This disorder is also known as lateral femoral cutaneous neuralgia. It is defined as the itching, tingling, burning or other unusual sensations moving across the skin at the top or outer side of the upper portion of the thigh. The patient will experience more or less sensitivity to light touch. The disorder is caused by a disruption in the normal function of the nerve that originates near the pelvis and moves across the top of the thigh, quite close to the surface. Research shows the condition is caused by a sudden traumatic injury or by constant pressure on the lateral femoral cutaneous nerve, which passes along the front of the hip and thigh. Patients with large, protuberant abdomens may develop this problem from compression of the nerve while sitting. Alternatively, patients can develop this problem while standing with their hips pressed against a hard object, like a barber or hair stylist who leans on the armrest of a client’s chair. Extending the hip can aggravate the pain, and some patients will describe numbness at the top or side of the affected thigh. Though the symptoms are troubling, they are usually due to superficial irritation and do not affect the deeper muscles.
Diagnosis
A physical examination will help confirm the patient has decreased sensitivity to light touch over the affected thigh. Many doctors will use electronic nerve conduction tests also. Doctors who specialize in pain management can use injections or nerve block treatments that are placed around the affected nerve to confirm the diagnosis.
Treatment
Some patients can find temporary relief with the use of nonsteroidal anti-inflammatory medications. If applicable, patients will be asked to not wear tight garments, like corsets or belts, which can compress the nerve as it emerges from the hip on its course to the top of the thigh. Obese patients will be asked to lose weight. If the disorder is linked to a specific activity, a physical therapist or occupational therapist will assist with developing alternative methods of performing the activities that are less likely to cause repeated irritation of the affected nerve. Long-term relief of meralgia paresthetica can be found through the use of nerve block treatments containing an anesthetic medication along with anti-inflammatory medications that are injected around the nerve. The injections are usually given in a series of three to five treatments over several weeks for maximum effect. Occasionally nerve stimulation measures, such as a TENS unit, are utilized. Surgery is only considered as a last resort in the most difficult cases.
The Priority Health Spine Centers of Excellence program was created to ensure that all patients with persistent neck pain, back pain or other spine-related problems receive a comprehensive, non-surgical medical evaluation for their condition. For patients whose condition does not require urgent or emergent surgical intervention, an evaluation by a certified Priority Health Spine Center of Excellence is required prior to any referral to an orthopedic or neurosurgeon for back or neck care.
Tri-County Pain Consultants, PC is honored to be recognized by Priority Health as a Spine Center of Excellence for West Michigan. Our team of pain management specialists have a proven track record providing high quality medical care that meets and exceeds the strict criteria required by Priority Health for a Spine Center of Excellence designation.
Acupuncture
Acupuncture is the practice of using small needles inserted at very precise points on the body to promote natural healing and improve functioning. Acupuncture stimulates nerves, muscles and connective tissues, prompting increased blood flow to injured areas of the body, boosting the body’s natural healing process. Acupuncture provides a low risk treatment option that can be beneficial for pain syndromes due to an injury or associated with chronic degenerative diseases.
Cryoablation
Cryoablation is a procedure done in office that utilizes a specially equipped needle guided under fluoroscopy to freeze the area surrounding a nerve that is causing pain or discomfort. The goal of cryoablation is to interrupt the nerve’s ability to send pain signals to the brain and provide pain relief.
Discography
A discography is a diagnostic tool your pain management specialist may use to help determine the disc or discs that are the source of your pain. For this procedure, a contrast dye is injected into the gel like center of the suspected disc or discs, allowing your pain physician to see cracks or leaks in the disc membrane. Typically a patient receiving a discography will be given a local anesthetic or numbing agent. All discographies are performed by a certified pain management specialists under fluoroscopy.
IDET
IDET, or Intradiscal Electrothermal Therapy, is a procedure used to treat discogenic back pain. IDET involves the use a heated probe inserted into the gel like disc which heats up the inside of the affected disc. Heating the inside of the disc can destroy pain causing nerve fibers and seals any cracks or holes in the disc.
Intrathecal Pump Therapy
An intrathecal pump is an implanted medical device that delivers pain medication directly to the intrathecal space surrounding the spinal cord. An intrathecal pump is indicated in cases where patients have difficulty with oral medications or where previous pain interventions have been ineffective.
Kyphoplasty
Kyphoplasty is a procedure designed to help relieve pain caused by compression fractures of the spine. During a kyphoplasty procedure, a small tube is inserted into the fractured area. Once the tube is in place, the physician inflates a small balloon within the fractured area to raise the area, returning the broken pieces to a more normal position. The balloon is then deflated and the space is filled with a bone cement, effectively stabilizing the fractured area.
Manual Therapy
Manual therapy, or manipulative therapy, is a direct contact physical treatment used primarily to treat musculoskeletal pain and disability, intended to restore joint or soft tissue mobility. Treatment may include joint mobilization and manipulation, muscle stretching, and resistance therapy to advance muscle timing and activation.
Medication Management
Mecication Management is medical care provided by your pain management physician to optimize the use of prescribed medication to improve therapeutic outcomes for patients.
Nerve Block Technique
A procedure in which an anesthetic agent is injected directly near a nerve to block pain. A nerve block is a form of regional anesthesia.
Occupational Therapy
Occupational therapy is a task orientated treatment program designed to help patients regain their ability to perform daily living and work activities after serious illness injury or disability. Therapy focuses on the facilitation of daily tasks of self-care, work, and play/leisure activities, to help patients regain the ability to perform daily living and work activities.
Radiofrequency Lesioning
Radiofrequency lesioning is an advanced procedure using a specialized machine to interrupt nerve conduction on a semi-permanent basis. The nerves are usually blocked for 6–9 months. The procedure is typically most effective in treating joint pain in the spine.
Spinal Cord Stimulation
A spinal cord stimulator is a small electrical device implanted just under the skin in the lower back that delivers low level electrical signals to tiny electrodes implanted in the epidural space of your spine. These electrical pulses interrupt the pain signal from reaching your brain, replacing them with a mild tingling in the area where pain is felt. The device is controlled through a magnetic remote control, which allows patients the ability to turn the device on or off, and adjust the intensity as needed.
Stress Management
Stress management is clinical therapy designed to help individuals cope with or lessen the physical and emotional effects of strain and anxiety. Stress-management may include relaxation techniques, time-management skills, counseling or group therapy, exercise, and maintaining an overall healthy lifestyle.
