Meralgia paresthetica is a benign condition and is a compression of the lateral femoral cutaneous nerve of the side as it passes beneath the inguinal ligament. It is affecting approximately forty thousand people per year and it tends to affect males more than the females in the ration of two to one. Onset can occur at any time but usually, it starts at the age of thirty to forty but can also occur in older individuals as well, and in about 80 percent it is unilateral.
Overview
When a person’s outer thigh is affected by numbness, and burning pain is considered as the meralgia paresthetica. Bernhardt-Roth syndrome is the other name of this condition. It is a neurological condition that can cause pain. And tingling in the outer part of your thigh. This is not a severe condition and the person who is suffering from this condition can resolve on its own. Regular check-ups are also needed for this condition sometimes otherwise things will go back to how they were.
People suffer from this condition due to too much pressure on the lateral femoral cutaneous nerve. It can cause a lot of damage to the nerve. People experience this condition due to wearing tight clothes, and the person whose job description is to stand all day long like security guards may often suffer from this condition. If you are experiencing meralgia paresthetica or Bernhardt-Roth syndrome talk with your physician about what’s going on and they can review with you about your family history and help you to determine what options are best for you.
People who have a medical history of diabetes are more likely to develop this condition. It will be difficult for a person who is suffering from meralgia paresthetica or Bernhardt-Roth syndrome to deal with their life. There are many treatment options available for the affected person to relieve from this condition.
What are the indicators of meralgia paresthetica or Bernhardt-Roth syndrome?
Symptoms can be exacerbated by long distance walking or prolonged standing and can be relieved by sitting down. The following are the symptoms of this condition. The symptoms include
- Tingling sensations in the lateral part of your thigh
- Burning pain
- Numbness in the outer part of your thigh
What are the risk factors of this condition?
There are a number of well-established risk factors developing the condition and all of these relate to increasing pressure on the nerve as it passes underneath the inguinal ligament. Intrinsic causes can include obesity and on a more temporary type of basis pregnancy as well so there is extra pressure of the abdomen onto the nerve. They can also be extrinsic pressure on the nerve as well. For instance, people who wear tight trousers or belt, and corsets kind of things. There can be a variety of metabolic causes that can include and this is very important to keep in mind. Diabetes increases the risk and makes it almost as common for the population.
What are the complications of this condition?
There are also a variety of surgical complications that can cause this whether it is relating to orthopedic surgery in that region or abdominal surgery. For instance, hernia repairs in terms of its clinical presentation symptoms tend to affect the front and the outer side of the thigh at the anterolateral aspect of the thigh and typically include sensations such as burning pain can be coldness, numbness, even bottling sensations are also known to be felt in the thigh.
As with any form of surgery, there are always risks of complications that have to be discussed with the treating surgical team apart from infection risks and bleeding risks. There is also the potential for persistent numbness in the area of pain and burning type sensations. Following are the complications associated with the treatment of this condition, these complications include
- Infections
- Bruising
- Scars
- Persistent pain
- Dysesthesia
- Anesthesia
How is Meralgia paresthetica or Bernhardt-Roth syndrome diagnosed?
In terms of the diagnosis, it is usually quite straight forward as a classical constellation of clinical symptoms and there are also a variety of clinical signs as well. For instance, that the pelvic compression test where the pelvis is compressed for about forty-five seconds and what happens here is that there is a reduction in the pressure over the inguinal ligament and it is pushing down on the pelvis and this will alleviate symptoms that the tinsels test by tapping over the course of the nerve. There is also in your dynamic testing as well where the leg is put into a stretching position and will stretch the inguinal ligament as well and shows positive if it produces pain.
There is also a variety of supporting diagnostic modalities as well. For example, a diagnostic nerve block is incredibly useful because it can also act as a form of treatment as well as at the same time as making a diagnosis, and for cases where there is any doubt your physician will recommend other imaging tests like ultrasound investigations and magnetic resonance imagining. These tests can provide a piece of the necessary information to your doctor and can have a look at the nerve and what might be compressing it.
The differential diagnosis for this condition is fairly limited the most common cause includes L2 and L3 radiculopathy, lumbar stenosis, femoral neuropathy, which should be distinguishable anyway from the distribution of sensory symptoms going down into the leg itself and a lumbosacral plexopathy too.
What are the treatment options available for Meralgia paresthetica or Bernhardt-Roth syndrome?
Seventy percent of the patients will resolve this condition just by themselves. If the patients who are suffering from this condition do not resolve by themselves and there are some physical things that one can do to try and reduce pressure whether it is avoiding wearing tight-fitting clothing or belts those kinds of things. It is important to consider weight loss as well to reduce the pressure on the nerves. There are a variety of medications that can be used to treat this condition.
What are the medications used in the treatment of this condition?
There are a variety of medications that can be used to treat this condition and if a person experiencing the symptoms for more than two weeks, it is advisable to consult a primary care provider or doctor. Your physician may recommend some medications to ease the symptoms of the condition. The following are the medications that can be used in the treatment of this condition. These mediations include
- Tricyclic antidepressants
- Antiseizure medications
- Corticosteroid injections
Let’s discuss the above medications in detail.
Tricyclic antidepressants
These antidepressant drugs have the capability to ease the symptoms of the meralgia paresthetica or Bernhardt-Roth syndrome. The following are the possible side effects of this medication. These side effects include
- Feeling sleepy all the time
- Dry mouth
- Hard bowel movements
- Impaired sexual functioning
You should consult a physician when you are experiencing the above side effects. Your physician may change the dosage of your medication or switch you to another antidepressant.
Anti-seizure medications
Antiseizure medications have the capability of relieving you from the painful symptoms of this condition. Examples of anti-seizure medications include Gralise, Neurontin, phenytoin, Lyrica, or pregabalin. The following are the possible side effects associated with these medications. These side effects include
- Constipation
- Light-headedness
- Nausea
- Feeling sleepy all the time or drowsiness
- Dizziness
If a person experiencing the above symptoms while using the anti-seizure medications, it is better to have a word with the physician. He or she may suggest you reduce the dosage of the medication or switch you to another drug.
Corticosteroid injections
In order to reduce the inflammation and to provide relief from the symptoms of this condition. Your doctor or physician may recommend using corticosteroid injections and you are able to manage the symptoms of this disease. The following are the possible side effects associated with this line of treatment. These side effects include
- Infections spreading to joints
- Damage to the nerves
- Too much pain
- Whitening skin around the injection site
It is also very important for patients who have got underlying diabetes and are considering to have a steroid injection for should have a word with their physician. an alternative and more permanent solution can be using local injection of an alcohol solution which in effect poisons and nerves and just stops it permanently from sending the signals. One has to understand that this will cause persistent numbness in that patch.
There are also a variety of symptomatic relieving medications that are available and this includes the usual selection of non-steroidal. There is also another alternative therapy is radiofrequency ablation which can also focus energy onto the nerve and stop it sending aberrant signals.
Conclusion
It is a painful condition and detecting the early symptoms of this condition is very important. If you are experiencing the symptoms of Meralgia paresthetica or Bernhardt-Roth syndrome symptoms, it is advised to talk with your physician about what’s going on and they can review with you about your family history and help you to determine what options are best for you. A discussion with your health care provider may help determine which option would be best for you.
Sirisha B 
Raju Ch