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Numbness and itching on inner thigh from Meralgia Paresthetica


#1

I have a patient who was referred to me by her MD b/c she has Meralgia Paresthetica. Her doctor told her that acupuncture has had great results with this condition. Basically what the condition is, is a numbness and itching on the inner thigh due to irritability to the Lateral Femoral Nerve. The patient has suffered from this condition for 4 years with the only relief from Neurotin, but it left her too lethargic. Pt denies any other sx's and hasn't noticed any changes with diet and supplements. Pt says that the only thing that seems to help her is when she wears loose clothing. Patient's pulses are slippery and her tongue is red w/ thick yellow coating. Pt refuses any herbal support and said it would be hard to eliminate dairy from her diet. So far we have tried laser, electro, surround the dragon, and distal points to clear dampness and heat. Pt has had little to no relief. Pt is also using Yin Care directly on the thigh, and std it has helped w/ the itching but not the numbness. I was hoping someone could give me some information on what they would do or suggest with this patient, because it deems to be a very difficult case for myself.

Thank you.


#2

Points: Lv3, 5, Sp6, Kd10, Li4, 11, Du14, Hua Tuo Jia Ji lower back(L1-L5), Ashi points use MeiHuaZhen knock the skin make it slightly bleeding, then use BaGuan(fire) 15 minutes on ashi points area.


#3

I will offer some advice as I&#39ve treated this successfully in the past, however, generally speaking when patients will not listen or follow your advice I would simply suggest they see another practitioner. 4 years is a long time to be in pain and personally I would do just about anything to get out of it - when people won&#39t there are usually other issues that are making them attach to their disease and if you cannot break them from this, perhaps someone else can - or perhaps now is not the time for them to take their own health seriously - either way their chances of healing are greatly limited with these blocks in place. From previous experiences the vast majority of times that you discharge patients for these reasons they inevitably come back months to years later and then resolution to their issues is much easier when they are 100% involved. I&#39m not saying this to be harsh, it&#39s just that the healing has to be taken seriously on both sides of the relationship, if it isn&#39t it may not matter what you do for the person they simply will not get better.... (this may or may not be applicable in this case, just thought I would mention it as it seemed appropriate).


Now onto what I would do. Unless this came from some kind of injury (sports, mva, etc.) to the thigh itself, meralgia paresthetica arises from an issue in the L2-L3 spinal segment where the related nerve is innervated. As Feng points out needling the huatuo points of L1-L5 is useful, personally I would also add S2. Then given her other conditions I would probably add GB 31, 34, LV 8, SP 9, GB 39, UB 57, UB 60 along with GV 19 (sensory cortex of the brain), GV 20 (motor cortex), and the huatuo at T7 (circulation into the lower abdomen and legs). Out of all these GV 19, the huatuo points and LV 8 are probably the most important in my opinion. Deep tuina and/or cupping in the lower back area particularly around L2-L3 is important. Locally needling generally doesn&#39t help these conditions and plum blossom or other techniques around the local area will often get limited results as the true cause is up much higher.



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