Meralgia paresthetica and low back pain

Abstract

Purpose: To determine the ratio of MP or non MP cases among patients with anterolateral thigh pain and/or disesthesia simulating MP. Material-methods: Forty patients with MP symptoms were included in the study. Demographic data, possible etiologic factors for MP, and symptom changes due to hip position were noted. Electroneuromyography (ENMG) and radiologic studies of lumbosacral and pelvic region were performed in all patients. The patients were divided in to two groups regarding ENMG results: The patients with no sensorial response at the distribution area of lateral femoral cutaneous nerve (LFCN) (group A, 22 patients) and those with normal LFCN responses (group B, 18 patients). Mann Whitney U and chi-square tests were used for statistical analyses. Results: Female/male ratio was 0.9 and the mean age was 55.4± 12.5 (27-75) years. Six patients were police-men, 6 were obese, 3 had story of pelvic laparascopy, 3 had carpal tunnel syndrome and 4 were diabetic. The remaining patients had no history of risk factors or disorders that may be related to MP like symptoms. Symptoms were aggravated by hip extension in 77.3% of real MP patients. The prevalence of low back pathologies including disc hernia, spinal stenosis and degenerative changes in group A and B was 54.5% and 94.4% respectively. Conclusion: The patients with MP like symptoms and findings may have low-back pathologies without any evidence of abnormal LFCN responses in ENMG. Symptom aggravation as a result of hip extension may be considered in favor of MP. But, we recommend applying ENMG to confirm or rule out the MP diagnosis.