Magic solution?

January 12, 2014

Sue asked The Guru for the following Physiotherapy Advice:

I am being treated at Guy’s Hospital for Meralgia Parasthetica – do you have any thoughts on this condition? It is since last November. Thank you Sue

January 12, 2014

Hi Sue

Funnily enough, yes, but no magic solution.

MP is a cutaneous rather than a spinal nerve. Treatments seen to go from injecting or releasing the nerve at the inguinal canal to rubbing capsaicin into the altered sensation area.

I’ve also had patients who have had spinal epidurals to try to change it. However, I’ve also seen great results with good manual therapy to the thoracic spine to alleviate either spinal pressure around L1/2 or change the way the body moves around the pelvic/inguinal region. I’m not sure which one causes what, but it can be effective.

The issue with MP is how do you know if it’s getting better, worse or the same. The line of delineation can be fudged so I think you should draw around it and then take a photo. Don’t look at this for 6 (ish) weeks and then redraw and compare.

Try getting a set treatment protocol (hands-on and rehab based) for 4 sessions (weekly) and then have a look and ask you if you think there’s a change. This way it’s contained, measured and there is an outcome. If there is no change then discuss the above. Certainly, passive therapies (electrotherapy) doesn’t seem to play a role in this.

Hope this helps

The Guru

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