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#What is Meralgia paresthetica (MP)? Meralgia Paresthetica is a thigh pain condition that develops as a result of problems with a nerve called the lateral cutaneous nerve of the thigh. This nerve supplies sensation to the side and front of thigh. It origin
#pain and altered sensation in the area supplied by the nerve and this condition is called Meralgia paresthetica. What causes this condition? The most common cause for this condition is pinching (entrapment) of the nerve as it enters the thigh travelling
#military armour and police uniforms Diabetes and other conditions affecting nerves such as alcoholism Underactive thyroid (Hypothyroidism) Nerve injury due to seat belt injury or injury associated with surgeries such as hip or back surgery
#surgeries requiring bone grafting
#keyhole (laparoscopic) hernia repair Growth/ swelling of the nerve (neuroma) Difference in the length of the two legs Activities involving repetitive leg motion for long hours such as walking or cycling. MP is seen associated with sports such as gymnastic
#soccer and strenuous exercise
#bodybuilding. What are the symptoms of Meralgia paresthetica? The main symptoms of this condition include Pain
#burning
#aching or stabbing sensation in the front and outer side of the thigh
#extending as far as the outer side of knee. This may be accompanied by groin and buttock pain Altered sensitivity in the front
#other side of thigh Numbness
#tingling sensation Worsening of symptoms with certain positions such as squatting
#walking or standing for long hours. Lying down with legs bent towards the tummy (hip flexion) or sitting may help to reduce the symptoms severity. As this nerve does not control any muscles
#there is no muscle weakness. How is Meralgia paresthetica diagnosed? In most cases
#the diagnosis can be made by the history and examination. Simple tests such as altered sensation in the area supplied by nerve
#pressure on the nerve in the groin
#moving the hip backwards may reproduce the symptoms and help in establishing the diagnosis. An ultrasound scan can be useful. I have previously identified nerve abnormalities with ultrasound scans prompting other investigations. Investigations such as MR
#physical therapy and ultrasound guided injections or radiofrequency treatment. Surgery is rarely required and is considered for chronic refractory cases not responding to other measures. Lifestyle changes– these include Avoiding tight clothes and belts
#this option can be utilised to prolong the pain relief. The procedure involves identifying the nerve under ultrasound guidance followed by placement of a special needle close to the nerve. The needle is connected to a radiofrequency machine which is used
#usually lasting 6-8 months although some studies have found even longer lasting benefits. If required repeat freezing of the nerves can be performed with good results. Surgical management. This is rarely required and is considered for non-resolving sever
#Meralgia paresthetica diagnosed
#Meralgia paresthetica treated
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#symptoms of Meralgia paresthetica
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Chronic Post Surgical Pain treatment in Delhi
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Posted by Dr Amod Manocha Filed in Health #Pain management centre in Delhi #Pain Treatment in Delhi #Chronic Post Surgical Pain treatment in Delhi 93 views
Chronic post surgical pain (CPSP) is pain localized to the surgical site or a referred area persisting 3 months after surgery. To diagnose CPSP pain should have been absent before surgery or should have different characteristics from preoperative pain. Other possible causes of the pain such as infection, recurrence of original problem etc need to be excluded.
CPSP is a common complication of surgery and rates up to 80 % in adults have been reported in some studies. CPSP is also reported in children although the incidence is less than in adults. It can have significant consequences for the individual and the World Health Organisation plans to include this as a separate diagnosis in the upcoming version of the International Classification of Diseases, ICD-11. Type of surgery influences not only the risk of development but also the severity of CPSP. Some surgeries are more prone to develop CPSP such as amputations, thoracotomy, and mastectomy. It is observed after commonly performed operations such as hernia repair, caesarean sections, knee replacement etc. Risk factors for developing CPSP include having pain before surgery, severity of acute pain immediately after surgery, multiple surgeries younger age and site of surgery. Genetic and psychological factors are also thought to play a role. A significant proportion of the cases are attributed to nerve damage.
Management of CPSP required multi-modal approach focussing on
- Patient and family education
- Optimization of medications
- Interventional approaches such as injections and neuromodulation.
- Physiotherapy
- Psychological interventions such as cognitive behavioural therapy