#Middlebury #ToYourGoodHealth
DEAR DR. ROACH: I am a 65-year-old male who has developed a lack of sensation in the lateral front half of my right thigh. The numbness involves strictly the skin. There is no loss of strength, function or balance in my leg. My gait is normal, although I find that if I go on a long walk, the skin will begin to “tingle.”
When I went to an orthopedic surgeon, he suspected that the condition could be caused by a disc problem. Although an X-ray did show some stenosis, it was not definitive.
I suspect I caused the problem by years of sleeping on my right side in a curled-up position, resulting in entrapment of the nerve. The orthopedist, however, says he generally sees this condition only in obese people, which I am not.
How likely is it that my condition is of spinal origin rather than an entrapped nerve? If the condition can resolve itself gradually by avoiding activities that contribute to the problem, what does “gradually” mean? Do stretching exercises help relieve the entrapment? – J.C.B.
ANSWER: What you are describing is meralgia paresthetica, the compression of the lateral femoral cutaneous nerve, which can be compressed as it passes under the inguinal ligament, exactly as you described. Your orthopedist is correct that this condition is more common in the overweight or obese; however, I have seen it in both people who are losing weight and people of normal, stable weight. It is more common in conjunction with diabetes, and it has been reported after long-distance walking and cycling.
Because of the area involved in your numbness, it is very likely to be meralgia paresthetica and not spinal in origin. It does usually resolve, but it does so over the course of months, typically. Stretching would seem to make sense, but as far as I know, it hasn’t been shown to work.
If it isn’t getting better, an injection into the nerve usually is effective. This is commonly done by an anesthesiologist or a pain-management specialist.
DEAR DR. ROACH: Can you please give me some information on Ehlers-Danlos syndrome? My daughter and two granddaughters have it. – E.E.H.
ANSWER: Ehlers-Danlos syndrome is actually a group of uncommon genetic disorders, with very stretchy skin, flexible joints and tissue fragility as common features. There are six different kinds of Ehlers-Danlos, and each is different in regard to what tissues and organs it most affects. Most are caused by mutations in genes for collagen and related structural proteins. They can be inherited or not (in which case they are new mutations).
Flexible joints (often but wrongly called “double-jointed”) and excessively stretchy skin are almost universal in EDS. The excess joint movement can cause dislocations and chronic joint pain resembling fibromyalgia. Other commonly associated conditions include prolapse of the mitral valve, hernias and, in the vascular type of EDS, aneurisms.
The prognosis in EDS depends to a great extent on the subtype. I would suggest you go with your daughter and granddaughters to their doctor (if they agree) to learn more about their particular type.
Dr. Roach regrets he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.
(c) 2018 North America Synd. Inc.
All Rights Reserved
You must be logged in to post a comment.