I put my hands in my pockets and I can't feel anything. I have paresthesia.

Home fitness has become increasingly popular recently, and this type of patients often appear in the outpatient clinic after holidays. After finishing weight training, they often cannot feel whether there are keys in their trouser pockets. Upon careful touch, they find that there is no feeling on the outside of their thighs. They don’t know which department to see?

Paresthesia of meralgia, also known as lateral femoral cutaneous neuritis, is a disease of abnormal sensation in the lateral thigh skin. I often call it the silent killer of thigh sensation. This disease is more common in slightly obese middle-aged men, or women who like to wear tight jeans and body-shaping pants. There is burning, tingling or numbness in the front and outer sides of one or both thighs, especially the loss of sensation, numbness, insect crawling sensation, burning, tingling and heaviness in the outer two-thirds of the thigh. Sometimes there will be tender points on the outer thigh (as shown in Figure 1).

Figure 1: Common locations of meralgia paresthesia (circled).

Sitting or squatting for a long time, standing with the thigh muscles contracted (such as holding a barbell or squatting for a long time, standing in a horse stance, etc.), or wearing a thick and wide hard belt around the waist, hanging a large mobile phone around the waist, etc., will compress the nerves and aggravate symptoms such as numbness and tingling. Professional doctors can find the compression points through physical examinations, and use nerve conduction tests to find the lesions and confirm the degree of compression.

The treatment of this disease should avoid further compression of the affected area, such as losing weight to reduce waist circumference, wearing looser pants and avoiding the use of hard belts, not squatting for too long, getting up and moving every 15-20 minutes, or doing soothing stretching exercises for the front hip (as shown in Figures 2 and 3). Physical therapies such as electrotherapy, far infrared, and laser in the rehabilitation department usually have good effects. Those with severe symptoms can consider receiving injection treatment, using water dilation under ultrasound guidance to separate the adhesion tissue, and then using nerve proliferation repair treatment. Patients who do not respond well to injections should pay attention to the possibility of lumbar spine disease. Patients with severe recurrent attacks can undergo ligament release surgery.

Figure 2: Right hip stretching exercise, cross your legs, bend your body to the left with your right hand upward, stretch the right hip to relieve the right anterior iliac ridge. Do it 5 times each time, three times at a time, and three times a day. Don't do it for too long or too many times.

Figure 3: Left hip stretching exercise, squat on one foot and kneel on the other, cross your arms upwards, push your left hip forward, this can relieve the left anterior iliac spine, do 5 times each time, do three times at a time, do three times a day. Don't do it for too long or too many times.