Meralgia paresthetica
Overview
Meralgia paresthetica is a condition characterized by tingling, numbness and burning pain in the outer part of your thigh. The cause of meralgia paresthetica is compression of a nerve — the lateral femoral cutaneous nerve — that supplies sensation to the skin surface of your upper leg. Common causes of this nerve compression include tight clothing, obesity or weight gain, and pregnancy. Meralgia paresthetica can also be due to nerve injury, from a disease such as diabetes or from trauma. Treatment for meralgia paresthetica is directed at relieving the compression and usually consists of self-care measures, such as wearing looser clothing or losing weight. In severe cases of meralgia paresthetica, treatment may include medications to treat the discomfort or, rarely, surgery.
Symptoms
Pressure on the lateral femoral cutaneous nerve, which supplies sensation to your upper leg, may cause the following symptoms of meralgia paresthetica: Tingling and numbness in the outer part of your thigh Burning pain in or on the surface of the outer part of your thigh Less commonly, dull pain in the groin area or across your buttocks These symptoms commonly occur only on one side of your body and may intensify after walking or standing.
Causes
Meralgia paresthetica occurs when the lateral femoral cutaneous nerve — a nerve that supplies sensation to the surface of your upper leg — becomes compressed, or "pinched." In most people, this nerve passes through the groin to the upper thigh without trouble. But in meralgia paresthetica, the lateral femoral cutaneous nerve becomes trapped — often under the inguinal ligament, which runs along your groin from your abdomen to your upper thigh. Common causes of this compression include any condition that increases pressure on the groin, including: Tight clothing Obesity Pregnancy Scar tissue near the inguinal ligament, due to injury or past surgery Walking, cycling or standing for long periods of time Nerve injury, such as due to diabetes or seat belt injury following a motor vehicle accident, also can cause meralgia paresthetica.
Diagnosis
In most cases, your doctor can make a diagnosis of meralgia paresthetica based on your medical history and a physical examination. He or she may touch the affected leg, ask you to describe the pain, and ask you to trace out the specific location of the numb or painful area on your leg. In order to rule out other conditions, your doctor may recommend: X-ray imaging. This diagnostic tool uses electromagnetic radiation to make images of your hip and pelvic area. Electromyography (EMG). This test measures the electrical discharges produced in muscles to help evaluate and diagnose muscle and nerve disorders. During the test, a thin needle electrode is placed into the muscle to record electrical activity. This test is normal in meralgia paresthetica, but may be needed to exclude other disorders when the diagnosis isn't clear. Nerve conduction study. In this test, patch-style electrodes are placed on your skin to stimulate the nerve with a mild electrical impulse. The electrical impulse helps diagnose damaged nerves.
Treatment
Treatment for meralgia paresthetica is directed at relieving compression of the nerve, which may include self-care measures, such as wearing looser clothing or losing weight. These conservative measures are effective for most people, with pain usually going away on its own within a few months. Mild pain relievers, such as acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory medications, may be helpful if you have bothersome pain. Medications If symptoms persist for more than two months or your pain is severe, treatment may include: Corticosteroid injections. Injections can reduce inflammation and temporarily relieve pain. Tricyclic antidepressants. These medications may relieve the pain. Gabapentin (Neurontin). This anti-seizure medication may help lessen the painful symptoms. Surgery Rarely, surgery is necessary to decompress the nerve. This option is considered only for people with severe and long-lasting symptoms.