Tegretol. In general, avoid prolonged use of NSAIDs and narcotics. The painkillers recommended here not only greatly reduce pain from MP, they also create a pleasant drowsiness at night and allow 8 hours sleep, making additional sleeping pills unnecessary. In addition, GABA drugs produce a pleasant euphoria throughout the next morning, which provides a welcome break from feeling “sick”.

1. Gabapentin

My favourite is Sandoz 300 mg. Gabapentin. Its action is fairly subtle but is has four advantages:

1. It does not leave you feeling hungover.

2. It makes you feel euphoric until noon the next day (there’s no reaction in the afternoon; the euphoria simply fades.). “GABA Euphoria” is a well-known phenomenon in medicine. Why not take advantage of it?

3. It’s non-habit forming.

4. It helps you sleep, and so to avoid taking sleeping pills.

2. Neofenac (Diclofenac Potassium)

Neofenac is a brand name for Diclofenac, a non steroidal anti inflammatory drug (NSAID). It works by reducing substances in the body that cause pain inflammation. I used it simply because my local pharmacist recommended (I live in Thailand where prescriptions are unnecessary) it and it seemed to work. If you have a recommendation for a painkiller that works, and knocks the pain out for 6-8 hours, let us know.

50 mg orally 3 times a day. In some patients an initial dose of 100 mg of diclofenac potassium, followed by 50 mg doses, will provide better relief. After the first day, the total daily dose generally should not (and need not, if you use the regime suggested in this website) exceed 150 mg. Diclofenac Potassium liquid filled capsules (Zipsor[R]) are only approved by the FDA for mild to moderate acute pain. The dosage for this product is 25 mg orally 4 times a day.

SLEEPING PILLS

Sleeping pills should not be necessary if you use the combination recommended above along with the evening and morning regimes. But just in case, here’s some information about them:

    Non-benzodiazepine sedative hypnotic sleeping pills: some newer medications don’t have the same chemical structure as a benzodiazepine, but act on the same area in the brain. They are thought to have fewer side effects, and less risk of dependency, but are still considered controlled substances. They include
  • zalepon (Sonata)
  • zolpidem (Ambien)
  • eszopiclone (Lunesta) which has been tested for longer-term use, up to six months.

Drawbacks to non-benzodiazepine sleeping pills
Generally, non-benzodiazepines have fewer drawbacks than benzodiazepines, but that doesn’t make them suitable for everyone. Some may find this type of sleep medication ineffective at helping them sleep, while the long-term effects remain unknown. Side-effects include:

  • Morning grogginess
  • Drug tolerance
  • Rebound insomnia
  • Headaches, dizziness, nausea
  • In rare cases, dangerous sleep-related behaviors such as sleep-walking, sleep-driving, and sleep-eating

More information on sleeping pills here.

LIDODERM PATCH
Some people get relief from repeated application of LIDODERM patches. Talk to your doctor or, better still, neurologist.

One or more of these drugs for Meralgia Parasthetica should give you temporary relief and help get you ready to start the meralgia exercises in this blog.

You can download Curing Meralgia Paresthetica here.

godfree@thailandretirementhelpers.com

Meralgia Paresthetica Emergency Treatment

Here’s A Meralgia Paresthetica Emergency Treatment Guide

If you’ve got a fresh case of Parasthetica Meralgia and your outer thigh, hip, back/knee are hurting badly, here’s an emergency treatment regime:

20120113-115359.jpg

1. Take 300 mgm. of Gabapentin (or equivalent) every 4 hours.

2. Take 50 mgm Neofenac (diclofenac sodium), then 25 mg. every 6 hours.

3. Wrap some ice in a thick washcloth and apply it to your inguinal region, moving it back and forth slowly. Do the same for the L2-L3 area of your spine.

4. Do the same with a HOT washcloth. Alternate the hot/cold treatments.

5. Apply a small dab of Capsaicin cream (an over-the-counter product from your pharmacist) to your inguinal region, rubbing it in until it disappears. Keep a moist washcloth handy in case it stings your skin too much. Do not get it on your genitals. Wash your hand immediately after applying it. Re-apply the cream every 3-4 hours. It has no side-effects and you will not develop a tolerance: it keeps on working.

6. As you’re lying down, rotate your tailbone in tiny circles, using your abdominal muscles to control the movement. Do this whenever you remember to.

7. Do the yoga Bridge (see the Exercise page) slowly and gently, only lifting your spine up about halfway off the bed or floor, then laying it back down one vertebra at a time. Use your abdominal muscles to control this.

8. Make an appointment with a Chinese acupuncturist. Acupuncture is the most effective treatment for most MP symptoms.

9. Rest. Lie on your back with your feet on the floor or bed. if you want to sleep on your side, place a pillow between your legs.

10. Can’t sleep? Listen to a podcast of Etruscan history, or to the Buddha Machine (an Apple iTunes app).

11. There’s much more you can do to suppress the pain and help you recover in three weeks instead of six. Read the rest of this website and follow the simple instructions.

You can download Curing Meralgia Paresthetica here.

 

godfree@thailandretirementhelpers.com