Meralgia, Sciatic and Femoral Muscles

Meralgia Paresthetica and its Relationship to the Sciatic and Femoral Muscles

The femoral muscle is key to meralgia symptoms, but remember the role of the sciatic muscle, too.

Transcript:

This is Dr. Barry Lewis and Dr. Jane Eckerman from Chiropractic Health. Once again, welcome to our site. This morning we’re going to test for weakness in the leg associated with the femoral and the sciatic nerve. First off, by doing the slump test looking for restriction in the sciatic nerve raising first the one leg and then the other leg and then putting extra stretch on the nerve. We’ve done this in a separate video so I won’t go into the details. Let’s assume the patient has pain in the right leg.

Dr. Eckerman, would you come and stand over here please, facing this chair with one hand over there. This finger here is just for balance, don’t put any weight on it. First we’re going to test the quadriceps muscle which is associated with the femoral nerve and we’ll test the leg first so that she knows what is normal. Would you please lift your right leg and now bend your left knee and feel and bounce a little, feel the strength of this leg. Remember what you feel.

Now stand on your right leg, please and again, bend your knee, bouncing a little. Does it feel any weaker or different or like it’s going to give in comparison to the left leg? No it doesn’t, that’s fine. The quadriceps muscle is strong. Now we’re going to test the two muscles frequently affected by the sciatic nerve, firstly the extensor (01:40). Dr. Eckerman, can you please lift your left toe for me? And if I press down, I’m testing the strength of the muscle that lifts the great toe and now test, raise your left toe and press upward while I’m going to press down and I can feel that’s both the extensor (02:01) muscles are equally strong.

Now I’m going to test the calf muscles to see how strong they are. Please lift your right leg up and stand three times on your left toes, please, putting only slight weight on your hands and up and down and up and hold it. Hold it, go up and hold it, hold it, hold it. You’re looking to see if the leg has any tremor in it or weakness and down. And now would you repeat it raising your left leg but please raise your right heel now, standing on your toes. We’re testing the calf muscles here, we’re going to do it three times and now hold it there. Hold, you’re looking again to see if the whole leg is beginning to shake or in fact, if the patient cannot lift the heel at all.

Thank you very much, Meralgia, Sciatic and Femoral Muscles are the muscles most frequently affected by the sciatic and femoral nerves. This is ChiropracticHealth.com.

Meralgia Symptoms and Treatment

Simplified Meralgia Symptoms and Treatment

A short video introduction to meralgia paresthetica symptoms and treatment:

Here’s the transcript:

Meralgia Paresthetica is a condition characterized by symptoms like tingling, numbness and burning pain in the outer part of your thigh. The cause of meraligia paresthetica is compression of the nerve that supplies sensation to the skin surface of your thigh, tight clothing, obesity or weight gain and pregnancy are common causes of meralgia paresthetic.

However, meralgia paresthetica can also be due to local trauma or diabetes. Meralgia paresthetica symptoms, pain or burning over the outside of the thigh. Numbness over the outside of the thigh. Sensitivity to light touch over the outside of the thigh. Worsening of symptoms with certain positions. Increased symptoms when wearing tight belts, work belts, or tight waist clothes, recent weight gain or pregnancy

Meralgia paresthetica treatment, physical therapy to strengthen the muscles of the legs and buttocks and reduce injury to the hips. Wearing less restrictive clothing. Weight loss management. Surgical treatment, called sensory nerve surgery. Cortisone injections may also be prescribed.

Meralgia paresthetica is a common disease, yet every individual needs unique treatment and care. We encourage people with meralgia paresthetica and their families to learn as much as possible about the latest medical treatment and approaches as well as healthy lifestyle choices.
For more information about the meralgia paresthetica symptoms and treatment, just click on the link at the description. Or visit www.MainMD.com.

Meralgia and Tight Clothes

A Short Video About Meralgia and Tight Clothes

Female: Well it’s been a top fashion fade for the last few years, but could wearing those trendy skinny jeans land you in your doctor’s office?

Male: Yeah it’s a concern that one of the major reasons why I personally don’t wear skinny jeans. ABC’s Rachel Smith who’s been known to doan a pair once in a while, she’s been looking into whether hot pants can make you a hot mess, Rachel good morning.

Rachel: I know, good morning you guys. Maybe feeling like a hot mess is more like it. It’s probably fair to say that many of us have been a victim of fashion at some point in our life. Yet, some people are wearing these jeans everywhere. Skin tight, painted on and yes they look great, but what if that trend pinches more than your wallet and crushes more than your ego?

Rachel: Will Farrell may have mocked them on Jimmy Fallon, but everyone is still shimmying into them. The first family, Taylor Swift, even her new beau Harry Stiles, all styling it in skinny. But doctors warn that this fashion do, may pose some troubling health don’ts. According to the medical community, those tight pants can squeeze more than your silhouette, temporarily pinching the nerves in your hips causing something call meralgia parasethetica.

Female: It’s a disorder that occurs when one of the nerves that runs in the outer part of the thigh gets compressed and pressure on it causes symptoms of tingling, numbness and pain.

Rachel: Other possible health hazards, abdominal pain, heart burn, even blood clots. But most fashionistas outside our New York studios were willing to take the risk.

Will, circulation problems, potential health risks, stop you from wearing this trend?

Female: No, it just looks too good.

Rachel: If you’re going to sport the skinny, doctors say best bet, go stretchy and give your body a little room to breathe. Another tip, ditch the heels. They only increase circulation problems.

Female: Because the pelvis tilts on, it can further accentuate the pressure that’s caused.

Rachel: As the tight trend continues to squeeze society, one leg at a time.

Just remember to wear them responsibly.

Well, that video is something, right? But all jokes aside, these risks will continue as long as the style is trending. Now if you have to do a lunge, a squat or perhaps an awkward stretch to get into those tight pants, chances are, you should probably toss them right back into the closet.

Female: You mean that’s not normal protocol?

Rachel: But you know we’re all guilty of it. Pull them out of the washer and done the lunge, done the squat.

Female: Those are good tips, stretching and make sure you get some that fit.

Rachel: Absolutely.

Female: Then you don’t have to give up the idea of wearing skinny jeans.

Male: Yeah, I tuned out that entire conversation.

 

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:

Results From PatientsLikeMe Survey Highlight Patient Beliefs About Medical Marijuana

 

A new survey of 219 PatientsLikeMe members has found that patients with certain conditions who use medical marijuana believe it is the best available treatment for them, with fewer side effects than other options and few risks. The survey, conducted in June 2015, is among the first to gauge patient perceptions about the benefits and risks of medical marijuana and their level of willingness to recommend its use.

PatientsLikeMe’s Vice President for Advocacy, Policy, and Patient Safety, Sally Okun, RN said that while the number of respondents and conditions represented is limited, the survey and its results come at an important time. “As more people consider using medical marijuana, and more states legalize it, patients need to know what others are experiencing. This survey starts to gather real world data about marijuana as medicine—information that may be useful for patients and their physicians as they explore options and make treatment decisions.”

Half of the survey respondents started using medical marijuana in the last five years, while 25% started to do so in the last two years. Smoking (71%), edibles (55%), and vaporizing (49%) were the most commonly used methods for taking the treatment. The top three conditions represented were multiple sclerosis, fibromyalgia and depression. Key findings are as follows:

Usage and Perceived Side Effects

  • About three quarters (74%) of survey respondents agree that medical marijuana is the best treatment available for their health issue. Another 20% are unsure if there is another option available.
  • 76% report that they use medical marijuana because other treatments weren’t working and/or caused too many side effects. About 21% use it to avoid the side effects of other treatments.
  • When asked about the severity of side effects from using marijuana, 86% of PatientsLikeMe members who report using marijuana indicate the side effects are either “none” or “mild.” The same group says those side effects include dry mouth, increased appetite, and sleepiness.

Perceived Benefits and Risks

  • Survey respondents use medical marijuana for more than one reason, including to treat pain (75%), muscle stiffness or spasms (69%), insomnia (67%) and anxiety (55%). The majority (63%) considered marijuana as a treatment option because they think it is more natural.
  • Most (93%) say that they would recommend medical marijuana to another patient.
  • About 61% say their healthcare provider is supportive of their medical marijuana use, and 60% have a letter of recommendation or prescription.
  • Most patients report a low level of concern (“Not at all” or “A little”) with long-term health risks, such as developing lung cancer (89%), long-term lung damage (86%), or becoming addicted/dependent (96%).
  • One in four patients (26%) report being “Somewhat” or “Very” concerned with legal problems.

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