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Meralgia Paresthetica Treated with Acupuncture Plus Myofascial Release Technique: Case Report
Abstract
Objectives : The purpose of this case is to report the improvement after treatment about a patient with meralgia paresthetica. Methods : We treated the patient with acupucture therapy, cupping therapy, electroacupuncture therapy, percutaneous radiofrequency thermoablation and myofascial release technique by Turbo SASO from June 2015 to July 2015 by evaluating femoral function with VAS score. Results : After 5 times of treatment, this patient achieved excellent outcome following the technique, showing that clinical symptom as able to walked and pain was disappeared, VAS changed from 10 to 3 and the result of patrick test came out negative. Conclusions : The various symptoms appear in the Meralgia paresthetica such as numbness, paresthesia, and pain in the anterolateral thigh, which may result from either an entrapment neuropathy or a neuroma of the lateral femoral cutaneous nerve(LFCN). Oriental medical treatment for meralgia paresthetica resulted in satisfactory results by diminishing the symptoms progressively during the five days of treatment. Differential diagnosis was based on careful physical examination. More research of meralgia paresthetica is needed.
Acute trauma and repetitive microtrauma connected with certain sports and athletic activities are often mentioned when describing the etiology of nerve entrapment syndromes. According to the literature it is obvious that nerve entrapment syndromes in athletes are not as rare as they were once considered to be. To support this contention, we present currently available information about nerve entrapment syndromes in athletes. For each syndrome, we describe possible causes of compression, clinical symptoms and signs, and the most effective treatment. In conclusion we stress that nerve entrapment syndromes must be considered in the differential diagnosis of pain in athletes.
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The purpose of this study is to prove the increase of range of motion of shoulder joint in the patients with shoulder adhesive capsulitis by applying the vibratory stimulation. In terms of subjects of the study, the experimental group 15(4 male, 11 female)and the control group 15(5 male, 10 female) were divided. The measurement of the shoulder range of motion was taken by measuring the degrees of flexion, abduction, and external rotation with a goniometer from pre treatment to one to four weeks. The results were as follows : In the experimental group and control group, there was the statistical significance in the range of motion of the shoulder flexion, abduction, and external rotation during four weeks. In summary, the vibratory stimulation are effective interventions for improving shoulder adhesive capsulitis, patient`s range of motion of shoulder joint.
Somatosensory evoked potentials elicited by stimulation of the lateral femoral cutaneous nerve were investigated in 20 able-bodied persons and 22 patients diagnosed clinically to have meralgia paresthetica. There was no statistically significant difference between the right and left sides for P0 and N1 latencies in able-bodies subjects. For all patients, abnormalities were found on the side clinically affected. The mean values were 38.11 msec for P0 and 47.49msec for N1 on the affected side and 32.62msec and 41.44msec on the unaffected side (p less than .01). The mean latency differences between the two sides P0 and N1 were 5.49msec and 6.05msec, respectively (p less than .01). Hence, this technique proved to be a useful objective diagnostic aid in meralgia paresthetica.
Meralgia paresthetica is a syndrome of pain or dysesthesia, or both, in the anterolateral thigh caused by entrapment or neurinoma formation of the lateral femoral cutaneous nerve. Conservative treatment was successful in relieving symptoms in 91% of 277 patients with this syndrome; however, 24 patients required surgical treatment for intractable symptoms. Although neurolysis with transposition is the most common procedure, sectioning of the lateral femoral cutaneous nerve was performed in 24 cases and was successful in 23. One patient had early symptomatic relief, but subsequently developed different neurological signs and symptoms because of an undetected pelvic neoplasm.
Anatomical variations of the nerve and neurinomas, which occur frequently, are easily handled with sectioning but may lead to recurrence with neurolysis and transposition.
The lateral femoral cutaneous nerve of the thigh is frequently affected in clinical conditions, such as diabetes mellitus, resulting in meralgia paresthetica. To evaluate objectively the integrity of this nerve, the following technique was devised. Surface electrodes were constructed to record (antidromically) the action potential of this nerve following stimulation 1 cm medial to the anterior superior iliac spine. Anatomic dissection of cadavers revealed the course of the nerve. In 24 adults free of disease the mean conduction velocity in the nerve was found to be 47.9 ± 3.7 meters per sec.
We reviewed the findings in twenty children and adolescents who had meralgia paresthetica, a common entity in adults that has only rarely been reported in children. Ten patients had bilateral involvement; thus, the study included thirty lesions. Twenty-four lesions were eventually treated with open decompression of the lateral femoral cutaneous nerve; the results of twenty-one of these operations were followed for at least two years. The presenting symptom was severe pain resulting in marked restriction of activities. The pain could be reproduced with palpation of the nerve, and a trial injection of Xylocaine (lidocaine) always produced transient relief of symptoms. The average age at the onset of the symptoms was ten years (range, one to seventeen years); the diagnosis was missed initially in ten patients, which resulted in multiple, unnecessary diagnostic tests being done. The average duration of the symptoms before the patient was first seen was twenty-four months (range, two to eighty-four months), and the average duration of follow-up after the twenty-one operations was thirty-eight months (range, twenty-five to sixty months). Fourteen of the twenty-one operations led to an excellent result, with complete relief of pain and no restriction of activities; five led to a good result, with occasional pain but no limitation of sports or other activities; and two led to a fair result, with pain that interfered with sports activities but not with walking. We believe that meralgia paresthetica is much more common in children than has been previously recognized.(ABSTRACT TRUNCATED AT 250 WORDS)
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