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Physical Medicine and Rehabilitation for Meralgia Paresthetica Medication

  • Author: Christopher Luzzio, MD; Chief Editor: Consuelo T Lorenzo, MD  more...
 
Updated: Mar 30, 2015
 

Medication Summary

Medications for treatment of meralgia paresthetica (MP) discomfort include nonsteroidal anti-inflammatory drugs (NSAIDs), narcotics, and other agents, such as amitriptyline, Neurontin, and Tegretol. In general, avoid prolonged use of NSAIDs and narcotics if possible.

A TCA or anticonvulsant is started at a low dosage and titrated upward until symptoms resolve or side effects dictate otherwise. These drugs are discontinued if there is no relief with maximal quantities. A common error is stopping the medication before serum levels reach therapeutic ranges.

Suggestions for initiating chemical treatment for MP follow. The treatment of neuropathic pain varies significantly among physicians. Consult the Physicians' Desk Reference (PDR) for more detailed drug information on the following agents.

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Tricyclic antidepressants

Class Summary

Use for treatment of neuropathic symptoms; the exact mechanism is unknown.

Amitriptyline (Elavil)

 

Good medication for neuropathic pain, often discontinued because of somnolence and dry mouth.

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Anticonvulsants

Class Summary

For treatment of neuropathic symptoms; the exact mechanism is unknown. These agents are used to manage severe muscle spasms and to provide sedation in neuralgia.

Carbamazepine (Tegretol)

 

Because of adverse side effects and risks associated with carbamazepine, this compound is initiated judiciously; prolonged use is monitored carefully.

Gabapentin (Neurontin)

 

Has anticonvulsant properties and antineuralgic effects; however, exact mechanism of action is unknown. Structurally related to GABA but does not interact with GABA receptors. Titration to effect can take place over several days (300 mg on day 1, 300 mg bid on day 2, and 300 mg tid on day 3). Well-tolerated and safe medication that essentially is excreted 100%.

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Contributor Information and Disclosures
Author

Christopher Luzzio, MD Clinical Assistant Professor, Department of Neurology, University of Wisconsin at Madison School of Medicine and Public Health

Christopher Luzzio, MD is a member of the following medical societies: American Academy of Neurology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Michael T Andary, MD, MS Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, Association of Academic Physiatrists

Disclosure: Received honoraria from Allergan for speaking and teaching.

Chief Editor

Consuelo T Lorenzo, MD Medical Director, Senior Products, Central North Region, Humana, Inc

Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

Additional Contributors

Everett C Hills, MD, MS Assistant Professor of Physical Medicine and Rehabilitation, Assistant Professor of Orthopaedics and Rehabilitation, Penn State Milton S Hershey Medical Center and Pennsylvania State University College of Medicine

Everett C Hills, MD, MS is a member of the following medical societies: American Academy of Disability Evaluating Physicians, Association of Academic Physiatrists, American Academy of Physical Medicine and Rehabilitation, American Association for Physician Leadership, American Congress of Rehabilitation Medicine, American Medical Association, American Society of Neurorehabilitation, Pennsylvania Medical Society

Disclosure: Nothing to disclose.

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Basic anatomy of the lateral femoral cutaneous sensory nerve. The blue region over the anterolateral thigh outlines the area of cutaneous innervation.
 
 
 
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