Possible Neuropathy from Femoral Nerve Compression

by Caroline
(London, UK)

I am a healthy 41 year old female who has developed just over 3 weeks ago (following a bike ride of 20 miles having done no exercise for a while) a strange sensation on the front outer thigh that feels like I have sunburn at the lightest touch ie bedsheets or clothes touching me as opposed to pressured touch but there is nothing there.
I did have a smaller patch of the same on the inner thigh just above the knee on the same leg but that went away a few days ago. I also have some deeper shooting nerve type pains in the top and side of thigh but these seem to be less now however the skin tender sunburn sensation remains and it is becoming quite annoying. I went to the GP who confirmed it was a nerve issue and the sunburn feeling under the skin was quite common and to take ibuprofen for 2 weeks but I don't seem to find it talked about being common except for in the case of some scary illnesses.

Is this Meralgia Parasthesia or something else? I know the term is allodynia but I am not sure if this fits in with sort of nerve problem? I do have a slight tenderness around the groin but nothing to speak of but I do also have what seems to be a slightly enlarged inguinal ligament which sticks out more on that side than the other side and is a bit tender too.

Any ideas?

Hello Caroline,
It certainly sounds like meralgia paresthetica.

Just to be sure that it has nothing to do with the hip, lie on your back and pull your knee to the chest and then to the opposite shoulder. Drop your knee into the lotus position. No significant stiffness or side of hip or groin pain?

Usually there's associated discomfort and sometimes pain in the mid to upper lumbar spine. If you lie on your tum and your partner presses in that region, is it tender?

Take a needle and prick the side of your thigh and compare with the other leg. Is it more or less sensitive, or no difference?

The key features of MP are the burning pain you describe, tenderness just medial to the ASIS (google it), some lower back pain or tenderness and no motor effects; in other words no change in the knee jerk reflex and no weakness at the knee if you hop on one leg.
There is no scientifically proven treatment that I know of, either medical or chiropractic but I treat it quite regularly and successfuly. It's a so-called 'double entrapment' syndrome, both in the mid to upper lumbar spine and under the inguinal ligament. Both have to be addressed for a successful resolution of the condition. The treatment in the groin is quite painful; ask hubby to go with you.

Tight belts and clothing, and obesity are often blamed but frankly that hasn't been my experience, but it's worth a thought.

Start looking for a chiropractor with a sport injury background. A FICS qualification would be a great help; I'm sure the BCA could help you find a chiropractor in your area who could help.

Start our 'Maigne's syndrome exercises' which is a kindred condition. Use the search this site function at chiropractic help.

Let me know how you get on.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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