Meralgia paraethetica, also known as lateral femoral cutaneous nerve irritation or entrapment, is an unusual condition of significant pain often around the hip and into the outside part of the thigh possibly all the way to the outer edge of the knee (the area shown in red below). It is what we call a ‘neuropathic’ type pain - meaning that it can give all different sensations from burning, stinging, electrical, tingling etc. Unfortunatey, it also means that commonly used pain relief medications such as paracetamol (Panadol), anti-inflammatories (such as Nurofen), and even morphine type medications - do not work as well as for other types of pain.
Essentially it is caused by either damage (such as in diabetes injuring the nerve), trauma, or even entrapment around tight muscles and/or scar tissue compressing/pinching the nerve. To diagnose this condition, your health practitioner will complete an examination to consider this diagnosis and possibly rule out alternative causes for your pain (such as referred pain from your back).
We will often then recommend a ‘diagnostic block’ to see if this nerve is contributing to your pain. We do this by either ultrasound and/or body landmarks guiding us to the nerve and then using a small needle to inject a numbing local anaesthetic around the nerve. The procedure works to ‘turn off’ the nerve, only temporarily, but if your pain reduces or is gone from this procedure, it means this diagnosis is likely.
Management for this condition can be addressed in several ways. Firstly, gently stretching, massaging, and strengthening areas we suspect the nerve is being pinched, can be helpful for some people. Sometimes trying to do these activities doesn’t help or is too sore. So we often recommend therapies such as prolotherapy, platelet rich plasma injections and or perineural hydro dilation.
All these minimally invasive injection therapies are basically designed to use fluid to stretch any muscles or scar tissue which may be compressing the nerve.
We may also talk about performing a procedure called pulsed radiofrequency ablation which turns down or ‘scrambles’ the pain signal in that nerve for a period of time for you to perform the exercises and movements needed to help reduce the nerve entrapment. If you’d prefer medication options, there are some medications which can help dampen the pain - but your health practitioner can discuss the possible pros and cons of these options as you will need to be aware of possible side effects.
Finally, if none of the above is helpful, we can implant small electrodes next to damaged nerves to scramble the pain signal to try and get your movement as normal as possible to correct the underlying problem.
Resolve Pain are experts at managing difficult to diagnose and difficult to treat conditions. We use every available option for you to attempt to reduce your pain and get you back to doing the activities that you want to do.
*Please be aware the video below is external content and not part of Resolve Pain*