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Meralgia Parasthetica (Bernhardt-Roth Syndrome) Physiotherapy

Meralgia parasthetica, or Bernhardt-Roth syndrome, describes a condition in which .

• numbness
• tingling
• burning pain

is experienced in the outer portion of the affected thigh and happens as a result of nerve compression.

Meralgia parasthetica most commonly affects middle-aged individuals, and men more than women. That being said, it can develop in people of all ages.

Physiotherapy is a safe and effective approach for managing the symptoms, and some causes, of meralgia parasthetica.

What is Meralgia Parasthetica (Bernhardt-Roth Syndrome)

Meralgia parasthetica occurs as a result of compression to the lateral femoral cutaneous nerve, which refers to a long nerve that stretches from the spine through the groin and into the upper thigh. Abnormal compression at any point along that nerve can cause symptoms.

The lateral femoral cutaneous nerve provides sensation to the outside portion of the thigh, but does not help or play a part in the movement of the leg.

If the lateral femoral cutaneous nerve becomes compressed and irritated, patients may experience the numbness, tingling, or burning pain in the region of the outer thigh associated with meralgia parasthetica.

The most common causes of meralgia parasthetica are those associated with increased pressure in the groin area, including:

• Wearing compressive garments such as a work belt, a military or police uniform, or tight jeans
• Obesity or weight gain
• Pregnancy
• Recent hip injury

Other causes can include:

• Direct trauma to the nerve, such as from a seatbelt in a car accident
• Repetitive leg motions (extended periods of biking, walking, squatting)
• Muscle spasms
• Scoliosis
• Postsurgical complications, most common after surgery to the hip or lower back
• Diseases, such as diabetes, alcoholism, or lead poisoning

How Does it Feel?

A person with meralgia parasthetica may experience:

• Numbness, tingling, or burning pain on the outside of the thigh
• Increased tenderness to light touch on the outside of the thigh
• Pain when lying on the involved side
• Increased sensitivity to extremes in air or water temperature
• Increased sensitivity to different textures of clothing

Pain is often worse with standing or walking, and decreases with sitting.

How Is It Diagnosed?

The diagnosis of meralgia parasthetica is based primarily on the findings of a patient’s history and physical exam.

Further tests are rarely needed.

Diagnostic imaging techniques, such as x-ray or MRI, are not used to diagnose meralgia parasthetica, but may be used by a physician to rule out other disorders.

Our senior physiotherapists will review your medical history and discuss your symptoms with you. We will also discuss your

• daily and work activities
• exercise regimens
• clothing or uniforms that you typically wear to identify contributing factors of your condition

We will perform a thorough physical examination of your back, hip, and leg. The goals of the initial examination are to determine the source of your pain or discomfort, and identify any contributing factors.

We will

• assess the mobility and strength of your back, hip, and leg
• may watch you walk, step onto a stair, squat, or balance on 1 leg

We will also gently touch the front, side, and back of your hip and leg to determine exactly where your symptoms are most bothersome.

how our senior physiotherapists can help

Each case of meralgia parasthetica is unique.

No matter what the cause, we can implement treatments to help manage your symptoms. In addition, for patients whose meralgia parasthetica is caused by a disorder in the hip or pelvis, physiotherapy will also address those areas, with the goal of eliminating compression on the nerve.

We will work together to develop a plan to help achieve your specific goals. To do so, we will select treatment strategies in any or all of the following areas:

Pain Relief

Many pain-relief strategies may be implemented. Desensitization strategies, using items of various textures and temperatures, are used to decrease your leg's extreme sensitivity.

We may prescribe a decrease in or avoidance of certain activities, or a change in clothing. We also may apply therapeutic tape to the affected area to help relieve your symptoms.

Range of Motion

Your back, hip joint, or surrounding muscles may be moving improperly, causing increased compression on the nerve.

We may teach you self-stretching techniques to decrease tension and help restore normal motion in the back, hip, and leg.

Manual Therapy

We may apply hands-on manual therapy treatments to gently move your muscles and joints to improve their motion and strength, most likely in your back or hip. These techniques often address areas that are difficult to treat on your own.

Muscle Strength

Muscular weaknesses or imbalances often correlate with an injury to the hip or pelvis, which can contribute to nerve compression.

Based on your specific condition, we will design a safe, individualized, progressive resistance program for you, likely including your core (midsection) and lower extremity.

You may begin by performing strengthening exercises lying down, and advance to exercises in a standing position. We will choose what exercises are right for you, based on your age and physical condition.

Functional Training

Often with meralgia parasthetica, symptoms are caused or made worse by any repetitive movements required in your daily or work activities.

Based on your own unique movement assessment and goals, wewill create a series of activities to help you learn how to use and move your body more correctly and safely.