This is a type of neuralgia (pain caused by a damaged nerve) causing numbness and pain in the distribution of lateral femoral cutaneous nerve.

What is the lateral femoral cutaneous nerve?

It is a sensory nerve taking sensations from the front and side of the thigh to the brain. The nerve originates from the lumbar plexus, a collection of nerves in the lower back.

 

What are the symptoms of meralgia paresthetica?

It causes numbness, tingling, sensitivity to touch, and burning discomfort on the front and side of a thigh. This feeling is not felt below the knee.

 

What are the causes of meralgia paresthetica?

Typical cause is obesity, or the belly folds, pressing on the nerve in the inguinal region. Pregnancy related weight gain is a common cause. Overall, it is more common in men with truncal obesity, and/or wearing large or tight belts, or tool belt. It can also happen in a non-obese patient if the inguinal area is stretched, e.g., during difficult labor, or any activity stretching the tissues of the inguinal area. Sometimes it is a symptom of a more widespread peripheral neuropathy.

 

How is meralgia paresthetica diagnosed?

It is diagnosed by its typical symptoms and clinical examination. Testing usually does not help. There is no imaging test to diagnose this condition. Nerve conduction study (NCS) can be considered but it is technically difficult to perform due to obesity and cannot be completely relied upon. In most cases, its diagnosis is straight-forward. NCS can help in cases suspected of having widespread peripheral neuropathy.

 

How is meralgia paresthetica treated?

In most cases, avoiding pressure in the inguinal region (by not wearing tight belts or clothes), and losing weight is helpful. If numbness is the major symptom, or the pain is mild, patient only requires education, and no pain med is needed. Pain medicines are considered, if a patient has significant and consistent neuropathic pain (burning, stinging, shooting type). In that case, medicines like gabapentin, pregabalin, or carbamazepine can be tried. One reason for this approach is because these medicines may impact the patient’s ability to lose weight, which is a better treatment. In some cases, if medicines do not work, a nerve block with a local anesthesia and long-acting steroid can be tried. Ideally, it should be done when patient is having the pain, as the nerve block can also help to confirm the diagnosis.

 

Where can I get more information about meralgia paresthetica?

American Academy of Neurology   

American Academy of Pain Medicine