LATERAL FEMORAL CUTANEOUS NERVE & MERALGIA PARESTHETICA
Domlur, Bengaluru Feb 9, 2017
Lateral Femoral Cutaneous nerve arises from the dorsal divison of the 2nd and 3rd lumbar nerve and emerges from the lateral border of the psoas major (middel), cross the iliacus muscle obliquely, towards the ASIS. It then passes under the inguinal ligament, through the lacura musculorum and over the sartorius muscles in to the thigh. It divides in to anterior and posterior branches. Anterior branch supply the anterior and lateral of thigh, terminal filament of this nerve communicate with the anterio cutaneous branch of femoral nerve and saphenous nerve. Posterio branch pierces the fascia lata and supply the posterio lateral of thigh. The root is from greater trochanter to the middle of thigh.
This nerve has sensory innervations only.
Movement between thigh and pelvis can stretch the nerve and increase the entrapment at the opening of inguinal ligament. Most commonly developed from the nerve fascia attachment in the thigh pulling the nerve tightly against the opening at the lateral end of inguinal ligament.
Compression near the ASIS and inguinal ligament is known as Meralgia Paresthetica. This is also known as Bernhardt-Roth syndrome. During this patient experiences burning pain, tingling and numbness in the outer part of thigh.
- Tight Fitted Clothes
- Obesity or Weight Gain
- Lax Abdominal Muscles
- Rubbing of Clothing
- Prolonged Standing or Walking
- Prolonged Cycling
- People in the age group of 40 – 60 years
- Diabetic people
- Pregnant women
The diagnosis of meralgia paresthetica varies depending on the history of patient and physical examination.
Wearing loose clothing and tight bands around pelvis
- Losing excessive weight
- Pain killer
- Life style changes
- Strengthening abdominal muscles
- Surgery (in advance cases)
Physiotherapy treatment includes moist heat, transcutaneous electrical nerve stimulation and interferential current or low-intensity phonophoresis. These modalities are used to help alleviate pain and enable the patient to perform gentle stretching exercises with greater ease. Soft-tissue techniques (eg, trigger point therapy) also may be beneficial for pain and tightness around the hip and thigh muscles.
Exercise for the Treatment of Meralgia Paresthetica
This exercise promotes pelvic mobility and encourages movement of the lateral femoral cutaneous nerve through the pelvic area.
Muscles worked: Spine stabilizers, Lumbar extensors, Abdominals
- Step 1: Start on all fours, with your hands directly under your shoulders and knees directly below your hips at 90 degrees.
- Step 2: Begin by slowly arching your back, letting your belly sag and lifting your chest and eyes up to look up at the ceiling.
- Step 3: Hold this position for 15 to 30 seconds.
- Step 4: Slowly return to starting position. Next, tuck your pelvis and arch your back in the other direction while you let your head drop down and relax.
- Step 5: Hold position for 15 to 30 seconds.
- Step 6: Repeat 3 to 5 times.
Physiotherapy exercises to relieve sciatica pain.
- Step 1: Stand facing a wall with one hand on the wall for balance.
- Step 2: Bend one leg at the knee and bring your foot towards your buttocks.
Step 3: Reach back with your free hand to gently guide your foot closer to your body until you feel a stretch in the front of the thigh.
- Step 4: Hold this position for 30 seconds and repeat 3 times on each side.
Lunges work to build strength in the legs and help improve balance and stability. They can also provide a stretch to tight muscles of the hip, which may improve pain.
Muscles worked: Thigh muscles including quadriceps and hamstrings, as well as the glutes and core muscles.
- Step 1: Stand up tall with hands by your side.
- Step 2: Take a large step forward and slowly bend your knees and lower the body down until your back knee touches the floor. Be sure to take a big enough step so that your front knee doesn’t go past your toes.
- Step 3: Return to starting position and repeat on the other side.
- Step 4: Do 10 to 15 repetitions on each side and complete 3 sets.
This exercise helps stretch the hip flexors and strengthens the muscles of the core, legs, and buttocks to improve function and reduce pain.
Muscles worked: Spinal stabilizers, Lumbar extensors, Abdominals, Ggluteus, Hamstrings
- Step 1: Start by lying on your back, knees bent and feet flat on the ground
- Step 2: Slowly raise the hips off the ground until the body is in a straight line, pushing the heels into the floor and squeezing the glutes at the top
- Step 3: Hold position for 15 to 30 seconds. Return to starting position and repeat
- Step 4: Repeat 10 to 15 repetitions for 2 to 3 sets.