Pregnancy numbness- what is it?
As some of you may know I work full time as a physiotherapist. I recently had a women come to me 5 months postpartum struggling with pain and numbness that started in pregnancy. Her presentation was something I hadn’t seen before so I got to researching! We were able to find the correct diagnosis and treatment and after only a few weeks she is not getting any numbness and the pain is significantly reduced. I thought this would be a great opportunity to share what we learnt along the way and hopefully help someone else who may have the same diagnosis.
So at our first appointment these were her symptoms:
Left leg numbness that started in the second trimester
Numbness was from the outside of the hip down to the knee during pregnancy
At our appointment the numbness had improved overtime but was still present from the mid thigh to the knee
Low back and hip pain
Tummy seperation
Her main physical symptoms on assessment that lead me to the diagnosis was:
Pain when touching the inguinal ligament. This ligament runs from the bony part of the hip at the front on a diagonal to the pubic bone.
Weakness in the hip muscles especially the ones that abduct (move leg to the side) and internally rotate the hips
You may also see a loss of hair in the region of the inguinal ligament. I suspect because this condition had slowly started to improve since having her baby the hair may have had a chance to grow back in the last 5 months, however that is something to look for.
So, what was the diagnosis?
Meralgia Paresthetica
Meralgia paresthetica is caused by the compression of one of the large sensory nerves in the leg — the lateral femoral cutaneous nerve. This nerve provides sensation to the skin along the outer thigh starting from the inguinal ligament and extending down toward the knee. Compression of this nerve can result in numbness, tingling, pain or a burning sensation felt in the outer thigh. A common cause of this compression is pregnancy and weight gain.
It was great to know the diagnosis so now we started to focus on treatment. Here are a list of treatments we did that has helped her to get to a point where the numbness is gone:
Prescription of a hydrotherapy based exercise program to complete on her own 1-2 times a week.
Prescription of a home exercise program which specifically targeted weakness in the hip abductors and internal rotators, hip mobility and abdominal strengthening
Recommendations to wear the tubi grip she had in pregnancy to support the abdomen
Looking into compression leggings or shorts. This advice is actually different to what you might read on the internet. Most recommendations are to actually avoid wearing tight clothing, belts ect to avoid more compression on the hip. For my client, she found she felt much more supported when wearing tighter clothing and so we’ve gone with that. Your case might be different!
Began physiotherapy led clinical exercises on the reformer once a week. A strong focus on core & pelvic floor strength, hip strength and mobility, pelvic stabilisation and balance.
Friction massage to the inguinal ligament
Massage and dry needling to the glutes
Remember every case is going to be different and this is just a case study of one person. However, I believe sharing stories is an amazing way to help others so share this to anyone who you might think has Meralgia Paresthetica.