MP stands for meralgia paraesthetica. Meralgia paraesthetica is a nerve compression syndrome. It is also known as inguinal tunnel syndrome.
What is paraesthetic meralgia?
In medicine, there is talk of meralgia paraesthetica when the lateral cutaneous nerve of the femur is trapped. This nerve originates in the lumbar plexus. It is also equipped with general somatosensitive fibers.
The thin nerve is located below the inguinal ligament and is responsible for supplying the thigh region up to the knee. In the case of meralgia paraesthetica, the people affected suffer from pain that is almost electrifying. Numbness also occurs in half of all patients. See AbbreviationFinder for abbreviations related to meralgia paraesthetica.
Meralgia paraesthetica is also known as inguinal tunnel syndrome or Bernhardt-Roth syndrome. Meralgia paraesthetica is one of the most common bottleneck syndromes. It occurs three times as often in males as in females. In principle, meralgia paraesthetica can break out in anyone.
Causes
Meralgia paraesthetica is usually caused by mechanical pressure below the inguinal ligament. However, tensile effects or pressure effects in the course of the lateral femoral cutaneous nerve can also be responsible for the development of the syndrome, which is particularly true for the pelvic exit region. In some cases, nerve damage during medical treatment is also the reason for painful meralgia paraesthetica.
This can be a puncture of the iliac crest, an opening in the abdominal wall or the removal of bone chips. The occurrence of meralgia paraesthetica is often favored by special risk factors. This is primarily high pressure on the inguinal ligament due to pregnancy, being overweight (obesity), or belts or pants that are too tight.
Diabetes ( diabetes mellitus ) represents an additional risk factor. Standing work, which involves strong extension of the hips, longer walks and pronounced strength training of the hips, thighs or abdomen are also considered unfavourable. The pain associated with meralgia paraesthetica is caused by compression of the lateral femoral cutaneous nerve, because certain muscle fibers pass through it. For this reason, the nerve bends by around 90 degrees.
Symptoms, Ailments & Signs
Meralgia paraesthetica becomes noticeable through burning pain that occurs on the outer side of the thigh. In addition, those affected suffer from unpleasant paresthesias such as numbness, impaired perception or tingling. If the affected person bends their hip joint in the front direction, this results in an improvement in the symptoms.
In the further course of the inguinal tunnel syndrome, sensory disturbances such as hypalgesia or hypaesthesia also become apparent. About 20 percent of all patients suffer from the symptoms on both sides of the body. Sometimes a meralgia paraesthetica turns out to be so uncomfortable that even wearing clothes causes symptoms in those affected. However, a loss of strength does not occur as a result of the inguinal tunnel syndrome because the lateral femoral cutaneous nerve does not contain any motor fibers.
Diagnosis & disease progression
If meralgia paraesthetica is suspected, a visit to a doctor is recommended. This begins his examination by recording the medical history (anamnesis) of his patient. He then performs a thorough physical exam. This also includes a neurological examination, which usually reveals noticeable sensory disturbances on the outside of the thigh.
In addition, the patient usually reacts sensitively to pressure pain, which the doctor produces by applying pressure with two fingers on the anterior superior iliac spine. At this point, the nerve passes through the inguinal ligament. In some patients, the doctor can also derive pathological somatosensory evoked potentials (SEP).
In some cases, magnetic resonance imaging (MRI) is required to better assess the inguinal ligament structures. In most patients, meralgia paraesthetica takes a positive course. This improves the pain in nine out of ten sufferers. However, every fourth patient suffers from spontaneous remission.
Complications
Meralgia paraesthetica causes the patient to experience very unpleasant feelings of paralysis or numbness. In most cases, those affected suffer from severe tingling or disturbances of perception and sensory disturbances. In some cases, pain can also occur, which can spread to other regions of the body. The quality of life is significantly reduced and limited by the sensory disturbances.
Various types of paralysis can also lead to limitations in everyday life, so that those affected are dependent on the help of other people due to the meralgia paraesthetica. Pain occurs primarily in the form of pressure pain or stress-related pain. If there is pain at rest, it can also lead to sleep disorders during sleep.
Meralgia paraesthetica is treated with the help of painkillers and various therapies. In most cases, there are no complications and the symptoms can be alleviated relatively well. However, it is usually not possible to predict whether complete healing will occur. Life expectancy is usually not affected by the disease.
When should you go to the doctor?
Disorders of perception or sensory disturbances on the skin must be clarified by a doctor. A tingling sensation on the skin or numbness is a cause for concern. The symptoms often increase in scope and last for several days or weeks. If there is pain on the outer side of the thighs, a doctor is needed. If locomotion is impaired due to the symptoms or if there is unsteady gait, the general risk of accidents and injuries increases. A doctor’s visit is necessary so that a treatment plan can be drawn up and the possible risks can be minimized.
A loss of strength, difficulty in completing daily chores, or a decrease in physical activity should be discussed with a doctor. In the case of restricted mobility or the inability to carry out usual professional activities, a doctor must be consulted. If the body is in poor posture due to the thigh complaints, a doctor’s visit is advisable.
In the case of a permanent bad posture, damage to the skeletal system can develop, which should be prevented. If, in addition to the physical inconveniences, there are also mental problems, a doctor is needed. If you are irritable, have mood swings or are withdrawing from social life, it is advisable to consult a doctor. If movement is greatly reduced, countermeasures should be developed and taken.
Treatment & Therapy
The treatment of meralgia paraesthetica depends on the triggering cause. It is also advisable to adapt the treatment individually to the needs of the patient. The longer the symptoms last, the worse the chances of recovery. The patient can also help improve their symptoms by avoiding wearing tight clothing or doing hip extensions.
Painkillers such as nonsteroidal anti-inflammatory drugs (NSAIDs) are usually used in conservative treatment. Furthermore, preparations such as baclofen, gabapentin, pregabalin, carbamazepine and pyrimidine nucleosides can be administered. Supplementary analgesics such as ibuprofen are also considered useful for therapy. In addition, the treatment of existing underlying diseases is extremely important.
If all of these therapeutic measures do not improve the symptoms, surgery can be considered. The affected nerve is either decompressed or even severed. Severing the nerve causes complete deafness within the supply area.
On the other hand, there is the possibility that the nerve ending that forms in the process is highly sensitive to tissue pressure, which in turn leads to new pain. Therefore, a transection of the lateral femoral cutaneous nerve is not recommended. On the other hand, during a surgical procedure, the parts of the leaf on the inguinal ligament are severed in such a way that movements of the hip joint can no longer cause pain in the small nerve.
Outlook & Forecast
The prognosis of meralgia paraesthetica is generally favorable. Conservative treatment is initiated once the diagnosis is made. In addition, the affected person can make a significant contribution to positive development by changing their posture and movement sequences to alleviate their own symptoms.
Without medical care, the symptoms can be expected to remain constant. In addition, pain or other secondary diseases can occur due to the physical impairments. In particular, the muscular system is additionally stressed, so that in the event of an unfavorable course, poor posture and tension can be expected. Gait uncertainties occur and general locomotion is made more difficult.
If the person concerned consults a doctor, the first step is to prescribe medication. In addition, physiotherapeutic training can be arranged. In these, the affected person learns how to optimize their movement sequences in the long term. If the drug treatment is unsuccessful, an operation is performed. Although the operation is associated with risks, it is often the last chance to achieve an improvement in the overall situation. At the same time, exercises for an improved movement should be carried out. If the surgical procedure and the healing of the wound go smoothly, the patient is discharged from treatment within a few weeks as having recovered.
Prevention
Special preventive measures against meralgia paraesthetica are not known. However, it is important to avoid certain risk factors such as being overweight or wearing clothing that is too tight.
Aftercare
Since self-healing cannot occur in meralgia paraesthetica, aftercare focuses on alleviating the symptoms and improving the quality of life. Various complications and symptoms can occur with meralgia paraesthetica. In most cases, this disease causes various numbness or disturbances of perception. Those affected often suffer from tingling in various parts of the body, and everyday life is made significantly more difficult by these symptoms. The temperature sensitivity is also reduced and made more difficult by the meralgia paraesthetica. In children, the disease can cause significant developmental disorders if not treated properly.
Even when wearing clothes, these symptoms can occur and have a negative impact on the person concerned’s everyday life. It is not uncommon for many patients to develop mental disorders or even depression, which should be clarified by a psychologist. Sometimes therapy is advisable. Contact with others who are equally ill can also help to reduce suffering and promote the exchange of experiences.
You can do that yourself
Patients with meralgia paraesthetica are affected by unpleasant symptoms such as pain, tingling and numbness in the thigh. The disturbances of sensitivity and the perception of pain have a negative effect on the quality of life. The patients visit a doctor and attend all check-ups, which often take place with different medical specialists. After the diagnosis, the treating physicians establish a therapy plan that the patient strictly adheres to in their own interest.
The person concerned takes the prescribed painkillers at the specified time. If side effects arise from the medication, the patient reports this immediately to the responsible doctor or an emergency doctor. Many patients report the unpleasant effects of clothing that is too tight on sensory disorders. It is therefore helpful to find individually fitting clothing that does not aggravate the symptoms.
Physiotherapy has a positive effect on the state of health and thus the quality of life of those affected. However, this is usually only an accompanying therapy, since the pain does not go away. If desired, those affected undergo surgery, in which the surgeons often cut the nerve. Postoperatively, the patients remain in the clinic and follow the doctors’ rules of conduct.