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Having meralgia parenthetica. Getting tingling and numbness while sleeping, hips feel sore. Any thoughts?

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Practicing since : 1981
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I was diagnosed with meralgia parenthetical 14 years ago. It used to not be that bad- it would come and go, and only bother me if I slept on my left leg. It has gotten worse over time and now I get the pain tingling or numbness any position when I sleep, and my left hip feels sore. Sometimes I wake up at night with my whole left leg numb or tingly. I have had problems with low back pain in the last 2 years, so I am wondering if his could be related. I also have parasthesias elsewhere- I have to sleep with my arms straight or my forearms and hands go numb and tingly. It is hard to get comfortable and sleep well. I don't know how I can improve my situation if possible. Could all these things be inter-related? I am female, age 42, about 50 lbs overweight, and have had 3 c- sections. I don't have diabetes or anything, but have acid reflux and orthostatic intolerance. I know I need to lose weight, but it is hard because I am always tired and seem to have pain or injuries that discourage me. Any thoughts or advice for me? Thanks
Posted Tue, 7 Aug 2012 in Bones, Muscles and Joints
Answered by Dr. Anil Grover 1 hour later
Thanks for writing in.
I am a medical specialist with an additional degree of cardiology. Seventy percent of my cardiology patients are diabetics and seen meralgia paraesthetica in some of them. Frankly, I have not come across any one carrying this diagnosis who is non diabetic. I read your history mail with diligence and intend to reply in detail.
Rarely, it has other etiologies such as direct trauma, stretch injury, or ischemia. It typically occurs in isolation. The clinical history and examination is usually sufficient for making the diagnosis. Same etiology like compression due to wear and tear of spinal vertebrae can involve other nerves that way it can be inter-related with other areas like low back ache as you mentioned. Apart from most comfortable posture you probably need one or both of the following things (to be done by a specialist)

•When the pain is severe, a focal nerve block can be done at the inguinal ligament with a combination of lidocaine and corticosteroids. This should temporarily relieve the symptoms for several days to weeks. Ultrasound guidance for the blockade may be beneficial in patients with regional anatomical variations.

•Neurogenic pain medications such as carbamazepine or gabapentin typically are not as helpful but may be beneficial in rare patients. If medication of this type is required, then surgical decompression should be considered.

In rare and particularly painful cases that are unresponsive to nerve block, surgical decompression may be warranted.

Other thing is you have to be seen in Pain Clinic. Usually they are supervised by anesthesiologist, you can ask around for referral. From the net I found one which I thought is near your place. At least there are good reviews in net.
Category: XXXXXXX Medicine [Edit]
680 Mowry Ave
Ste 101 (at Ford Ln)
Fremont, CA 0000
(510) 790-8821

If you have any followup query about the original question please ask, I will be happy to answer.

With Best Wishes
Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
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