When something meant to aid a runner became a pain in his "thigh"
1. 45-year old Dev presented with sharp, shooting pain & tingling in right thigh for three months. Pain occurred in episodes, lasting a few minutes to a few hours; repeating several times in a day.
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1. 45-year old Dev presented with sharp, shooting pain & tingling in right thigh for three months. Pain occurred in episodes, lasting a few minutes to a few hours; repeating several times in a day.
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2. Dev also had mild numbness in the rigft thigh region, however, he had no back pain and the pain did not radiate below the knee. He had no leg weakness and had normal urinary control.
His daily life was adversely affected due to thigh pain.
His daily life was adversely affected due to thigh pain.
3. Dev consulted a local doctor, who conducted several tests, including MRI lumbar spine and nerve conduction studies, which were normal. He was prescribed pain-relief medicines, however, Dev was not keen to take medicines without knowing the root cause of his symptoms.
4. I went through the entire history with Dev & enquired about his job & hobbies. He was a CEO of a big firm and had a busy schedule, which involved sitting as well as walking throughout the day.
Dev was a passionate runner too and ran 4-5 days a week at a good pace (5-6 min/km).
Dev was a passionate runner too and ran 4-5 days a week at a good pace (5-6 min/km).
5. Dev's hobby made me curious and I enquired about his shorts while running. He excitedly told that he had started using tight compression shorts (pic below) for three months, and his pace had improved by 15-30 seconds/km. His recovery after long runs were quicker since then.
6. Now, the diagnosis was obvious. It was a case of meralgia paresthetica, caused by compression of right lateral femoral cutaneous nerve (the nerve located in upper/outer aspect of thigh). Compression of nerve was caused by tight shorts.
(Image of nerve below- source: Internet)
(Image of nerve below- source: Internet)
7. I suggested Dev to stop wearing compression shorts. He was not keen, as he was enjoying his improved pace & recovery with those shorts. He agreed to restrict wearing tight shorts to 1-2 days a week & on race days only. No regular pain medicines were prescribed.
8. At one month review, Dev was a much happy person. He had significant relief from thigh pain and he had re-started enjoying his running, without thigh pain.
9. Take home message
Compression (tight-fitting) shorts can be an uncommon cause of meralgia paresthetica, leading to pain, tingling and numbness of front and outer sides of thigh.
Compression (tight-fitting) shorts can be an uncommon cause of meralgia paresthetica, leading to pain, tingling and numbness of front and outer sides of thigh.
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