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LEG PAIN DURING PREGNANCY CaseFile

(keywords: LEG PAIN DURING PREGNANCY CaseFile, upper leg pain, lower back and leg pain, meralgia paresthetica)


LEG PAIN DURING PREGNANCY is clearly a common affliction as measured by my own clinic and the amount of mail I get at CONTACT. There are indeed many causes of upper leg pain so a careful clinical examination is always indicated.
UPPER LEG PAIN ...


My TWITTER ...

MERALGIA PARESTHETICA

Mrs P, 38 years old, was not enjoying her fifth pregnancy. The first four were routine, but now she has severe upper thigh and groin pain, and some buttock pain for the last six weeks. The pain was particularly bad at night, and she couldn't sleep. There was no obvious cause except that she is 'high pregnant' (hoog zwanger) as we say in the Netherlands. She's in her 35th week.









The Examination of our LEG PAIN DURING PREGNANCY CaseFile

The first and most noteworthy observation was that Mrs P was clearly exhausted. She had a haggard look about her that I didn't like. What's more she was very apprehensive never having consulted a chiropractor before, but she was desperate. Having tried all else, I was her last port of call ...

Having gone through the usual clinical history, where does it hurt, when did it start, what makes the pain worse, what previous treatment had she had ... we proceeded to the examination.

  • Pain on forward bending in the right buttock.
  • A marked right sacroiliac joint fixation.
  • A less obvious L2 fixation that I could have missed, except that I was expecting it, and thus looking out for it. Why? You'll see ...
  • Extreme pain in the Adductor magnus muscle in the inner thigh.
  • Exquisite tenderness where the Superficial Femoral Cutaneous nerve exits from the groin.
  • No sensory, reflex or muscle weakness abnormalities.
  • Full and normal range of motion of the hip, albeit with discomfort in the groin.
  • A positive femoral nerve stretch test.

  • TREATMENT of LEG PAIN DURING PREGNANCY CaseFile

    I always ask that the spouse accompany the patient in this instance. Firstly to reassure them both about the condition and the proposed treatment, secondly because the treatment is painful and thirdly because it is in an intimate area: the inner thigh, the pubic bones and the groin.

    IT'S GOOD TO TAKE YOUR SPOUSE ALONG.

    The activator technique lends itself well to the pregnant patient. So I used this little instrument to adjust her sacroiliac joint and L1.

    The treatment of the groin is awkward and painful for all concerned. I don't like inflicting pain, and chiropractic treatment isn't usually painful, and she didn't like receiving it.

    I gave her the Maignes syndrome exercises to try (very gently). MAIGNES SYNDROME EXERCISES ...

    OUTCOME @ LEG PAIN DURING PREGNANCY CaseFile

    It was gratifying this morning to see a very different patient. She looked rested and at ease.

    Mrs P reported that she had slept normally for the first time in weeks for the last two nights.

    All this after only two treatments.

    There was not much improvement in the sacroiliac joint pain, so we attempted a gentle general chiropractic adjustment, and a drop toggle on her hip bone whilst lying supine.

    Whilst we have a ways to go yet, as she says if it simply remains this much better for the next four weeks she will be more than delighted.


    DISCUSSION of our LEG PAIN DURING PREGNANCY CaseFile

    Meralgia paresthetica is what we call a double-crush syndrome. There is always an upper lumbar subluxation, from where both the Femoral nerve and the Lateral Femoral Cutaneous nerve originate, and an entrapment in the groin.



    Notice where the Lateral Femoral Cutaneous nerve emerges in the picture above from under the Inguinal ligament. That's exactly where Mrs P was exquisitely painful. It's a condition often related to pregnancy (and obesity, and tight clothing) but certainly not exclusively.

    Double crush: Lumbar facet syndrome at L1-2-3 area + impingement under the inguinal ligament.

    The condition responds very gratifyingly to both doctor and patient if the correct careful, and I'm sorry to say, not too gentle treatment is applied. I make only three swoops through the area and it hurts. A lot. You may have some bruising. She didn't fortunately, but it does happen.




    LOWER BACK AND LEG PAIN

    The differential diagnosis of conditions like this LEG PAIN DURING PREGNANCY CaseFile is not without difficulty. A sacroiliac joint syndrome, slipped disc symptoms case file, a lumbar facet syndrome, Maignes syndrome casefile and even hip joint conditions like Femero Acetabular Impingement syndrome come into the equation.

    Purely 'medical' conditions too, like swollen lymph nodes, inguinal hernias, hip arthritis (rare, but does occur in this age group, especially after a poorly managed Perthes disease or Slipped Capital Femoral Epiphysis).

    Your Chiropractor will examine you carefully to make a correct diagnosis and apply the appropriate treatment. X-rays obviously are discouraged during pregnancy except in very exceptional circumstances which makes his/her work more difficult.


    LOWER BACK AND LEG PAIN ...

    SACROILIAC JOINT ...

    SLIPPED DISC SYMPTOMS Case File ...

    LUMBAR FACET SYNDROME ...

    MAIGNES SYNDROME CaseFile ...

    FEMERO ACETABULAR IMPINGEMENT SYNDROME ...

    PERTHES DISEASE ...

    LOW BACK EXERCISES FOR PREGNANCY

    Because pregnancy and lower back pain are almost synonymous I recommend that all pregnant women do some simple lower back exercises ... they take only two minutes before getting out of bed in the morning, and the trick is to start them BEFORE backpain begins. At this page you'll find lumbar facet exercises, disc exercises, sacroiliac exercises, core strengthening exercises. If you have no pain, or only mild discomfort then all are suitable.

    Just remember, you're not preparing for the Olympic squad! Take them slowly, get to know your own body, because there is no set of exercises that are suitable for every back. If in doubt, get advice from your chiropractor.

    Mind you... that big day is not unlike your own personal Olympics! Get into training. This little test will give you an idea of your overall level of fitness... KASCH PULSE RECOVERY TEST


    IMPORTANT CONSIDERATIONS

  • General low back exercises from CHIROPRACTIC TIPS are suitable during pregnancy too.

  • UNEXPLAINED inFERTILITY ...

  • COLIC CHIROPRACTIC ...

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    LEG PAIN DURING PREGNANCY CaseFile

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