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J Chiropr Med. 2006 Fall; 5(3): 92–96.
Published online 2006. doi:  10.1016/S0899-3467(07)60140-2
PMCID: PMC2647064
A manual therapy and exercise approach to meralgia paresthetica in pregnancy: a case report
Clayton D. Skaggs,ab Brett A. Winchester,c Michael Vianin,b* and Heidi Pratherd
aDepartment of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
bDivision of Research, Logan College of Chiropractic, St. Louis, MO
cPractice of chiropractic
dDepartment of Orthopedics, Washington University School of Medicine
*Submit requests for reprints to: Dr. Michael Vianin, 100 Milwaukee St., Ste 230, Saint Louis, MO 63122
Received April 13, 2006; Revised August 25, 2006
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.
Key Indexing Terms: Pregnancy, Pelvic Pain, Meralgia Paresthetica
Footnotes
Sources of support: No funding was provided for this project.
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