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Meralgia Paresthetica: Symptoms, Causes And Treatment

Meralgia paresthetica is also termed as [1] Bernhardt-Roth syndrome. The condition causes numbness or pain in the outer part of the thighs. The pain is not a result of any wounds or injury but an injury to the nerve that connects the spinal cord to the thighs.

Basically, it is the compression of the lateral femoral cutaneous nerve that caters sensation to the surface [2] of your thighs. The nerve becomes caught or trapped under the inguinal ligament that goes from your groin to abdomen and to the upper thigh. And the condition does not affect your ability to move your leg muscles.

The neurological condition is commonly found in pregnant women as it is natural for them to gain weight during the period. In their case, the condition diminishes after childbirth. It is not serious and goes away in a period of a few months or through adopting measures such as using loose fitting clothes. In severe cases, the individual will need to undergo [3] treatments and medication. Although rare, surgery might be advised in some cases.

Symptoms Of Meralgia Paresthetica

The burning sensation in the skin on your outer thigh shows various signs. The symptoms can worsen after walking or standing for a longer period [4] of time.

The symptoms are

  • constant tingling, numbness or burning sensation in the outer side of the knee,
  • sting like pain in the affected area,
  • occasional aching in the buttocks and groin area,
  • hypersensitivity to heat and
  • in some cases, it can cause itching and irritation [5] .

Causes Of Meralgia Paresthetica

The suppression of the lateral femoral cutaneous nerve is the result of the nerve being trapped, compressed or pinched. The sensory nerve becomes unable to function properly when there is trauma, swelling or a lot of applied pressure [6] on the area.

Meralgia paresthetica can be caused due to [7]

  • running or walking for a long period of time,
  • constantly wearing tight clothes, corsets or belts,
  • sudden weight gain and obesity,
  • pregnancy,
  • repetitive leg movements that can irritate the nerves, for example, biking,
  • trauma to the hip or back caused due to an injury or a [8] surgery and
  • diseases that can damage the nerves [9] (diabetes).

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Risk Factors Of Meralgia Paresthetica

Individuals who fall under the following factors are prone towards developing the neurological condition.

You are likely to develop meralgia paresthetica if you

  • had a recent [10] surgery done to your back or hip,
  • are overweight or obese as it increases the pressure on the lateral femoral cutaneous nerve,
  • are pregnant because it adds pressure on your [11] groin area,
  • have diabetes as it can cause nerve damages[12] and
  • is between the ages of 30 and 60.

Diagnosis Of Meralgia Paresthetica

In order to carry out the identification of the problem, the doctor will examine your medical history and conduct a [13] physical examination. The doctor will ask you questions about your lifestyle and work life, so as to analyse all the possible causes.

1. Physical examination

The doctor will test the sensation on your thighs, so as to detect any pain and numbness. By touching the thighs and the lower part of your leg, the doctor will try to analyse [14] if there are any neurological abnormalities. The physical examination will help the doctor in finding the difference between the affected leg and the other leg.

2. Imaging studies

Under this method, the doctor will conduct an X-ray or an MRI [15] to develop images of your pelvis and hip. Although meralgia paresthetica will not be visible in an X-ray image, the doctor will use it to rule out other conditions that can cause similar symptoms.

3. Nerve conduction study

This diagnosis method will make use of patch-style electrodes [16] which will be placed on your skin so as to stimulate the nerves with electrical impulses that are mild. The study will help in finding out the damaged nerves.

4. Electromyography

Under this test, the electrical discharges made in your muscles will be measured. This is done so as to help the evaluation and diagnosing of the nerve and muscle [17] disorders. Electromyography is conducted by placing a thin needle into the muscle, which will aid in recording the electrical activity.

5. Nerve blockade

In this diagnosis method, an anaesthetic will be injected into your thigh, where the lateral femoral cutaneous nerve is located at. This will help in getting immediate pain relief [18] , which will help the doctor diagnose that you have meralgia paresthetica. The relief will last for a period of 30 to 40 minutes.

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Treatment For Meralgia Paresthetica

In the case of most individuals, the symptoms of the neurological condition reduce in a span of a few months. In the severe conditions where the symptoms last for more than two months, the individual will be advised to adopt medications.

1. Corticosteroid injections

These will help in reducing the levels of inflammation and pain. The pain reduction will be temporary, however. The injections may cause possible [18] side effects such as nerve damage, joint infection, pain, whitening of skin around where the needle was inserted.

2. Tricyclic antidepressants

These medications also help relieve the pain. It also has potential side effects such as dry mouth, sexual dysfunction, drowsiness and constipation.

3. Surgery

In rare cases, it is required to decompress the damaged nerve. Surgery is the option in this case and it is only required for people suffering from long-term and severe [19] symptoms. On carrying out the surgery, the nerve damage will be repaired, thereby providing relief from the pain.

Some of the other medications of treatment include anti-seizure medicines such as gabapentin, phenytoin and pregabalin. These will also help in reducing the pain but may cause nausea, dizziness, constipation, and drowsiness.

Home Remedies For Meralgia Paresthetica

This is beneficial in the case of individuals who do not suffer from severe and constant painful symptoms. The home remedies [20] can be adopted so as to remove the factors that cause nerve compressing.

The home remedies include

  • wearing loose clothing,
  • losing and controlling weight,
  • proper rest and
  • deep tissue massages.
View Article References
  1. [1] Ghent, W. R. (1961). Further studies on meralgia paresthetica.Canadian Medical Association Journal,85(16), 871.
  2. [2] Macnicol, M. F., & Thompson, W. J. (1990). Idiopathic meralgia paresthetica.Clinical Orthopaedics And Related Research, (254), 270-274.
  3. [3] Malessy, M. J., Eekhof, J., & Pondaag, W. (2018). Dynamic decompression of the lateral femoral cutaneous nerve to treat meralgia paresthetica: technique and results.Journal of Neurosurgery,1(aop), 1-9.
  4. [4] Kalichman, L., Vered, E., & Volchek, L. (2010). Relieving symptoms of meralgia paresthetica using Kinesio taping: a pilot study.Archives of Physical Medicine And Rehabilitation,91(7), 1137-1139.
  5. [5] Ivins, G. K. (2000). Meralgia paresthetica, the elusive diagnosis: clinical experience with 14 adult patients.Annals of Surgery,232(2), 281.
  6. [6] Bajaj, N. (2018). Massive Right-sided Ovarian Tumor as a Probable Cause of Left-sided Meralgia Paresthetica (P3. 342).
  7. [7] Weng, W. C., Wei, Y. C., Huang, W. Y., Chien, Y. Y., Peng, T. I., & Wu, C. L. (2017). Risk factor analysis for meralgia paresthetica: A hospital-based study in Taiwan.Journal of Clinical Neuroscience,43, 192-195.
  8. [8] Agarwal, N., Mistry, J. B., Khandge, P. V., Hansberry, D. R., & Goldstein, I. M. (2018). Meralgia Paresthetica After Spine Surgery on the Jackson Table.Clinical Spine Surgery,31(2), 53-57.
  9. [9] Majmundar, N. J., Shastri, D., Assina, R., Goldstein, I. M., Kanumuri, V. V., Raikundalia, M. D., ... & Eloy, J. A. (2017). Meralgia paresthetica following prone position in posterior lumbar spinal surgery: Case series and review of the literature.INTERDISCIPLINARY NEUROSURGERY-ADVANCED TECHNIQUES AND CASE MANAGEMENT,8, 84-88.
  10. [10] Holtzman, A. J., Glezos, C. D., Feit, E. J., & Gruson, K. I. (2017). Prevalence and risk factors for lateral femoral cutaneous nerve palsy in the beach chair position.Arthroscopy: The Journal of Arthroscopic & Related Surgery,33(11), 1958-1962.
  11. [11] Weng, W. C., Wei, Y. C., Huang, W. Y., Chien, Y. Y., Peng, T. I., & Wu, C. L. (2017). Risk factor analysis for meralgia paresthetica: A hospital-based study in Taiwan.Journal of Clinical Neuroscience,43, 192-195.
  12. [12] Dineen, J., & Gibbons, C. (2017). Diabetes, neuropathy, and old age.Diabetes in Old Age,2, 125.
  13. [13] Cho, W. C., & Son, B. C. (2018). Delayed Diagnosis of Meralgia Paresthetica: A Case Report.The Nerve,4(2), 82-85.
  14. [14] Satpathy, J., Mounasamy, V., Golladay, G., & Reynolds, J. P. (2016). Retroperitoneal hematoma presenting as acute meralgia paresthetica: Case report, review of literature and cadaveric demonstration.Journal of Case Reports and Images in Orthopedics and Rheumatology,1, 6-11.
  15. [15] Ata, A. M. (2016). Ultrasound-guided diagnosis and treatment of meralgia paresthetica.Pain physician,19, E667-E669.
  16. [16] Ahmed, A., Arora, D., & Kochhar, A. K. (2016). Ultrasound-guided alcohol neurolysis of lateral femoral cutaneous nerve for intractable meralgia paresthetica: a case series.British Journal Of Pain,10(4), 232-237.
  17. [17] Iyer, K. M. (2018). Advances in the Treatment of Meralgia Paresthetica in Surgery of the Hip Joint in Adults. InHip Joint in Adults(pp. 101-105). Pan Stanford.
  18. [18] Choi, H. J., & Heart, C. S. (2016). Clinical efficacy of pulsed radiofrequency neuromodulation for intractable meralgia paresthetica.Pain physician,19, 173-179.
  19. [19] Malessy, M. J., Eekhof, J., & Pondaag, W. (2018). Dynamic decompression of the lateral femoral cutaneous nerve to treat meralgia paresthetica: technique and results.Journal of Neurosurgery,1(aop), 1-9.
  20. [20] Najafi, S., & Thomas, S. A. (2017). Meralgia Paresthetica. InMusculoskeletal Sports and Spine Disorders(pp. 243-245). Springer, Cham.

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