@Exstoreman Thank you for the meralgia parasthetica webinar on locals.
M/65
Chronic Systemic
1) Diabetic
2) Arthritis
3) High blood pressure and cholesterol
4) Very high stress from becoming blind later in life
CC (1 year issue):
1) Pain at trigger point of TFL
2) L/ Hip Pain
3) Back Pain
So I have been treating him as meralgia parasthetica but I didnt originally due to avoidant answers of this patient and reports he kept bringing up.
Doctors originally wanted a fusion to lumbar area or a nerve ablation to the area. The doctors kept saying different things for this case whether it was hip, lower back, or front of the leg related.
After a few visits he mentioned a fuzzy feeling over the top of his leg which I feel guided me more to meralgia parasthetica.
Tx 1: Patient came in bent entirely over. His pain went from 10/10 to 3/10 1st visit treating the tight bands along TFL and doing Lower Perfusion since there was some bulging of the disc felt with doctors mentioning L2/L3/L4.
Manual Work: Slide Cupping from TFL down.
His pain was coming back quickly after walks at a specific trigger point near the TFL and IT band felt tight.
EXSTORE assessment day 1:
Internal Rotation of the knee shows tension to TFL
Supine lateral leg pressure holds but not with foot turned to assess TFL. that is weak.
Hip Flexion holds well and goes to 120 degrees on affected side.
Side leg raise holds pressure and has ideal mobility.
Prone posterior leg raise shows no issues with strength or mobility.
Pain no longer elicited by rotation of the leg standing or with resistance post 1st visit.
Referral:
A few visits went by before pain was back and forth so I referred out for a nerve conduction test. Btw he said this test was horrible to experience as they hook you up to electricity like an ITO that is too high.
Other physicians did nerve conduction test to determine that the LFCN was showing not ideal signal.
Along with history of Diabetes and also past history as a cop which was mentioned in webinar that that nerve can have issues.
Injections were performed but lasted a day before returning.
What makes it reoccur is walking for short bits of time. The pain catches at the trigger point near the TFL.
Today's Tx:
I did not work on the low back or the hip since it keeps showing strong but just what was mentioned in the webinar for meralgia parasthetica.
Tx:
2NT TFL/Sartorius
2NT TFL/Rectus Femoris
Post Tx:
Minimal pain. Im not sure how long it may last but the difference this time is direct 2NT rather than some time in the area with pointer plus before perfusion. The tension of the tissue is much more reduced with this direct 2NT treatment though.
These are not my notes on the patient but a summary since I have been seeing them for a few weeks. Let me know if anything is confusing.
January’s webinar is here! This one is a favorite of mine because it includes the fascial lens when teaching the movement of the foot and ankle. It cover anatomy, fascia, and accessory motion of the foot and ankle. Definitely worth checking out.
Give this a read after you watch the video: https://pmc.ncbi.nlm.nih.gov/articles/PMC7689775/
Click the kink to join: https://us02web.zoom.us/j/82386638283
@Exstoreman .I have this patient with chronic neck pain. She is 51 years old. She said a flare up started around xmas 2025. She has stiff neck, sharp pain, and have headaches (all starts occipital RT side and go temporal). She also complained of pain around the masseter.
Hx: Sjogren's disease (diagnosed 2020)
Shingles December of 2023
Thyroid nodule + surgery 2009, treatment for hypothyroidism since
Well, i have seen her 8 times. She was coming 2x per week , for 3 weeks, now is coming weekly. She says her headaches are no longer present, and she said her facial pain is gone(I actually had to remind her that she was complaining of face pain and pressure). Well she seemed like she was getting better, and stating that her neck was feeling stiff and weird, but the sharp pain was better.
On feb 3nd she came in and said she had a really bad sharp , shooting pain, over the weekend. She said that the pain would come and go. I treated her and then she came back the same week on Friday, and said...
@Exstoreman: I’ve been reading about cross-education and the role of supraspinal and corticospinal neural drive when working a muscle contralaterally, and it made me start thinking about the clinical implications. For example, could contralateral needling- esp MP’s- be helpful in a post-surgical shoulder patient who isn’t far enough along to treat the involved side yet? Eccentric movement seems to provide the strongest stimulus for cross-education, but since needling also has neural effects, I’m curious whether similar principles might apply clinically.
