Therapy
Depending on the cause, the therapy also differs. For example, thrombosis is treated by means of compression treatment (wrapping bandage) for 3 months and medication with blood thinners (anticoagulants) such as heparin or vitamin K antagonists – also for at least 3 months. PAVK is treated differently depending on the stage of the disease.
In the case of arterial occlusion, it is particularly important to ensure good blood pressure control and sufficient exercise. If it is a diabetic polyneuropathy that causes the pain, painkillers such as non-opioids (paracetamol, metamizole), opioid analgesics (tramadol), anticonvulsants (pregabalin) or even antidepressants (duloxetine, amitriptyline) can be used. Of course, it is also important that the blood sugar level is adjusted sensibly in order to delay further damage to vessels and nerves.
In the case of Meralgia paraesthetica, tight clothing should be avoided. In addition, this nerve disease is often found in overweight persons. Weight reduction is therefore important.
If these measures do not bring improvement, local pain therapies can provide relief. This means that local anaesthetics such as scandicain 1% with cortisone are injected under the inguinal ligament. In some patients – for whom other measures do not help – an attempt can be made to surgically remove the pressure from the nerves (neurolysis).
Diagnosis
An anamnesis (questioning of the patient) provides information about the type of complaints, when they occur or how long they have been occurring. Thus, even if thrombosis is suspected, patients should always be asked about a long-haul flight. A physical examination, during which the thigh and also the rest of the leg are examined and examined, should always be carried out.
If the suspicion of thrombosis is confirmed, a blood sample with the determination of D-dimer elevation, BSG elevation and leucocytosis (increased white blood cells in the blood) can make the diagnosis of thrombosis more likely. However, the gold standard for ruling out thrombosis is an ultrasound examination of the leg veins – the so-called compression sonography. If an arterial occlusion is suspected, an ultrasound examination of the arteries is performed.
The diagnosis of herpes zoster is based on the clinical picture (blisters and crusts and their distribution pattern) and typical symptoms. If the burning sensation is caused by a meralgia paraesthetica, a loss of sensitivity on the affected leg on the outside will be noticed during the physical examination. In addition, pressing at the level of the inguinal ligament (where the nerve is pinched) is often painful. If the complaints are accompanied by pain in the spinal column, an X-ray or MRI should be taken to rule out bony damage that could cause, for example, nerve entrapment.
Duration
The duration of the burning in the thigh depends on the cause. In some cases the symptoms do not disappear completely. Especially if it is a diabetic neuropathy, one must even expect a progression of the symptoms.
The drug treatment of a thrombosis takes 3 to 6 months. In addition, there is still the risk of developing a thrombosis again in the course of life. If the Meralgia paraesthetica is treated sufficiently and quickly enough, almost 90% of the complaints will improve within a very short time.
