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"Want to hear my sad story?" she asked. This can't be good, I thought to myself. "I think it's back again," she said. "It started three or four days ago. I thought this was over for good, but here we go again." Months ago, my client Ms. S. had a bout of sciatic nerve irritation that was stubborn and quite complex. It took multiple sessions to resolve the problem, and it was a delicate process to create results without further irritating the nerve. The thought of revisiting this issue wasn't pleasant for either of us. "It's so frustrating not to be able to sleep on this side again," she continued. "I've been able to sleep on either side for weeks, but now if I lie on my left side for more than 30 minutes, I feel a deep aching pain going down my leg," she said as she brushed her hand over the pain pattern. Even though my brain was consumed with the idea of revisiting a difficult road, her tracing of the pain pattern caught my attention—something didn't fit the previous pattern. "Can you show me again where you feel the pain?" I asked. Ms. S. traced the pain pattern, which did not follow the path of the sciatic nerve but the lateral and anterior part of the thigh. I instructed her to repeat the tracing yet again, and it was clearly not what she experienced weeks ago. When I mentioned my observation of the difference between the two presentations, she immediately agreed. "You know, that's right. I didn't even notice that until you pointed it out. I was so focused on the fact that I could not sleep on my side, I didn't notice the difference." "Do you ever feel the aching pain go below the knee?" I asked. "Nope, it always stops about here," she replied, pointing to the area just above the femoral condyle. "You know, that is also different than the sciatic pain I felt into my calf." best practices | TABLE LESSONS Mistaken Identity When Meralgia Paresthetica Poses as Sciatica By Douglas Nelson 26 m a s s a g e & b o d y wo r k n ove m b e r/d e ce m b e r 2 0 2 1

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