A manual therapy and exercise approach to meralgia paresthetica in pregnancy: a case report

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Abstract

Objective

To present a case of a pregnant patient with meralgia paresthetica who improved using manual therapy and exercise procedures.

Clinical Features

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.

Intervention and Outcome

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.

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    Moreover, friction massage is known to stimulate fibroblast proliferation and collagen fiber realignment with cross linkages.22 Although there is limited evidence that home stretching exercises improve MP, the incorporation of these exercises and active patient participation have been a major factor in improving the condition.23 Iliopsoas muscle stretching has been shown to relieve nerve entrapment mononeuropathy, and the author believes that it should also be considered as an important alleviating factor in MP.24

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