Tag Archives: nerve

Meralgia Paresthetica: Causes, Symptoms, and Myotherapy Treatment

drawing of Meralgia Paresthetica

Meralgia Paresthetica is a condition characterized by numbness, tingling, and burning pain in the outer thigh. It occurs when the “lateral femoral cutaneous nerve” (LFCN), which supplies sensation to the skin of the thigh, becomes compressed or irritated. While not life-threatening, it can be uncomfortable and disruptive to daily activities. Now let’s see how Myotherapy treatment can help with this presentation. Causes of Meralgia Paresthetica Meralgia Paresthetica presents with symptoms of lateral thigh weakness and numbness, which are caused by compression or the lateral femoral cutaneous nerve. This compression can have typical causes, which include: Tight clothing – Wearing tight jeans, belts, or shapewear can compress the nerve at the hip height. Obesity or weight gain – Excess weight puts pressure on the nerve. Pregnancy – The growing uterus may contribute to nerve compression. Prolonged standing or walking – Excessive movement can irritate the nerve. Injury or trauma – Previous surgeries, injuries, or direct impact to the hip area can damage the nerve. Diabetes – Diabetic neuropathy may increase susceptibility to nerve-related conditions. Inguinal ligament – The LFCN passes right under the inguinal ligament, which may create compression on the nerve itself. All those factors can compress the branch of the femoral nerve, which innervates the lateral portion of the thigh. The origin of the nerve is at the lumbar level L2/L3. Indeed, when a portion of the skin has altered sensation, it is often a peripheral compression that causes the symptoms. Symptoms of Meralgia Paresthetica The symptoms for Meraglia Parestetica often involved one leg only, as it is quiet uncommon to get compression bilaterally. Those symptoms include: Burning, tingling, or numbness in the outer thigh. The skin of the lateral thigh can also become very sensitive and painful to the touch. Sharp or aching pain that worsens with prolonged standing or walking. If the compression is due to organs or the inguinal ligament, movement can aggravate the presentation due to the tightness of the structure during movement. Increased sensitivity to touch in the affected area. Muscle weakness is not a symptom, as this condition affects sensation, not motor function. How can myotherapy treatment help individualise this presentation? As a myotherapist, I specialise in muscular skeletal presentations, and we focus on soft tissues. Through a series of assessments, we can determine whether the compression is peripheral or root nerve compression. Let’s see how. Medical History In the first step, we examine the medical history and physical examination, identifying risk factors and symptoms. Along with the physical examination, we examine the Myotome and Dermatome. Examination On top of active range of motion and another orthopedic test to rule in and out other possible presentations, there are some specific tests which we want to focus on, Myotome and Dermatome. The Myotome are resisted movement, like in this case, hip flexion, knee flexion, knee extension, where it would result in positive findings if we have evident weakness and or back pain. This test would rule in a compression to the spine level. Dermatome, on the other hand, are used to test the connectivity of the cutaneous nerve. So with a sharp and soft object, we will mark some line along the thigh area, looking for loss or confused sensations. This test would rule in a peripheral compression of the nerve. Notice that both presentations can be presented at the same time. Other tests that can be done for this presentation include: Electromyography (EMG) – To rule out other neurological disorders. Imaging tests (MRI, X-ray, or ultrasound) – Identifying structural issues or nerve compression. For those tests, Giovanni would write a referral letter for your GP. Treatment Options for Meralgia Paresthetica As often happens, the treatment options are multiple and must be embraced in groups, not individually. The overall aim of any treatment is to relieve pressure on the nerve and reduce symptoms. Here is a list of treatment options and modalities: Lifestyle Modifications Wear loose-fitting clothing to reduce nerve compression. Weight management to decrease excess pressure on the nerve. Avoid prolonged standing or walking if symptoms worsen. Medical Treatments Pain relievers – NSAIDs (like ibuprofen) or acetaminophen for mild pain relief. Myotherapy treatment – along a series of myotherapy sessions we can reduce symptoms and improve the presentation. Corticosteroid injections – Reduce inflammation and pain. Nerve blocks – In severe cases, numbing the nerve can provide relief. Surgical Options (For Severe Cases) Nerve decompression surgery – Relieves pressure on the nerve. Neurectomy – Removing the affected nerve if pain is persistent. How Myotherapy Can Help At Melbourne Massage and Treatment, during a myotherapy session, after ensuring we are dealing with a Meralgia Paresthetica I may use a series of techniques to help you out with your symptoms. What technique to use is based on your individual presentation,, other cohexsitng presentations, adn also your choice and comfort. Here is a list of modalities used during a Myotherapy session: Muscle Energetic Technique (MET) – Helps reduce tension in the hip, thigh, and lower back muscles that may be contributing to nerve compression. Trigger Point Therapy – Addresses myofascial trigger points that can exacerbate pain and discomfort. Mobility and Strengthening Exercises – Improves mobility and reduces pressure on the nerve. Postural Education – Helps correct movement patterns that may be aggravating symptoms. Joint Mobilization – Enhances circulation and reduces inflammation in affected joints. Dry needling – Using a needle can help reduce pain and muscle ache and increase the neurological connection of those same soft tissues. After the hands-on treatment, we will then look into exercises that can help maintain the change we created. That said, there are other precautions to take in consideration, like: Maintain a healthy weight to prevent excess pressure on the nerve. Choose comfortable clothing that doesn’t constrict the waist or thighs. Incorporate gentle mobility and exercise into your routine. Monitor underlying conditions, such as diabetes, to reduce nerve-related complications. Conclusion Meralgia Paresthetica can be managed effectively with lifestyle changes, medical treatment, and preventive care. Myotherapy can be a valuable complementary […]

Carpal Tunnel

Carpal Tunnel median nerve impingmenet

The carpal tunnel is a narrow passageway in the wrist that opens into the hand. The median nerve runs through the carpal tunnel and gives feeling to the 2nd through the 4th finger (the medial half of it). Carpal tunnel is a condition that affects any gender, and the prevalent of people affected by this condition, are people who do repetitive movements with their hands and arm. Carpal tunnel Symptoms Numbness Pins and needles in the hand Pain, particularly at night Darting pains from the wrist Radiated or referred pain in the arm and shoulder Weakness of the hand The little finger and half of the ring finger are unaffected. Causes of Carpal Tunnel Presentation Occasionally there is no clear cause for Carpal Tunnel. Said so, sometimes there is a combination of factors such as: Arthritis – C.T. is a consequence of inflammation and swelling Pregnancy – During the pregnancy period, given the increase of hormones, the body tends to retain more fluid, which can compress the median nerve and replicate CT symptoms. Genetics – some people can have smaller carpal tunnel Overuse injury – as previously mentioned, repetitive movement and overload of the wrist can lead to CT syndrome Treatment options Along with different treatment options, massage is the first non-invasive approach someone can try for carpal tunnel. As soon as the symptoms show up, it would be wise to go and see a massage therapist. Techniques such as Remedial Massage, Myotherapy can easily address the problem and alleviate the pain. Depending on the presentation and the cause of the carpobual tunnel, even Applied MLD (manual lymphatic drainage) can be an ideal treatment option. Along the physical therapy, rest is highly recommended, and exercises, as often happen, play the main role. To prevent pain from wrist movement, a splint can help. Other treatment options. Surgery is a standard alternative option for Carpal Tunnel. It is a common intervention and can be done on both hands simultaneously. The patient can choose to go for local or general anaesthesia. Surgery for Carpal Tunnel involves a cut along the palm and the wrist. The surgeon then cuts the ligament to reduce pressure on the underlying median nerve. Once the skin gets stitched back, the ligaments heal themselves, and the new scar would not put so much pressure on the median nerve. Even though the surgery is easy, it can have some complications, like swelling and damage to the median or ulnar nerve. Also, if the ligament was not cut completely, it would still apply pressure on the Median Nerve, and a second surgery would be needed.      

Dry Needling

Dry needling session on the patient's back

Myofascial Dry Needling (MDN) treats sore muscles and trigger points. How does Dry Needling work? As discussed in another blog post, muscles are made of many individual fibres. As the fibre contract and stretches, this does give the muscle the ability to have strength and elasticity. Along with repetitive movements and lack of posture, the muscle fibres can accumulate tension that we generally call knots. Those “knots” are also known as trigger points. This is one of the many theories behind the formation of trigger points. Said so, a trigger point is a terminology used to describe a painful spot. And still, nowadays, there is no exact explanation for how trigger point forms and what exactly they are. But what we know for sure is that not everyone develops trigger points in the same spot. Now, to release the tension out of the trigger points, we can either apply external pressure, with the thumb or the elbow, in case of a Remedial Massage or even the knee or the heel of the foot with a Thai Massage, or we can break the fibres from within by using a needle. What a needle is like? The needles used in this practice have a diameter from 0.15 to 0.25mm, so really thin needles. Whereas the length can vary from 15mm to 90mm. Depending on the target muscle, the length of the needle is different. So, as we penetrate the muscle with the needle, we brake the fibre, and we recall an inflammatory response from the patient’s immune system. Which drives more blood and nutrients to the target area. As discussed further in this study published on PubMed, Dry Needling is effective for chronic non-specific neck pain 1. Is dry needling safe? Yes, it is, as long as the practitioner offering the service is qualified for it, and well knows the anatomy of the muscles. Said so, when you receive dry needling, there are a few things that you may want to consider. Firstly you better not have any metal allergy. Also, Dry Needling is not recommended if you have just done any strong physical activity or training, as the muscles would be in an acute inflammatory stage. In addition to this, other contraindications are: If the patient is on a blood thinner Diabetes type 1 The area is affected by Lymphedema The patient is unable to give the consent The patient would not be able to stay still as the needle is in the body Book now, your next Myotherapy session at Melbourne Massage and Treatment, Fitzroy North Clinic. How long the needle stays in the body? Depending on the area needing treatment, the needle may stay in the body for 3 to 10 minutes. And always based on the target muscle that needs to be treated would also depend on the type of treatment. Indeed, the needle could be placed in the muscle and left there to sit and create the physiological response needed, or it could even be partially extracted, moved around and placed back. This type of technique is called “peppering”. Peppering along a dry needling session allows the therapist to target other fibres around the muscle fibre area.     1. Cerezo-Téllez E, Torres-Lacomba M, Fuentes-Gallardo I, Perez-Muñoz M, Mayoral-Del-Moral O, Lluch-Girbés E, Prieto-Valiente L, Falla D. Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial. Pain. 2016 Sep;157(9):1905-1917. DOI: 10.1097/j.pain.0000000000000591. PMID: 27537209.  


This will close in 0 seconds


This will close in 0 seconds


This will close in 0 seconds