A manual therapy and exercise approach to meralgia paresthetica in pregnancy: a case report.
OBJECTIVE
To present a case of a pregnant patient with meralgia paresthetica who improved using manual therapy and exercise procedures.


METHODS
A 22-year-old patient in the sixteenth week of pregnancy had low back pain, bilateral anterolateral thigh paresthesia and groin pain for a duration of 1 month. She had no motor deficits in either lower extremity and her reflexes were intact. As a standard clinic procedure, a battery of functional tests were performed including: active straight leg raise, long dorsal ligament test, and the pelvic pain provocation procedure. Based on her clinical history and physical responses to the aforementioned functional tests, the diagnosis of meralgia paresthetica was deduced.


RESULTS
Treatment was provided at 6 visits over a 6-week period where the patient underwent evaluation, manual intervention, and exercise prescription. Active Release Technique (ART) was performed to the restricted right sacroiliac (SIJ) complex and quadratus lumborum muscles. ART and post-isometric relaxation were applied to the illiopsoas muscles. The home exercise program consisted of pelvic/low back mobility, stabilization and relaxation exercises. After 6 treatments, the patient reported complete resolution of low back pain and left lower extremity symptoms and a 90% improvement in the right thigh symptoms. At her one-year follow-up, the patient reported no further complications and the absence of pain.


CONCLUSIONS
Manual therapy and exercises may serve as an effective treatment protocol for pregnant patients experiencing low back pain complicated by paresthesia. Because these conservative procedures offer a low-risk intervention, additional clinical studies are warranted to further study this treatment.
Skaggs
Clayton D
CD
Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO; Division of Research, Logan College of Chiropractic, St. Louis, MO.
Winchester
Brett A
BA
Vianin
Michael
M
Prather
Heidi
H
J Neurosurg. 1991 Jan;74(1):76-80
1984510
Obstet Gynecol. 2003 Feb;101(2):279-88
12576251
JAMA. 1977 Mar 14;237(11):1125-6
576446
Acta Obstet Gynecol Scand. 2002 May;81(5):430-6
12027817
Can Med Assoc J. 1974 Sep 21;111(6):541-2
4414641
Acta Neurol Scand. 1972;48(5):547-55
4643254
Spine (Phila Pa 1976). 2004 May 15;29(10):E197-203
15131454
Ann Plast Surg. 1995 Dec;35(6):590-4
8748340
J Bone Joint Surg Am. 1994 Jul;76(7):993-9
8027128
Muscle Nerve. 1995 Jun;18(6):601-5
7753122
Ann Surg. 2000 Aug;232(2):281-6
10903608
Spine (Phila Pa 1976). 2001 May 15;26(10):1167-71
11413432
Spine (Phila Pa 1976). 2002 Dec 15;27(24):2831-4
12486356
Aust N Z J Obstet Gynaecol. 2002 Nov;42(5):482-5
12495090
Anesth Analg. 1995 May;80(5):1060-1
7726412