MERALGIA PARESTHETICA, from the Greek "meros" for thigh and "algia" for pain consists of unpleasant burning pain in a well defined oval on the side of one thigh or the other, stirred up by contact, even the weight of bedsheets in some cases. It is usually unilateral, almost always worse at night and sometimes the result of obvious activities such as one worker who offloaded petroleum drums from trucks by resting them on his upper thigh.
Sigmund Freud suffered and recovered from this and wrote it up in one of his early monographs when he was struggling to make a living as a neurologist. He wrote that he switched from neurology to psychiatry because he got tired of "talking people into and out of things," which strikes me as exactly backward.
This condition is easy to recognize but only if it is suspected. It is benign and usually resolves spontaneously after months or years. It does NOT involve any weakness or low back pain.
The condition is due to irritation of the lateral cutaneous sensory nerve of the thigh where it passes under the inguinal ligament.
The discomfort can often be relieved remarkably by amitryptalline, (Elavil) 10 mg at bedtime.
Meralgia Paresthetica tends to resolve spontaneously after a year or so. Rarely, surgical decompression may be necessary.
If a Tinel's Sign (tingling on tapping) is present over the nerve (it's course is exceptionally variable and subject to neuroma formation) local xylocaine/steroid injection sometimes works but not as dependably as it does for carpal tunnel syndrome.
For painful (typically "burning, prickling") peripheral neuropathies generally, once a diagnosis has been made or the worst ruled out, topicals are an innocuous first try.
For years I've been recommending capsicum in it's cheapest form: McIlhenny's Tabasco. Now that it's been widely recognized, the consumer can pay a lot more for a commercial version such as Capsaizin or Zostrix.
Dab it on (no need to rub) several times a day to UNBROKEN NORMAL SKIN ONLY for a few days and if it doesn't work, quit. Avoid eyes and delicate mucus membranes (genitalia). Theoretically capsicum leaches out "p" (for pain) substance. Empirically it works symptomatically for many patients with such problems as Post Herpetic Neuralgia and Diabetic Neuorpathy and even Trigeminal Neuralgia (Watch the eyes!).
The other topical worth a try a trademarked product, Myoflex. I have no interest in the manufacturer but I wish I did. Aspirin, in their form of Trolamine (I picture little trolls carrying it across the skin) Sailicylate, may also provide temporary but effective relief in certain painful neuropathies. Watch for aspirin allergy.
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