Meralgia paresthetica

Overview

Meralgia paresthetica is a condition that causes tingling, numbness and burning pain in the outer thigh. It happens when the nerve that gives feeling to the skin on the upper leg is compressed. This is the lateral femoral cutaneous nerve.

Meralgia paresthetica also is known as lateral femoral cutaneous nerve entrapment.

Tight clothing, obesity or weight gain, and pregnancy are common causes of meralgia paresthetica. It also can be due to an injury or a disease, such as diabetes.

Conservative measures, such as wearing loose clothing, often lessen meralgia paresthetica symptoms. In severe cases, treatment may include medicines to ease discomfort. Rarely, surgery may be needed.

Causes

Meralgia paresthetica occurs when there is pressure on the lateral femoral cutaneous nerve. This is the nerve that supplies feeling to the skin of the outer thigh. The nerve only affects how the leg feels. It doesn't affect how the leg muscles work.

In most people, this nerve passes through the groin to the upper thigh without trouble. But in meralgia paresthetica, it becomes trapped. Often the nerve is trapped under the inguinal ligament. This is a ligament that runs along the groin from the belly to the upper thigh.

Conditions that raise pressure on the groin can compress the lateral femoral cutaneous nerve, including:

• Tight clothing, such as belts, corsets and tight pants.
• Obesity or weight gain.
• Wearing a heavy tool belt.
• Pregnancy.
• Fluid buildup in the belly.
• Scar tissue near the inguinal ligament due to injury or past surgery.

Nerve injury also can cause meralgia paresthetica. For example, the nerve can be injured due to diabetes, trauma after surgery or seat belt injury after a motor vehicle accident.

Prevention

Although there's no sure way to prevent meralgia paresthetica, you can take steps to help reduce your risk. For instance:

• Opt for looser fitting pants and other clothing.
• Limit what you carry in your pockets and on your belt, especially heavy items.
• Keep a healthy weight, or lose weight if you're overweight.
• Try to have correct posture.

Treatment

For most people, treatment for meralgia paresthetica isn't needed because the symptoms ease in a few months. Treatment focuses on lessening pressure on the nerve.

Conservative measures

Conservative measures include:

• Wearing loose clothing.
• Losing excess weight.
• Taking pain relievers that you can buy without a prescription, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).
• Seeing a physical therapist, who can design an exercise program to strengthen the back, neck and stomach muscles and relieve pressure on the nerve.

Medicines

If symptoms last for more than two months or the pain is severe, treatment might include:

• Corticosteroid shots. These can reduce swelling and provide short-term pain relief. Side effects may include joint infection, nerve damage, pain, and whitening or lightening of skin around the injection site.
• Tricyclic antidepressants. These medicines might lessen pain. Side effects may include feeling drowsy, dry mouth and constipation. They may worsen sexual functioning.
• Antiseizure medicines. Gabapentin (Gralise, Neurontin), phenytoin (Dilantin) or pregabalin (Lyrica) are antiseizure medicines that may help lessen nerve pain. Side effects can include constipation, nausea, dizziness and lightheadedness. They also may make you feel drowsy.

Surgery

Rarely, surgery is used to decompress the nerve. This option is only for people with severe and long-lasting symptoms.

Preparing for an appointment

Here's some information to help you get ready for your appointment.

What you can do

Before your appointment, it's a good idea to:

• Write down any symptoms you have, including any that may seem unrelated to the reason you scheduled the appointment, and when they started.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medicines, vitamins or supplements you take and how much you take.
• Write down questions to ask your healthcare team.

For meralgia paresthetica, some basic questions to ask include:

• What is likely causing my symptoms?
• What tests do I need?
• Is my condition likely to last a short time or a long time?
• What is the best course of action?
• What are the alternatives to the primary approach you're suggesting?
• I have other health conditions. How can I best manage them together?
• Are there restrictions I need to follow?
• Should I see a specialist?

Don't hesitate to ask any other questions you have.

What to expect from your doctor

A healthcare professional may ask you questions, such as:

• What part of the leg is affected?
• Have you had recent surgeries?
• Have you had recent injuries to the hip area, such as from a seat belt in a motor vehicle accident?
• Do you regularly do repeated actions involving the hip, such as cycling?
• Have you gained weight?
• Have you recently been pregnant?
• Do you have diabetes?
• Does the burning or tingling come and go, or does it persist?
• How severe is the discomfort?
• Are there things you do that worsen the symptoms?
• Is there weakness in the leg?

What you can do in the meantime

If the pain bothers you, pain relievers that you can buy without a prescription may be helpful, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others). Wearing loose clothing can help too.