Question
Hello Dr.,
I'm sure I've had MP for over the past 10 years.  I'm 36 years old now and seem to remember when I was in my early 20's waking up with both legs numb on the sides, with no pain.  This would go away quickly and I never had anything done about it.  I just assumed I slept funny.  Then one day in 2002 I had a rock climbing injury where the safety harness I was wearing was worn incorrectly atop my iliac crest, which sustained numerous falls and my entire body weight.  This caused permanent nerve stretch damage and left me with chronic tingling and paresthesia in both legs and buttocks as well as muscle fasciculations (didn't start until 8 months after injury). The MP, however, didn't bother me much after that incident.  For the fall injury I had a complete workup with lumbar/pelvis MRI's, 2 EMG's which were normal, and blood work.  Essentially, I had paresthesia sensations and have a small anesthetic patch of skin on my right thigh, but neuros said nothing is wrong with me.  Over time the symptoms have gotten better and I am used to living with it.  

Then maybe 2 years ago I started to really be bothered by my MP.  I don't know whether it got worse from the rock climbing falls, but I'd assume if it had anything to do with the falls I would have had worse symptoms back in 2002.  Anyway, I am awoken multiple times during the night by my MP.  Sometimes it burns me at night and I have to sleep on my side with legs tucked to relieve the pressure.  Plus, over the past 2 years, I'm getting cold sensations after standing for about 5 minutes, which then progresses to full blown numbness.  Then I have to sit down to relieve it.  I'm going to a chiro who's trying to release my inguinal ligament and the LFCN.  However, I sense this is only getting worse and I'm worried about having to live without standing for long periods (i enjoy hiking and mountain climbing and would need to stand for hours on end; plus looking into becoming a doctor so would need to stand for long periods).  

I'm assuming the LFCN is just entrapped near the groin or else I would have had bothersome symptoms going back to the rock climbing falls in 2002.  But only in the past 2 years has it really been a concern for me.  Can you suggest any other treatments?  I've tried everything including acupuncture and herbs.  I doubt my condition is related to anything else but MP.  I had another EMG in Jan. 2009 and the neuro did an physical exam and said nothing is wrong.  But obviously there is.  

I'm also a weight lifter and feel my best when I'm lifting heavy weights.  It seems my condition actually improves when I'm going to the gym regularly and lifting heavy.  But it's the down time, when I'm standing or lying down when my MP comes back.

Would it be wise to get a cortisone injection?  or surgery to relieve pressure?  My personal trainer says I have very tight hip flexors.  I try stretching them but seems to aggravate the MP.  Maybe I'm so tight in the hip region that the nerve is compressed by muscles and need to have inflammation reduced.

Thank you,
Joe

Answer
Dear Joe,

Of particular interest to me is the fact that when you try to stretch the tight hip flexors your Meralgia Paresthetica becomes worse. I definately think that there is a link to the hip flexors and the Meralgia Paresthetica that you suffer with.

There two avenues for which you might recieve some help and these are:
1) A chiropractic neurologist who employs exercise with oxygen therapy (EWOT). I suggest going to my website www.drqdc.com and learn a little about EWOT and you can Google it also and if you do don't use the acronym but spell exercise with oxygen out in the search bar. Also to find this type of practicioner go to www.lifechangingcare.com and let em know I sent you!!!
2) Find a chiropractor who practices MUA manipulation under anesthesia. Yes you read that Right manipulation under anesthesia is performed while you are under complete sedation. The idea is too break up scar tissue and adhesions that may be causing your Meralgia Paresthetica. The stretches you would undergo could not possibly happen when you are awake because it would be too painful.This is a covered procedure by insurance. Google MUA or spell it out for your city and or surrounding cities.

Hope this info helps..keep in touch.

John Q Quackenbush DC
www.drqdc.com
Phoenix Chiropractor