Expert: Scott F. Gillman, DC, DACBSP - 9/21/2009

Question
I am postop 4 lumbar laminectomies - L4 -L5 and L5-S1. I also have RSD of my left foot which had been resolved. Almost one year ago, I underwent a total knee replacement on the left side which re-initiated the RSD. that is just background.  Since before my TKR, I was confined a lot to a chair and I started to develop numbness, tingling, and severe burning in  both outer thighs. I assumed it was from my back for having spent so much time sitting. It was severe at night - enough to keep me awake. I have a fairly high pain tolerance after all the surgery etc. so never said anything to drs - except to my chiropractor. She has kept my back relatively painfree even while limping, being on crutches, in bed postop etc. My knee is improving - it's been almost a year since the surgery, but the thigh issues seem to be getting worse -esp when sitting and esp when sitting in a recliner using a laptop on a lapdesk. It feels remarkably like my RSD pain and at first I thought postop it was related. I just found "meralgia paresthetica" online when I decided the newest symptom of "extreme stinging" came about. I wondering if there is known chiropractic treatment for this. I understand it could be from my back (L3 I think could be the issue since I have chronic subluxations and slipped disks) but before doing the traditional route, I would like to see if there is something my chiro can do. BTW, the days I my underwear is tighter in my inguinal area seems to make it worse - which seems to make this diagnosis more real. (I am an RN btw. so I understand the differential diagnoses that you can't address. I am just wondering if you know of any treatments a chiro can do to help with meralgia paresthetica. I have asked her to look into it as well.  thanks.

Answer
Betty,

The only real shot at this conservatively is with soft tissue therapy around the inguinal ligament, sartorius, psoas regions using myofascial release methods (Active Release Technique or ART, or other forms of active myofascial release).   A quick pubmed.com search brought up one article that described this procedure:  http://www.ncbi.nlm.nih.gov/pubmed/19674679?ordinalpos=12&itool=EntrezSystem2.PE...

'Hope this helps,

Scott