Mrs B is a 37-year-old female, with a BMI of 36 (113 kg), who presents with a five-year history of bilateral burning, pins-and-needles sensations localised to the lateral aspect of both thighs. The pain is sharp and blade-like, with no identifiable precipitating factors. Dysaesthesia and hypersensitivity have been persistent, though no skin changes have been observed. While the pain occasionally disrupts sleep, she is able to continue working as an assistant service manager. However, physical activities such as walking and gym attendance are limited due to pain exacerbation during flare-ups.
She has a background of PCOS and endometriosis, with a five-year history of chronic pain. Pharmacological management with pregabalin 100 mg BD has provided only partial relief.
