Meralgia Paresthetica: Frequently Asked Questions
Do you suffer from a persistent, burning pain or strange numbness in your outer thigh? Sometimes, these symptoms can be caused by a condition called meralgia paresthetica, also known as Bernhardt-Roth syndrome or femoral cutaneous nerve syndrome.
If you have this relatively uncommon condition, the good news is that in most cases, it can be managed with medication, physical therapy and avoiding things that may contribute to your symptoms (such as wearing tight pants or heavy tool belts). Here are answers to frequently asked meralgia paresthetica questions.
The classic signs of meralgia paresthetica help doctors diagnose the condition. Meralgia paresthetica develops on the upper, outer portion of one of your thighs. Typically, only one side of your body will be affected (though about 20% of the time, people experience symptoms on both thighs). Pain or numbness may also extend down your leg to the outer side of your knee. These signs and symptoms of meralgia paresthetica may include any of the following sensations at the top of your outer thigh:
- Stabbing pain
- Feeling of “pins and needles” (paresthesia)
In addition, you may notice:
- Light touch on your thigh triggers the pain, while deep pressure does not.
- Your pain gets worse after walking and standing for a long time.
- Besides your leg, you may feel aching in your groin, which may spread to your buttocks.
If your doctor needs to rule out other possible causes of your symptoms, he or she may order:
- Imaging studies to evaluate the structure and anatomy of your pelvis
- Muscle and nerve studies to evaluate how your muscles react to a nerve stimulus. Your doctor may perform electromyography and a nerve conduction study.
- Nerve block of the femoral cutaneous nerve, which will stop your pain. Your doctor may perform this procedure to confirm the diagnosis.
The lateral femoral cutaneous nerve runs from your spinal cord through your pelvic or groin region to the outside of your thigh. Many things can cause pressure or squeezing of this nerve (also referred to as compression or entrapment), including:
- Tight garments (such as pants, girdles, stockings and belts)
- Heavy utility belts (such as a police gun belt or a tool belt)
- Seat belt injury
- Recent hip or thigh injury
- Recent surgery, such as for an inguinal (groin) hernia or surgeries of the spine and pelvis
- Repetitive leg motion
A mass (benign or malignant) pressing on the lateral femoral cutaneous nerve is a very rare cause of meralgia paresthetica.
About 3 to 4 of 10,000 people develop meralgia paresthetica. While anyone can develop it, some risk factors make it more likely, including:
- Being male (men are more likely than women to have this)
- Age between 30 to 60 years old (some experts say 30 to 40)
- Having diabetes, especially if not controlled or poorly controlled
- Being overweight or obese
- Being pregnant
- Exposure to lead paint
- History of carpal tunnel syndrome
- Having legs of two different lengths
- Having hypothyroidism (underactive thyroid)
- Drinking too much alcohol
The first meralgia paresthetica treatment is to discover the most likely cause of your femoral nerve compression. When you know what’s causing the problem, you can take steps to avoid it or relieve it. This may mean losing weight (if you are overweight), wearing looser clothes, or avoiding tight belts. Treating any underlying condition may improve nerve health, including meralgia paresthetica symptoms.
- Over-the-counter pain relievers and anti-inflammatory medications, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin) or aspirin. These generally are given as part of conservative treatment during the first two months of symptoms.
- Corticosteroid injections for persistent pain (longer than two months). However, these carry risks of joint infection, nerve damage, pain and whitening of your skin near where the shot is given.
- Phonophoresis, the use of ultrasound waves to help your body absorb topical pain-relieving medication
- Transcutaneous electrical nerve stimulation (TENS) to stimulate your lateral femoral cutaneous nerve, which can provide pain relief.
- Some antidepressants may also be given to relieve pain (in particular, tricyclic antidepressants, such as amitriptyline). Possible side effects are drowsiness, dry mouth, constipation and impaired sexual functioning.
- Antiseizure medications are another option for persistent pain, including gabapentin (Gralise, Neurontin) and others. Side effects may include constipation, nausea, dizziness, drowsiness and lightheadedness.
- Surgery to decompress the nerve, which is rare and usually performed only on people with severe and long-lasting symptoms that do not respond to other treatments.
If a pelvic injury is the cause of meralgia paresthetica, exercises (physical therapy) to strengthen your leg and buttock muscles will help you recover, which may relieve pressure on the nerve and improve your nerve symptoms. There is some evidence abdominal exercises may reduce nerve compression.
For most people, meralgia paresthetica goes away within a few months, especially the pain and “pins and needles” sensations. For some people, numbness and altered sensation in the area remain. The prognosis depends on the cause of the nerve entrapment.
If you are experiencing symptoms of meralgia paresthetica, especially if they aren’t going away on their own, visit your doctor. If you have this condition, your doctor can advise remedies to help provide relief. Left untreated, long-term compression of the nerve can cause permanent damage and long-term symptoms. If your symptoms are due to another disorder, it should be treated as well.