Meralgia Paresthetica

Overview

What is meralgia paresthetica?

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

Who is likely to have meralgia paresthetica?

Anyone can develop meralgia paresthetica. However, you are more likely to develop this condition if you are:

  • Diabetic
  • Exposed to lead paint
  • Injured by your seatbelt during a car accident
  • Overweight or obese
  • Pregnant
  • Recovering from a recent surgery

You are also more likely to develop meralgia paresthetica if you:

  • Wear tight clothing, girdles, or tight stockings or wear a heavy utility belt (like a tool belt or police gun belt)
  • Have legs of two different lengths
  • Live with medical conditions such as hypothyroidism or alcoholism

Symptoms and Causes

What causes meralgia paresthetica?

Meralgia paresthetica results from the compression of the lateral femoral cutaneous nerve (LFCN). The LFCN is a large sensory nerve. It travels from your spinal cord through your pelvic region and down the outside of your thigh. Meralgia paresthetica symptoms occur when the LFCN is compressed (squeezed).

A variety of factors cause compression of the LFCN. These can include injury to the hip area; medical conditions like obesity, pregnancy, and diabetes; and wearing clothing that is too tight or belts in the waist area.

What are the symptoms of meralgia paresthetica?

Many people with meralgia paresthetica experience symptoms including:

  • Pain on the outer thigh, which may extend down to the outer side of the knee
  • Burning, aching, tingling, stabbing or numbness in the thigh
  • Symptoms on only one side of the body
  • Worse pain when your thigh is touched lightly
  • Worse pain after walking or standing for long periods of time
  • Occasionally, aching in the groin that may spread to the buttocks

Diagnosis and Tests

How is meralgia paresthetica diagnosed?

Your doctor diagnoses meralgia paresthetica by reviewing your medical and surgical history. He or she will ask you questions about the types of belts and clothing you wear for work and recreation. Your doctor will also ask about your possible exposure to lead and your alcohol use. A thorough physical examination will be performed including a hands-on test called a pelvic compression test, in which the doctor applies pressure on your thigh to rule out other causes of your symptoms. Other light touch and reflex tests may also be performed.

Your doctor may order blood tests to check thyroid hormone levels, B vitamin levels, lead levels, and for signs of anemia and diabetes.

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

If you are a woman of childbearing age, your doctor may order a pelvic ultrasound. This test can rule out uterine fibroids, noncancerous growths in the uterus.

Rarely, doctors order a nerve conduction study. This test evaluates how well your lateral femoral cutaneous nerve sends electrical impulses to the surrounding muscles. To measure electrical impulses, your doctor places electrodes along the LFCN. These electrodes measure how fast the LFCN transmits impulses.

Management and Treatment

How is meralgia paresthetica treated?

The symptoms of meralgia paresthetica are relieved by treating the underlying cause. Your treatment may involve losing weight, wearing loose clothing, or avoiding certain restrictive items like belts.

Many people with meralgia paresthetica benefit from other interventions like:

  • Physical therapy, specialized exercises and stretches
  • Phonophoresis, which uses ultrasound waves to help your body absorb topically applied pain medications
  • Transcutaneous electrical nerve stimulation (TENS) to provide symptom relief by using an electric current to stimulate your nerve

Your doctor may recommend medications to help ease your symptoms, including:

In more severe cases, corticosteroid injections or injectable pain medications may relieve symptoms.

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

What complications are associated with meralgia paresthetica?

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

Prevention

Can meralgia paresthetica be prevented?

There is no way to prevent meralgia paresthetica. You can reduce your likelihood of developing the condition by:

  • Losing weight
  • Wearing loose clothing
  • Avoiding girdles or belts, including tool belts

Outlook / Prognosis

What is the prognosis (outlook) for people with meralgia paresthetica?

Most people with meralgia paresthetica recover completely with treatment.

Living With

When should I call my doctor?

If you have any symptoms of meralgia paresthetica, especially if they persist, contact your doctor for a thorough physical evaluation.

Last reviewed by a Cleveland Clinic medical professional on 11/08/2018.

References

  • American Academy of Orthopaedic Surgeons. Burning Thigh Pain (Meralgia Paresthetica). (https://orthoinfo.aaos.org/en/diseases--conditions/burning-thigh-pain-meralgia-paresthetica/) Accessed 9/10/18.
  • Merck Manual Professional Version. Electromyography (EMG) and Nerve Conduction Studies. (https://www.merckmanuals.com/professional/neurologic-disorders/neurologic-tests-and-procedures/electromyography-emg-and-nerve-conduction-studies) Accessed 9/10/18.
  • Onat S, Ata A, Ozcakaar L. Ultrasound-Guided Diagnosis and Treatment of Meralgia Paresthetica. (http://www.painphysicianjournal.com/current/pdf?article=MjcyOA%3D%3D&journal=96) Pain Physician 2016;19:E667-E669.
  • Practical Pain Management. Meralgia Paresthetica-A Common Cause of Thigh Pain. (https://www.practicalpainmanagement.com/pain/neuropathic/meralgia-paresthetica-common-cause-thigh-pain) 2014;14(7).

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