Meralgia paresthetica (MP) is a mononeuropathy - a clinical condition caused by compression of the lateral femoral cutaneous nerve (NCFL), especially in the inguinal (groin). This nerve is responsible for the sensitivity portion anterolateral (front and side) of the thigh. Its main manifestations are cutaneous sensations (skin) as numbness, tingling, burning, and cold and pain in the region of the thigh. In addition, there is a reduction in sensitivity and hypersensitivity to touch the affected area.
The word "meralgia" comes from two Greek words, "mere" meaning part and "algos" meaning pain. Paresthesia means a disorder of sensations (tingling, stinging, burning, anesthesia), also coming from the Greek "to" meaning disorderly or abnormal and "esthesia" which means sensitivity.
It is a relatively common disease caused by factors that predispose to nerve compression at the level of the inguinal ligament, which occurs in obese individuals, pregnant women, the use of tight clothing around the waist. Athletes are also subject to the development of meralgia paresthetica due to repetitive movements of flexion and hip extension.
Most people experience some type of temporary paresthesia during life when it gets cross-legged or sit for long periods, for example. The constant pressure on a nerve causes paresthesia skin and soon she is relieved the numbness goes away.
However, there may be Chronic paresthesia, which is often a sign of a nerve entrapment, or neurological disease or traumatic injury to a nerve. When the MP is not diagnosed and treated, can limit the individual for years.Incidence 4.3/10, 000 people per year and more frequently among people suffering from carpal tunnel syndrome (suggesting a predisposition to nerve impingement) and during pregnancy.
Paresthesia can occur due to several factors, including:
- Tight clothing, belts, obesity and pregnancy.
- Stroke and transient ischemic attack (mini-stroke), multiple sclerosis, transverse myelitis and encefalite.Um tumor or vascular lesion pressing against the brain or spinal cord can also cause paresthesia.
clamping carpal tunnel syndrome, in which the peripheral nerves may be damaged and cause paresthesia accompanied by pain.
Trauma Post-surgery of the hip, abdominal and inguinal; related plexopathy due to hemorrhage, muscle injuries or repetitive trauma.
Numbness (anesthesia), tingling, stinging or itching intermittently. Also common is burning or cold, the anterolateral surface of the thigh (front and side), from the hip to the knee, resulting from compression of the lateral femoral cutaneous nerve, recurrent pain frequent, sometimes felt like a deep muscle pain. There may be loss of hair in place and position can aggravate symptoms.
Symptoms may worsen when extending the hip and patients may experience difficulty staying upright standing and sleeping. In some people, sitting can aggravate the situation, while others do not have the same effect.
It is a common complaint of pain secondary to hip, knee and calf, once the person makes a compensation for the activities in an attempt to minimize the symptoms.
Often patients are treated for diseases of the hip, spine or groin before being properly diagnosed. Patients may find it difficult to describe their symptoms and start to think that they are suffering from some psychiatric problem.In general the symptoms are intermittent, but frequently resort.
Your doctor will do a survey of your medical history and examine you, asking you to describe your pain, and to identify the exact location of the painful area on her leg. May also recommend imaging tests such as radiography (X-ray), hip and pelvic region, electromyography (EMG) and eletromioneurografia to exclude the possibility of other diseases if the diagnosis is not clear.
The first step is the removal of the cause of compression. In most cases the handling is made by a conservative treatment, which provides relief of symptoms and consists of:
- weight reduction to reduce waist circumference
- use baggy clothes
- drugs: analgesics, anti-inflammatory non-steroidal, pregabalin (Lyrica). As per Doctor Prescription.
In pregnancy,treatment should be conservative, because the symptoms tend to disappear after childbirth.
When the condition becomes chronic and does not respond to conservative treatment, the next step is treatment with drugs with stronger effects of weight reduction:
- Tricyclic antidepressants
And, when they do not solve the minimally invasive interventional treatment is indicated.
- Dry needling of trigger points that may be causing nerve compression (trigger points)
- Lock diagnosis using local anesthetics provide temporary relief.
- Pulsed Radiofrequency the lateral cutaneous nerve of the thigh.
- Anesthetic blockade with corticosteroids (anti-inflammatory) - the plan Repeated treatment provides locks on alternate days.
And if all else fails, the last step of treatment, there is still surgery:
- Decompression of the nerve site with neurolysis
Remember that all pathology diagnosed and treated early are more likely to be controlled.
A big hug, all have a great week!