Meralgia Paresthetica

What is meralgia paresthetica?

Meralgia paresthetica is a medical condition that causes pain and sensations of aching, burning, numbness or stabbing in your thigh area. The condition results from compression (pressure on or squeezing) of your lateral femoral cutaneous nerve (LFCN). This large nerve supplies sensation to the front and side of your thigh.

“Meralgia” means “pain in the thigh,” and “paresthetica” means “burning pain, tingling or itch.”

While the condition can be bothersome, it’s not life-threatening or dangerous to your health.

Who does meralgia paresthetica affect?

Anyone can develop meralgia paresthetica, but you’re more likely to develop this condition if you:

• Have diabetes, hypothyroidism and/or alcohol use disorder.
• Have overweight or obesity.
• Have lead poisoning.
• Are injured by your seatbelt during a car accident.
• Are pregnant.
• Had recent surgery around your hip area.
• Wear tight clothing, girdles or stockings or wear a heavy utility belt (like a tool belt).
• Have legs of two different lengths.
• Have scoliosis.

How common is meralgia paresthetica?

Meralgia paresthetica is relatively common, but it’s frequently misdiagnosed. Researchers estimate that it affects 3 to 4 people out of every 10,000 per year.

What are the symptoms of meralgia paresthetica?

Symptoms of meralgia paresthetica only occur on one side of your body in the front of your upper thigh. They include:

• Pain, which may extend down to the outer side of your knee.
• Burning, aching, tingling or numbness in your thigh.
• Increased pain sensitivity (for example, gently touching your thigh may cause pain).
• Worse pain after walking or standing for long periods.

Meralgia paresthetica doesn’t directly cause issues with your muscles or movement.

What causes meralgia paresthetica?

Meralgia paresthetica results from the compression of your lateral femoral cutaneous nerve (LFCN). Your LFCN is a large sensory nerve. It travels from your spinal cord through your pelvic region and down the outside of your thigh. This compression can happen due to swelling and inflammation, injury or pressure.

A variety of factors causes compression of your LFCN, including external and internal causes. These can include:

• Injury or surgery in your hip area.
• Medical conditions like obesity, pregnancy and diabetes.
• Wearing clothing that’s too tight or belts around your waist.
• A tumor near your LFCN.

How is meralgia paresthetica diagnosed?

Healthcare providers can typically diagnose meralgia paresthetica with a physical exam and a thorough understanding of your symptoms, medical history and lifestyle.

Your provider will review your medical and surgical history. As several situations and conditions can cause meralgia paresthetica, they’ll ask many questions to try to determine the possible cause of your symptoms.

They’ll perform a thorough physical exam, including a hands-on test called a pelvic compression test. During this test, your provider will apply pressure on your thigh to rule out other causes of your symptoms. They may perform other light touch and reflex tests.

If they can’t determine the cause of meralgia paresthetica, they’ll likely order certain medical tests.

What tests will be done to diagnose meralgia paresthetica?

If your healthcare provider can’t determine the cause of meralgia paresthetica based on your medical and lifestyle history, they may order blood tests to check the following:

• Thyroid hormone levels for signs of hypothyroidism.
• B vitamin levels for signs of vitamin B12 deficiency or folate deficiency, which can affect nerve function.
• Lead levels for signs of lead poisoning.
• Blood glucose levels for signs of diabetes.
• Hemoglobin test or hematocrit test to look for evidence of anemia.

They may order an X-ray of your pelvis and thigh to rule out other medical conditions, like bone tumors. Other imaging tests, such as a CT scan or magnetic resonance imaging (MRI) scan can check for other spinal or nerve issues, like a herniated disc.

How do you treat meralgia paresthetica?

Treating meralgia paresthetica involves treating the underlying cause.

The majority of cases improve with conservative treatment, such as losing weight, wearing loose clothing or avoiding certain restrictive items like belts.

Many people with meralgia paresthetica benefit from other interventions, including:

• Temporary symptom relief: Icing the area may help reduce nerve irritation and symptoms. Nonsteroidal anti-inflammatory medications (NSAIDs) and topical medications such as capsaicin and lidocaine can also help symptoms.
• Radiofrequency nerve ablation: This treatment uses radio waves to create a current that heats a small area of nerve tissue. The heat destroys that area of the nerve, stopping it from sending pain signals to your brain.
• Medications: Medications like gabapentin, pregabalin, duloxetine, phenytoin or carbamazepine may help treat neuropathic pain.
• Nerve blocks: A nerve block is the injection of a local anesthetic close to a targeted nerve or group of nerves to lessen pain.

Physical therapy may help, but there’s limited research on its effectiveness in treating meralgia paresthetica.

Rarely, surgery is necessary to correct compression on the lateral femoral cutaneous nerve. Healthcare providers usually only recommend surgery for people who try other treatments but still experience symptoms.

Does meralgia paresthetica go away?

Most cases of meralgia paresthetica improve with conservative treatment or may even resolve on their own.

Can I prevent meralgia paresthetica?

There’s no way to prevent meralgia paresthetica. You can reduce your likelihood of developing it by:

• Maintaining a weight that’s healthy for you.
• Wearing loose clothing.
• Avoiding girdles or belts, including tool belts.

What is the prognosis for meralgia paresthetica?

The prognosis (outlook) for meralgia paresthetica is usually good. Approximately 85% of people with meralgia paresthetica experience recovery with conservative treatment.

Cases due to surgical intervention or direct nerve injury typically improve within three months. Pregnancy-associated cases typically improve after the delivery of your baby.

What happens if meralgia paresthetica goes untreated?

Left untreated, meralgia paresthetica may cause increased pain, numbness or other sensations like burning. These effects may interfere with the ability to walk or move as you normally do.

When should I see my healthcare provider?

If you’ve been diagnosed with meralgia paresthetica and your treatment isn’t working or you’re experiencing negative side effects, talk to a healthcare provider about other options.

A note from Cleveland Clinic

Meralgia paresthetica is a medical condition that causes pain and sensations of aching, burning, numbness or stabbing in your thigh area. While meralgia paresthetica isn’t a danger to your health, it can cause unpleasant and uncomfortable symptoms. If the condition is interfering with your quality of life, talk to a healthcare provider. They can determine the underlying cause and recommend treatments.