Meralgia Paresthetica

Introduction

 

Meralgia paresthetica is an entrapment or ‘pinching’ of the lateral femoral cutaneous nerve that supplies sensation to the outer portion of the thigh. The nerve becomes entrapped when passing through the groin. The term ‘meralgia’ implies pain that occurs in the thigh.

This in turn causes abnormal sensations of paresthesia .i.e. tingling, burning, pain and numbness in the outer and part of the thigh.

This disorder is also referred to as the lateral femoral cutaneous nerve syndrome and is more common in men than women. Besides, it is usually found in middle-aged or overweight individuals.

 

Key Symptoms

 

The main symptoms of meralgia paresthetica include:

• Pain, burning sensation on the outer side of the thigh, sometimes extending to the outer side of the knee.

• Numbness over the outside of the thigh.

• Sensitivity to light touch over the outside of the thigh.

• Worsening of symptoms with certain positions.

• Occasional pain in the groin area.

• Pain across the buttocks.

In general, people with this disorder report that it appears or worsens after walking or standing.

 

Causative Factors

 

The chief cause of the condition is ischemia .i.e. deficiency of blood due to constriction or obstruction, of the nerve caused by its entrapped position.

The condition is primarily caused by pressure on the lateral femoral cutaneous nerve and subsequent inflammation. The point of pressure or entrapment is usually where the nerve exits the pelvis, running through the inguinal ligament.

Other causes include tight clothing, pregnancy, postural alterations, diabetes and obesity. Moreover, meralgia paresthetica is also considered to be associated with nerve injury, such as due to seat belt injury or lower abdominal surgery.

Spinal nerve disorder, multiple sclerosis, nerve disorder and spinal cord disorder are rare causes of meralgia paresthetica.

Besides, the pain of meralgia paresthetica often gets aggravated by sitting or squatting for long periods of time.

 

Treatment Options

 

There are primarily three forms of treatment recommended for patients of meralgia paresthetica. Here we briefly explain each one of them:

A) Avoidance techniques

The first stage of treatment involves addressing the underlying cause of the disorder. All the major symptoms of meralgia paresthetica normally disappear when the patient discontinues or avoids the practices, which act as the causative factors.

In such cases, treatment is aimed at releasing compression on the nerve. For instance, if tight clothing were the cause, the symptoms would generally go away by wearing loose clothing.

B) Medications

Medication is prescribed in cases where the above fails to have an effect and the pain continues to be severe. Main forms of medications include:

• Gabapentin

• Pregabalin

• Tricyclic antidepressants

C) Minimally Invasive Procedures

• Pulsed radiofrequency to the nerve locally

D) Surgical intervention

Surgical decompression or destruction of the lateral femoral cutaneous nerve becomes necessary only in rare cases.