A Guide to Meralgia Paresthetica

Meralgia paresthetica, or burning thigh pain, arises with lateral femoral cutaneous nerve compression. This nerve supplies sensory information from the outer thigh to the brain. Causes can include tight clothing, rapid weight gain, and injury. Usually, meralgia paresthetica goes away on its own or after changing contributing factors, such as wearing loose-fitting clothing or stopping the physical activity causing the condition. Medication may help relieve nerve pain. Depending on the cause and condition severity, surgery may be necessary to decompress or release the nerve.

Left untreated, however, meralgia paresthetica may lead to serious pain or paralysis.

This article will explain the symptoms, causes, and treatment of meralgia paresthetica.

Symptoms of meralgia paresthetica include unusual or heightened sensation in the outer thigh of one leg. The medical term for a burning, tingling, stinging, or prickling sensation is “paresthesia.” You may experience the following symptoms daily or once in a while:

• numbness, burning, and tingling in the outer thigh
• pain in the knee, groin, or buttocks, and the outer thigh
• sensitivity to touch

Walking, prolonged standing, and getting up from a seated position may make symptoms worse, according to a 2022 review article Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source . These movements involve hip extension. Conversely, hip flexion, such as sitting, does not typically worsen symptoms.

Contact a doctor for symptoms that do not go away with rest and for severe pain that interferes with your ability to perform typical activities.

Symptoms of meralgia paresthetica do not involve leg weakness or pain that moves from the back to the front or outer thigh, explains the National Institute for Neurological Disorders and Stroke (NINDS). These symptoms may be due to more serious problems with the nervous system, such as nerve root compression at the spine. Get immediate medical care by calling 911 for:

• leg weakness
• pain that moves or radiates from the back to the groin area
• numbness, tingling or weakness in other parts of the body

Pressure on the lateral femoral cutaneous nerve causes meralgia paresthetica. This nerve comes from nerve roots exiting the lower lumbar spine. It passes through the pelvic region and under the inguinal ligament in the groin to the outer thigh.

Anything that squeezes these structures or directly compresses the lateral femoral cutaneous nerve can cause meralgia paresthetica.

Common causes of meralgia paresthetica include:

• certain types of physical activity
• injury
• surgery
• area of swelling
• tight clothing or equipment
• rapid weight gain, which could include abdominal weight from pregnancy
• diabetes
• tumor

Tight-fitting clothing and rapid weight gain are two of the more common causes of nerve compression in this area, according to American Academy of Orthopaedic Surgeons.

A physical examination and perhaps imaging tests can diagnose meralgia paresthetica and determine its severity.

Your doctor will start the exam by asking you questions about your symptoms, activities, lifestyle, and recent injuries or surgeries. They may ask you questions about the type of clothing you typically wear, including work equipment.

The doctor will compare sensation in your affected leg to the unaffected leg. To confirm that your symptoms are due to the lateral femoral cutaneous nerve, they may press on the nerve to reproduce or elicit symptoms. They may also examine the pelvic area. A nerve conduction study may be necessary to evaluate how well the nerve functions.

X-rays can identify bone anomalies that may be impacting your nerve. A CT scan or MRI scan may be necessary to rule out other internal causes, such as a tumor.

Depending on the diagnosis, treatment may include self-care strategies, medical treatment, and physical therapy. Below is a summary of different treatment strategies for meralgia paresthetica.

The following strategies may reduce compression of the affected nerve. Try to:

• Maintain a moderate weight.
• Stop activities that put pressure on your thighs.
• Wear loose-fitting clothing.

Sleeping on the unaffected side, with a pillow between your knees for support, may be more comfortable. Avoid sleeping on your stomach.

Medications and procedures may include:

• nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin)
• topical capsaicin or lidocaine for sensitivity
• antidepressants and antiseizure medications to suppress nerve activity and reduce pain
• corticosteroid injections to relieve swelling around the nerve
• nerve block
• surgery to free the compressed nerve

Peripheral nerve stimulation Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source is a potential new treatment for meralgia paresthetica Trusted Source American Journal of Clinical Nutrition Peer reviewed journal Go to source , according to two 2021 case studies.

One 2022 review article Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source on meralgia paresthetica notes that physical therapy is not a proven treatment method. However, movement is beneficial for many pain conditions, so ask your healthcare professional or a physical therapist about exercises and movements that may help your meralgia paresthetica.

Keep in mind that stretches and activities that straighten the hip may make symptoms worse.

The outlook is usually good for people with meralgia paresthetica, according to the NINDS. The condition may improve with nonsurgical treatment or remedies. It may also go away on its own naturally, even without treatment.

Below are some other questions that people ask about meralgia paresthetica.

An MRI may show the underlying cause of meralgia paresthetica. A newer type of MRI of the peripheral nerves — known as magnetic resonance neurography — can identify Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source the exact location of nerve compression or injury.

From the available literature, meralgia paresthetica does not appear to be a dangerous condition. However, it is a good idea for a medical professional to evaluate anyone with symptoms of meralgia paresthetica.

The pain of meralgia paresthetica can be debilitating in some people. It is also possible for continued nerve compression to permanently damage the nerve causing chronic pain.

Yes, a tumor that causes compression of the lateral femoral cutaneous nerve could cause meralgia paresthetica.

Meralgia paresthetica involves burning thigh pain due to pressure on the lateral femoral cutaneous nerve. Causes include rapid weight gain, tight-fitting clothing, and injury. Sometimes the condition goes away on its own.

However, contact a doctor for diagnosis and treatment if you have symptoms of meralgia paresthetica. Treatment is usually successful. Without it, nerve damage can be permanent.