Severe isolated sciatic neuropathy due to a modified lotus position

Abstract

A 51-year-old man presented to our hospital with progressive pain and weakness in his right leg. Neurological examination revealed atrophy of all muscles of the right leg, unilateral foot drop and paralysis of the anterior tibial and gastrocnemicus muscles. Electromyography confirmed a severe isolated sciatic neuropathy in the thigh. For unclear reasons, our patient habitually used to sit in a modified lotus position. We concluded that this position, in literature known as "lotus neuropathy" had resulted in the sciatic neuropathy. After more than a year our patient was referred again to our outpatient clinic. At that time there was only minimal improvement, now with an achilles tendon contracture and pes equinus due to immobility.

Wallet Neuritis – An Example of Peripheral Sensitization

“…Prolonged squatting while tiles’ fitting in kitchen exposed patient’s piriformis muscle and adjoining sciatic nerve under great stress, generating gluteal and homo-lateral radiating lower limb pain. On the other hand, in our 1 st and 3 rd cases, chronic external sciatic nerve compression from fatty wallet is well-supported by Stewart and Bosma study [ 11 , 12 ]. As per Bosma and colleagues, lotus posture (meditation posture) [ 11 ] triggered severe sciatic nerve pathology generating buttock and ipsilateral lower extremity pain, weakness, and devastating leg muscles atrophy, foot drop, etc .…”

“…On the other hand, in our 1 st and 3 rd cases, chronic external sciatic nerve compression from fatty wallet is well-supported by Stewart and Bosma study [ 11 , 12 ]. As per Bosma and colleagues, lotus posture (meditation posture) [ 11 ] triggered severe sciatic nerve pathology generating buttock and ipsilateral lower extremity pain, weakness, and devastating leg muscles atrophy, foot drop, etc . that echoed in our study as well, albeit none of our patients’ (1 st and 3 rd ) developed leg muscle wasting and foot drop.…”

Extra-spinal sciatica and sciatica mimics: a scoping review

“…Patients could complain gluteal pain, weakness and atrophy of lower limb muscle, and foot drop [28]. The modified lotus meditation position could result in severe SN neuropathy, as evidenced by the EMG of a patient who has no abnormal findings in lumbar MRI [28]. Bilateral compressive extra-pelvis EMG-evidenced SN injury has also been demonstrated in a 60-year-old alcohol-intoxicated Korean woman, who fell asleep in the lotus posture for 10 hours.…”

“…Isolated sciatic neuropathy is reported following performing the lotus position in yoga, a posture where the feet are tightly tucked under the thighs and buttocks for hours at a time [28]. Patients could complain gluteal pain, weakness and atrophy of lower limb muscle, and foot drop [28].…”

“…Isolated sciatic neuropathy is reported following performing the lotus position in yoga, a posture where the feet are tightly tucked under the thighs and buttocks for hours at a time [28]. Patients could complain gluteal pain, weakness and atrophy of lower limb muscle, and foot drop [28]. The modified lotus meditation position could result in severe SN neuropathy, as evidenced by the EMG of a patient who has no abnormal findings in lumbar MRI [28].…”