THR I have Meralgia Paresthetica

Keep us posted! Hoping the pain subsides. Nerves are so tricky. Have a great day!
 
@Zach65 When you are typing a post click on the smiley face in the tool bar there are lots of emojis there including many LOL ones ...:loll:
:heehee::rotfl::snork::rofsign:
 
To Zach65 — Have been taking Lyrica 100 mg 3xs a day for about 8 years and it helps my Idiopathic Peripheral Neuropathy considerably.
Had been having Cortisone injections for 3 years in left thigh for what was diagnosed as Bursitis. Went for MRI and was told problem was left hip - severe degenerative Arthritis.
Had complete left hip replacement 5/23/22.
Walked with the walker for about 3 weeks, and then started using the cane. Used the walker occasionally but used the cane most of the time. Had PT 2 times a week for 1 month.

Starting getting stronger with no pain for about 3 ½ months, and walked with a cane or nothing. Shortly thereafter I started feeling pain in my legs, especially left thigh down to my knee and down my leg to my feet, and started feeling week and very unsteady on my feet, and balance was bad. Went back to using the walker in the house.

At about 5 months I was at the kitchen sink and was feeling very week and unsteady and couldn’t prevent myself from falling. My legs felt like jelly. Fell on my backside with no injuries. Crawled around the house for about ½ hour but was unable to get up on either bed or sofa. I finally had to call the Fire Department for help. The Fireman who helped me up said I was a dead weight - had no lower body or upper body strength to get up.

Currently, at 9 months I use the walker all the time inside and outside the house. My balance is bad, my legs are very unsteady and I have pain in my left leg, particularly in my thigh and down my leg.

On December 3rd I saw my Orthopedic Surgeon. He x-rayed my hip & knee, removed some fluid from my knee and gave me a Cortisone shot in my knee. He said everything looked okay. The hip was fine and the knee was only slightly Arthritic & was not causing my problems. He said my problems were caused by my Peripheral Neuropathy and/or Spinal Stenosis and I should see my Neurologist. Since the surgery I have faithfully done my physical therapy exercises almost every day.

On November 9th I saw my Neurologist. He sent me for an MRI of my spine on 1/23 and an EMG on 1/27 and wanted me to see a Pain Management doctor.

Saw a Pain Management Doctor today. after looking at my MRI he said 2 of my discs L-4 & L-5 were touching my nerve causing my pain. He gave me an Epidural and said I should start feeling less pain in a few days. I see him again in 2 weeks.
 
I’ve been diagnosed with meralgia paresthetica. Driving me bonkers, especially at the end of the day! 10 months post op. Tried a little PT but I think they did the wrong type of PT. Pretty sure I got shi..y advice from my surgeon (who I’ve had enough of), because he just kept saying “Give it time, it’ll go away.” 10 months, no improvement. Now I’m hearing it can be permanent if you don’t address/treat it soon enough? I’m looking into all options, as I may be the uncommon case of surgery needed, though I’d obviously like not to go that route unless it’s very effective. PCP just prescribed Cymbalta 2 days ago to manage it, though started at 30mg, if that doesn’t help/work, I may try 60mg. I don’t want to manage it though, I want resolution. Thouhts/experiences?
 
Meralgia Parethetica (inguinal ligament pinching the lateral femoral cutaneous nerve), can be a complication from the anterior approach. I’ll likely go posterior if I need my right hip done down the road. Longer recovery, but I don’t want nerve damage on both sides!!
 
I am sorry you're still struggling, Zach. I will leave an article on Meralgia Paresthetica from our library.
You can also type Meralgia Paresthetica into the SEARCH at the top right of the page if you care to read about others that dealt with the same. Meralgia Paresthetica
I hope you're able to obtain relief. Please keep us posted.
@Zach65
 
This sucks Zach. I’m on my second hip (both posterior) and while I’ve been happy with the results (although only 2.5 weeks out on my 2nd), it’s clear that specialists really only focus on their speciality. Ortho looks at the X-ray and if the hardware is aligned, wipes his/her hands clean and moves on to the next carpentry project. While time does indeed cure the vast majority of aches and pains, they still need to do more for their patients. But they would rather just refer or have you rely on your PCP who isn’t really attuned to what happened with the surgery. Most orthos are so sure of themselves that they really just see the patient as complaining unnecessarily.

I have heard of some anterior nerve pains getting better and unfortunately one or two that have lingered. There is such a degree of chance with each surgery about every little thing going right. Are there any specialists that deal with this nerve issue? Your PCP is trying their best, but how much experience do they have with this type of procedure and outcome?
 
Hi @Zach65 sorry this is dragging itself out on you! I hope your perseverance will reward you with good solid answers. There are so many physical activities you can do without immediate pain now, you're bound to come to a good conclusion.

My hips are nearly 10 and 6, and on the younger one I developed something that matches the description of meralgia paresthetica at dermnetnz.org. I have a big numb patch, no real pain or sensitivity (it's numb lol) and occasional intense itching, at which time the skin definitely feels me scratching, go figure. Neither the Mayo Clinic nor Johns Hopkins' websites mention the itching. The symptoms started about 18 months post-op. I manage this mostly by forgetting about it until it itches...I also have a numb patch on the other side, much smaller. I just live with that. Why not if it doesn't bother me at all...

I also have had symptoms matching the description of bursitis in both hips, which started well before arthritis reared its unwelcome head. I have never sought treatment; I manage it with bedding that suits me beautifully.

I also have something on both sides that matches the description on here of IT Band problems. I manage that with a Tiger Tail foam roller.

None of this is causing me to think that I haven't got recovery from my THR. Nobody promised I'd be better than I was before I needed hip replacement. I've had other major surgeries, and I've had a tiny minor surgery to cause me the need for major surgery 40+ years later! In all fairness, on that one, the original surgeon, when I asked him if he'd moved my belly button, replied ( laughing in a friendly way), maybe he had and he'd most likely given me a hernia in my future. He was quite the prophet. Was the original surgery a failure? No, I healed quickly and all the doctors involved had the information they needed to proceed. After that, my body was in charge, as is pretty much the case for THR's extended recovery period. Listen to your body, we advise here. Your body will most likely reward you handsomely.

All these stories are to illustrate the point that "recovery can be subjective", exactly as you mentioned. It is also a very relative term. When I was in my 50's, I was already managing two chronic conditions which may appear to be"cured", but which in fact take a whole lot more of my daily thinking energy than all my surgeries put together. Many make it to later middle and even old age with no detrimental health symptoms, and a major surgery is the first run-in they've had with "the aging body". This can be quite the eye-opener. While I can't recommend major surgery in your 20's to anybody, it has certainly been a baseline upon which to peg my own attitude!

@Caison113 has an excellent point, that specialists focus on their specialty to the exclusion of almost all else. Given my life situation, I'm not sure I'd want that any different.

Thus endeth the sermon...:snork:
 
Hi Zach
Meralgia Parethetica (inguinal ligament pinching the lateral femoral cutaneous nerve), can be a complication from the anterior approach. I’ll likely go posterior if I need my right hip done down the road. Longer recovery, but I don’t want nerve damage on both sides!!
I've had Meralgia Paresthetica since my Anterior RTHR in September of 2022. It has gradually gotten better. Not that normal sensation has come back; it still covers a large part of my right hip, about midway from my scar to the outer thigh down to the knee. It's more that it's much less painful and just more of an annoyance. I feel like I've somewhat gotten back some sensitivity to cold, and when I drag a toothpick over the skin in the area there are some spots where I notice feeling. Anyway, the first couple of months were quite unpleasant and discouraging; a lot of burning on fire sensation at night. My sister-in-law (a nurse) suggested spraying the area with a solarcaine/lidocaine type product in the middle of the night so that I could get back to sleep. The surgeon's office was sympathetic but took an "Oh yeah, that can happen approach." I've since read that it is a known complication of the Anterior approach but couldn't really find anything noting why some people are impacted and not others with the following exceptions; in some people the LFCN is branches a little differently making it more likely to be in the way of all the surgeon's tools; and I saw some Japanese research that noted that females with low BMI seemed more susceptible to the problem after Anterior THR.

I needed a left hip replacement and went with the "devil you know vs. the devil you don't" approach. Other types of nerve damage can happen with the posterior approach too. My brother-in-law had both of his hips done recently with the Anterior approach with the same surgeon with no complications. And honestly, post covid here in our community, wait times for surgeons for elective procedures are not great. But I understand why someone would decide for a different approach/different surgeon.

I'm happy to report that 8 days out from my LTHR I don't have Meralgia Paresthetica on the left side. The only downside to this is that without that constant zappy feeling slowing me down I believe that I have been overdoing things.

Please let me know how things progress with you. I'm somewhat optimistic that some of the still healing scar tissue on the right side is keeping that pesky LFCN nerve from doing what it's supposed to do. Unless things are much improved by next fall I plan to talk with my PCP about options.
 
Meralgia Parethetica (inguinal ligament pinching the lateral femoral cutaneous nerve), can be a complication from the anterior approach. I’ll likely go posterior if I need my right hip done down the road. Longer recovery, but I don’t want nerve damage on both sides!!
Honestly from posts on here and my own experience of 2 posterior THR I don't see where the recovery time is any different.
 

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