Meralgia paresthetica is a condition in which the lateral femoral cutaneous nerve, which provides sensation to the outer thigh, is compressed, causing numbness and/or burning or lancinating pain to this region of the leg.
As it passes through the groin into the upper thigh, the nerve passes beneath the inguinal ligament, which runs on each side from the pubic bone to the iliac crest. It is here that the nerve is compressed or pinched, causing the above symptoms.
The disorder is caused by any condition that increases pressure on the groin, such as corsets, belts, and tight pants, wearing a heavy tool belt, pregnancy, or scarring near the inguinal ligament due to past surgery or injury.
Obesity or weight gain can also cause the condition. Nerve injury, as that sustained by seat belt during a motorvvehicle accident, can also cause meralgia paresthetica, as can the nerve damage seen in diabetes. The condition is most commonly seen between the ages of 30 and 60.
For most people, this disorder is self-limited, with symptoms easing in a few months. Treatment is centered on relieving pressure on the lateral femoral cutaneous nerve. This can be accomplished by wearing looser clothing, and by weight loss.
OTC NSAIDS, such as ibuprofen and naproxen, can provide some relief of pain. Certain anticonvulsant medications, such as gabapentin (Neurontin), phenytoin (Dilantin), and pregabalin (Lyrica) can help lessen pain. Amitriptyline (Elavil) is a tricyclic antidepressant which has been found useful. Corticosteroid injections can be beneficial in more severe cases.
Lastly, in those with severe and persistent symptoms, surgical decompression of the nerve can be considered.
It should be noted that the lateral femoral cutaneous nerve is a purely sensory nerve; hence, in meralgia paresthetica there is no effect on the muscle function of the involved leg.
(Dr. Robert Sweeten, M.D., is a family physician in Neosho. If you have a topic you’d like him to write about, he can be reached at 417-451-7425.)