Meralgia Paresthetica May Masquerade as Lumbar Radiculopathy

 In General Health & Wellness, Neurology

According to the Mayo Clinic Online Meralgia Paresthetica is a condition characterized by tingling, numbness and burning pain in the outer thigh.  The cause of meralgia paresthetica is compression of the nerve that supplies sensation to the skin surface in that area called the lateral femoral cutaneous nerve.  Tight clothing, obesity, or weight gain, and pregnancy are common causes of meralgia paresthetica.  However, meralgia paresthetica can also be due to local trauma or a disease, such as diabetes.  In my neurology clinic I am asked to perform nerve conduction studies with electromyography (NCV/EMG) on patients suspected of having lumbar nerve root compression.  This is particularly important because compression of the 5th lumbar nerve root will cause pain that radiates down the lateral thigh, and this can look a lot like meralgia paresthetica, or vice versa.  I have seen many cases of meralgia paresthetica confused for an L5 radiculopathy.  Of course, L5 radicular pain can often extend below the knee to the shin area and top of the foot.  But real life experiences of pain and numbness are not always like the textbook.  Furthermore, the treatment for the two conditions is completely different.  In both cases lifestyle factors can be important in addressing the underlying causes, and persistence with physical therapy in this setting can resolve even the most remarkable disk herniations over time obviating the need for surgical intervention.  This approach requires education and persistence on the part of our patients who naturally want the problem fixed sooner rather than later.  However, there is a lot to be said for an intact spine when it comes to surgical and anesthesia-related risks, and risk of long term treatment failure (“failed back syndrome”).  Even when the surgical site remains stable we often see spine problems above or below the surgical site because the root causes of the imbalance that lead to the problem in the first place have not been addressed.  For meralgia paresthetica wearing loose clothing, losing weight, and non-invasive pain-controlling modalities offered by therapists may be helpful definitive treatment may require a nerve block or even ablation therapy to resolve the discomfort.  In my practice I do not generally treat meralgia paresthetica with medication although the literature suggests this is an option.  So the next time you are asked to provide therapy on someone with lateral thigh pain and numbness, and the referring provider has listed “lumbar radiculopathy” as the diagnosis, think about the possibility that your patient may actually be suffering from meralgia paresthetica. 

Recent Posts
0

WE ARE OPEN
Protect Against Coronavirus: Doing our Part to Help you

 
In these difficult times we want to share with you some brief bullet-points about Sharlin Health and Neurology and COVID-19:
  • First and foremost, we want you to know that the safety and well-being of each and every one of you is number one importance to us. If you have a chronic lung condition or another health reason that would make you susceptible to the more severe effects of the coronavirus, we want you to stay at home.
  • Sharlin Health and Neurology is considered an “essential” business because we provide critically needed care to those with neurological disease in our community. Despite the threat of the coronavirus conditions like Alzheimer’s, Parkinson’s disease, seizures, migraine, MS, and other neurological diseases do not go away. We are a privately-owned neurology practice here to serve our community.
  • We follow all CDC guidelines for protection against the dissemination of coronavirus. There have not been any known cases of coronavirus in our office, among staff and those customers who have entered our door. 
  • We have six available exam rooms in our clinic and every effort will be made to prevent patients from having to stay in our waiting room. We can move you quickly from the reception desk to a private exam room, and have the doctor meet you there.
  • If you are sequestered at home, it may be possible to visit with you by telemedicine. We have the capability of using a telemedicine portal though the smart phone or computer that is HIPAA compliant and allows us to see you and speak with you. Alternatively, we can speak by telephone. Please ask our receptionist.
  • If you do come to our clinic for a doctor visit or a need a test please do not touch any surfaces you can avoid touching, and come by yourself or – if you do need to have someone with you – have them bring you to the door and we will help you from that point. If they wait in their vehicle, we can call them when you are finished.
  • If you have had contact with a person with known or suspected COVID-19, have had contact with a person coughing or with fever in the past 14 days, or you yourself have a fever, cough, or runny nose in the past 14 days, please let us know and we will either reschedule you or schedule you a telemedicine visit. 

If you think you may have been exposed to COVID-19 please reach out to your nearest medical center. We will not be testing patients at Sharlin Health and Neurology. 

Click Here To Learn More


 
close-link
Dr. Sharlin's Newsletter Sign-Up
Subscribe
Over 5K Subscribers
close-image
Download My FREE E-Book, "Master Chronic Pain" Today!
DOWNLOAD NOW
''
Are You Concerned About Your Memory? Take Our Free Evaluation Quiz
TAKE QUIZ
COVID-19 Updated Hours : Tuesday - Thursday | 8:30 a.m. - 5:00 p.m.
Despite limited hours for the month of April, we will be checking telephone messages and messages on our patient portal, including prescription refill requests. As always, if you have an emergency please go to your local emergency room or urgent care clinic.
close-image
Fibromyalgia Treatment Springfield MissouriFunctional Medicine Springfield Missouri