Introduction:
Meralgia paresthetica is a neurological condition that occurs in most pregnant women. It is mainly caused by obesity or weight gain during pregnancy or by wearing uncomfortable or tight clothes. It is a non serious and self-limiting condition.
What Is Meralgia Paresthetica?
Meralgia means pain in the thigh area, and paresthesia means numbness or a pricking sensation. So, meralgia paresthetica is pain associated with a tingling or burning sensation in the anterolateral region of the thigh. It happens when the lateral femoral nerve (the nerve that supplies the skin of the thigh in the anterior and lateral region up to the knee level) undergoes compression.
What Causes Meralgia Paresthetica?
In meralgia paresthetica, a nerve called the lateral femoral cutaneous passing through the inguinal ligament area or the anterior superior iliac spine region gets entangled or entrapped, leading to compression. This nerve causes sensations in the upper leg or thigh area, so pain and associated symptoms occur due to compression. However, this condition only affects the sensations and does not affect the motor activity or leg movements.
How Does Meralgia Paresthetica Occur in Pregnant Women?
In pregnant women, the growing fetus leads to weight gain in the uterine region. Sometimes the weight of the growing fetus put pressure on the groin area, thereby compressing the nerve leading to this condition. Other reasons may be wearing belts or tight clothing, obesity, standing, running, or walking for longer duration.
What Are the Symptoms of Meralgia Paresthetica?
The symptoms of meralgia paresthetica usually occur on one side and affect the outer skin of the thigh and not the muscles. A few of those symptoms are:
-
A pricking or burning sensation, numbness, and pain in the anterior and lateral aspects of the thigh region.
-
The thigh skin becomes overly sensitive to hot or cold objects and even to soft touches.
-
Pain while lying down on the affected side and in the groin area.
-
These symptoms worsen during long periods of walking or standing.
How Long Does Meralgia Paresthetica Last?
The symptoms or condition can worsen throughout pregnancy, eventually resolving after delivery. However, in rare cases, the symptoms also prevail after delivery.
Is Meralgia Paresthesia a Dangerous Condition for Pregnant Women?
No, meralgia paresthesia is not dangerous for pregnant women and will not cause any complications. It will not harm the baby or the mother. Even though it can interfere with the individual's daily activities, it is a self-limiting condition. It will eventually resolve with or without any medical intervention or treatment.
How Is Meralgia Paresthetica Diagnosed?
To diagnose the condition, the doctor or healthcare professional will take the history to get a general idea about the symptoms and condition. The physician will inquire about the type of clothes worn regularly or to work, if belts are worn etc,. Next, the physician performs a physical examination requiring one to point out the area of numbness or pain in the region. A detailed description of the pain should be provided to the doctor. Some additional examinations will be done, which include reflex testing and strength testing. The doctor might recommend further tests if the condition is not diagnosed by physical examination alone. Some of them include the following:
-
Imaging Studies - X-rays (not preferred in pregnant women) or MRI (magnetic resonance imaging) will provide a detailed image of the internal structures. Even though imaging studies prove very little significance in diagnosing meralgia paresthetica, we can use them to rule out any existing disorders like tumors in the pelvic region or a herniated disc.
-
Nerve Conduction Studies - Here, damaged nerves are detected via electrical stimulation. They are usually done on the affected and the non-affected part and then compared.
-
Electromyography - This technique measures the electrical activity and discharges produced by the surrounding muscles. A thin electrode is placed into the muscle to detect any signs of activity. This test is usually normal in meralgia paresthetica, but it is done to rule out other disorders.
-
Nerve Blockade - An ultrasonic-guided injection containing an anesthetic agent and steroid is given to the thigh area where the lateral femoral nerve passes. Usually, the pain resolves almost immediately.
What Are the Treatment Options for Meralgia Paresthetica During Pregnancy?
-
In most cases, the condition resolves independently without any medical intervention.
-
The patient is reassured that the condition will resolve once the baby is born.
-
Conservative treatment options are also suggested to ease the symptoms. Some include advising the patient not to wear any belts, wear loose-fitting clothes and reduce standing or walking for a long period. Advise the patient to reduce any extra weight.
-
Low-risk interventions like specific exercises are seen to be effective as it helps ease discomfort and pain.
-
In very rare conditions, surgery is advised. It usually happens in people with severe symptoms that do not resolve even with other treatment options.
How Can Pregnant Women With Meralgia Paresthetica Sleep Better?
Pregnant women should adequately take care of their sleeping positions. Using a pillow between the legs and avoiding lying on the affected side will help ease discomfort, as pain might substantially increase while lying on the affected area.
Which Exercise Will Help Meralgia Paresthetica During Pregnancy?
There are a few stretching exercises that help with the symptoms. However, always consult the gynecologist and get their approval before attempting any exercise.
Hip Stretching Exercises:
-
Start by being seated at the edge of the bed and gently lie down. Then slowly raise the unaffected leg and bend the leg towards the chest, leaving the affected leg hanging down at the bed edge. Hold the leg for at least a few seconds before dropping them. Do this stretch minimum three times per day.
-
Second, on a flat surface, lie down on the unaffected leg and bend both knees. Place an elastic band on the affected ankle and pull the ankle close towards the buttock region. Remember to keep the back straight while during this stretch. Hold the ankle for a few seconds and leave. Repeat this stretch minimum of two to three times a day.
-
Third, lie down on the back, keep the feet wide apart and flat and bend the knees. Gently place the arm on the sides. Try engaging the core and pull the tummy back to the spine, squeeze the muscles of the bottom and lift the bottom from the floor. Hold this position for about 10 seconds and gently lower the back down. Repeat this about ten times, every three times a day.
Conclusion:
Meralgia paresthetica is self-limiting and is fairly common among pregnant women. Even though it is a neurological condition, it is not serious and can be easily managed with adequate care and appropriate lifestyle modifications.
