Meralgia Paresthetica

What Is Meralgia Paresthetica?

Meralgia paresthetica is a condition that causes numbness, pain, or a burning feeling in your outer thigh. You might also hear it called Bernhardt-Roth syndrome. It happens when there’s too much pressure on or damage to one of the nerves in your leg, specifically the lateral femoral cutaneous nerve (LFCN).

In most cases, there are simple ways to treat the condition, such as wearing looser clothing. Some people with more severe meralgia paresthetica may need medication or surgery.

With the right treatment and enough time to recover, you can ease your symptoms and feel better.

Meralgia Paresthetica Symptoms

Usually, you’ll notice the warning signs of meralgia paresthetica only on one side of your body. You might feel:

• Pain, tingling, numbness, or burning in the outside of your thigh
• Sensitivity to light touch rather than to firm pressure
• High sensitivity to heat
• Pain may be worse after you’ve been walking or standing for a time

Your symptoms may be mild at first, but as the condition gets worse, you might feel sharper, shooting pain. It may go away and come back for no clear reason.

Meralgia Paresthetica Causes and Risk Factors

Nerves travel throughout your body, carrying messages to and from your brain. A certain set of nerves, called the sensory nerves, gather and send signals to your brain about your skin, muscles, and other tissues.

If you have meralgia paresthetica, a large sensory nerve in your outer thigh doesn’t have enough room to pass through your hip bone or joints. This may be due to swelling, trauma, or increased pressure in this area.

A lot of things can squeeze or damage the nerve, including:

• Weight gain and obesity
• Tight clothing, including pants, stockings, a belt, or girdle
• Pregnancy
• Injury, such as trauma from a seatbelt during a car crash
• Something heavy worn around your waist, like a tool or gun belt
• A disease that can damage the nerves, like diabetes
• Repetitive motions that could irritate the nerve, such as certain leg movements
• Standing or walking for a long time

Your risk of getting the condition is higher if you:

• Are overweight
• Are pregnant
• Have certain medical conditions, including diabetes, hypothyroidism, and alcoholism
• Are between ages 30 and 60
• Have been exposed to lead-based paint
• Have legs that are different lengths

Meralgia Paresthetica Diagnosis

Your doctor will give you a physical exam and ask about your symptoms and your medical history -- especially about any recent injuries or surgeries. The doctor will touch your leg to find the affected area. They will check for any neurological abnormalities of the lower leg.

You may get certain medical tests:

• Imaging tests. Your doctor may order pictures of the inside of your hip and pelvic area to look for other problems that could be causing your symptoms. You may get x-rays, a CT scan, or an MRI.
• Electromyography. This measures the electrical activity in your muscles through a thin needle electrode. If you have meralgia paresthetica, the results will be normal. But it can reveal another cause of your pain.
• Nerve conduction test. Electrode patches applied to your skin put out a small electrical impulse to see how well your nerve sends messages to the muscles.
• Nerve blockade. Anesthesia is injected into your thigh at the point where your LFCN is likely to be compressed. If you have meralgia paresthetica, the pain will temporarily go away.
• Blood tests. Your doctor may check for signs of diabetes, hormone or vitamin imbalances, anemia or lead exposure.

It can be hard to tell the difference between meralgia paresthetica and other back, hip, or groin conditions. Be patient as you work with your doctor to find the right diagnosis.

Meralgia Paresthetica Treatment

The goal of treatment is to ease the pressure on your nerve. The type of therapy you get depends on the cause of your condition.

Lifestyle changes and home care

For mild cases, your doctor may recommend:

• Heat, ice, or taking over-the-counter pain relievers like aspirin, acetaminophen, naproxen, or ibuprofen for a few days
• Weight loss
• Wearing loose- fitting clothing, especially around your upper front hip

Physical therapy

You may work with a physical therapist on stretching and strengthening exercises for your leg muscles or abs. They may also try phonophoresis, which uses ultrasound to help your body absorb a medication through your skin, or transcutaneous electrical nerve stimulation (TENS), which delivers electrical impulses through pads applied to your skin to block pain.

Medications

If your condition is more severe, you may need:

• A corticosteroid shot to reduce swelling.
• Tricyclic antidepressants, which can help relieve nerve pain.
• Anti-seizure medications including gabapentin, phenytoin or pregabalin, which also work against nerve pain.

Your doctor may recommend surgery to ease pressure on the nerve if no other treatment helps.

It can take some time for your pain to go away. Some people will still feel numbness even after treatment. In most cases, though, you should be able to recover within 4 to 6 weeks.

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