It can present with a burning sensation, paraesthesia, or hyperesthesia over the distribution of the nerve on the anterolateral aspect of the thigh. The patients usually rub the area as they describe the pain. The sensory loss is quite distinct and borders can be demarcated easily. The presentation is usually restricted to sensory symptoms due to the pure sensory nature of the nerve [6].

Neurologic exam usually reveals abnormal sensations of pinprick and touch in the distribution of the nerve. The rest of the lower limb examination (motor and tendon reflexes) is normal.

• Pain

  Meralgia paresthetica is a painful condition caused by entrapment or irritation of the lateral femoral cutaneous nerve. [indianahiparthroscopy.com]

  People with the disorder often notice a patch of skin that is sensitive to touch and sometimes painful. Meralgia paresthetica should not be associated with weakness or radiating pain from the back. [sharecare.com]

  Pain medicine (Malden, Mass.). 2020 Nov 7 [PubMed PMID: 32022852] [statpearls.com]

  The aim of this report is to emphasize that meralgia paresthetica can be confused with low-back pain. A 21-year-old man was admitted to hospital because of low-back and thigh pain. He had a history of low-back pain. [ncbi.nlm.nih.gov]

  During peripheral nerve surgery for Meralgia paresthetica: You will receive anesthesia so you won’t feel any pain during the surgery. [drducicplasticsurgery.com]

• Burning Pain

  Meralgia paresthetica is a disorder characterized by tingling, numbness, and burning pain in the outer side of the thigh. [sharecare.com]

  Overview Meralgia paresthetica (also known as lateral femoral cutaneous nerve entrapment) is a condition characterized by tingling, numbness and burning pain in your outer thigh. [mayoclinic.org]

  The lateral cutaneous nerve provides sensation to the front of the thigh, and irritation of this nerve can cause burning pain and/or numbness along the front of the thigh. [indianahiparthroscopy.com]

  A painful, burning sensation on the outer side of the thigh may mean that one of the large sensory nerves to your legs—the lateral femoral cutaneous nerve (LFCN)—is being compressed. [orthoinfo.aaos.org]

  The pain physicians at OPTIMAL Pain & Regenerative Medicine are available to assist patients experiencing tingling, burning pain and numbness in the thigh and to diagnose the condition meralgia paresthetica. [dfwregenerativemedicine.com]

• Weight Loss

  The treatment is mainly directed towards reducing the pressure over the area of compression; for instance, in obese patients, weight loss is indicated. [symptoma.com]

  Treatment may include physical therapy, weight loss, nerve block, injections or surgery. [hopkinsmedicine.org]

  These complaints may be worsened by walking or prolonged standing and typically disappear after weight loss, abdominal muscle strengthening, or elimination of the underlying cause. [ncbi.nlm.nih.gov]

  Alternately, weight loss or aging may remove protective fat layers under the skin, so the nerve can compress against underwear, outer clothing, and—most commonly— by belting. [en.wikipedia.org]

• Weakness

  Meralgia paresthetica should not be associated with weakness or radiating pain from the back. This answer is based on source information from the National Institute of Neurological Disorders and Stroke. [sharecare.com]

  Meralgia paresthetica should not be associated with weakness or radiating pain from the back. Treatment Treatment for meralgia paresthetica is symptomatic and supportive. [ninds.nih.gov]

  Meralgia paresthetica is a disorder of the lateral femoral cutaneous nerve that results in symptoms of anterolateral thigh paresthesias and dysesthesias without associated loss of reflexes or motor weakness. [ncbi.nlm.nih.gov]

• Surgical Procedure

  Another surgical cause is if the nerve is damaged while performing another surgical procedure. This can occur when bone graft is obtained from the pelvis, or during some surgical procedures such as an anterior hip replacement surgery. [verywellhealth.com]

  This case-series study came to address follow-up results of these two surgical procedures for managing MP. [ncbi.nlm.nih.gov]

  procedures such as iliac-crest bone graft procedures, anterior pelvic surgery, prone position for spinal surgical procedures and total hip arthroplasty.1,4 Anatomical variations of the LFCN occurs in up to 25% of patients and contributes to increased [sajr.org.za]

• Alopecia

  Meralgia paresthetica should be included in the differential diagnosis of localized alopecia of the anterior or lateral thigh. [ncbi.nlm.nih.gov]

  Alopecia over the affected area has been reported.4,6 Pressure at the inguinal ligament medial to the anterior superior iliac spine may elicit pain, allodynia, and dysesthesias. [mdmag.com]

  […] paresthetica: long-term outcomes in 13 cases. ( 30451004 ) 2019 2 Histopathologic changes inside the lateral femoral cutaneous nerve obtained from patients with persistent symptoms of meralgia paresthetica. ( 30560377 ) de Ruiter GCW...van Duinen SG 2019 3 Alopecia [malacards.org]

• Thigh Pain

  The aim of this report is to emphasize that meralgia paresthetica can be confused with low-back pain. A 21-year-old man was admitted to hospital because of low-back and thigh pain. He had a history of low-back pain. [ncbi.nlm.nih.gov]

  Your thigh pain started after surgery It’s not uncommon for people to report thigh pain after a surgery that dealt with a nerve farther up their back. After all, the thigh nerve travels out of your lower spine. [nevadanervesurgery.org]

  Indeed, the patient had already reported pain and paresthesia in her left anterior thigh in addition to posterior thigh pain during the first interview at the outpatient clinic. [thenerve.net]

  Meralgia Paresthetica is a condition characterized by pain in the outer part of the thigh. [acutepaintherapies.com]

• Tinel's Sign

  Tinel's sign was elicited on percussing the avulsed bony fragment of the anterior superior iliac spine. He underwent open reduction and internal fixation. [ncbi.nlm.nih.gov]

  Pelvic compression test, Neurodynamic testing, and Tinels sign have been shown through limited research to positively identify MP. More research is needed. [theinvertabelt.com]

  Links: pregnancy peripheral nerve lesions Tinel's test [gpnotebook.com]

  On physical examination, a positive Tinel’s sign is usually present 1 cm medial and inferior to the anterior superior iliac crest. [physiotherapy-treatment.com]

• Hip Pain

  Persistent bilateral anterior hip pain in a young adult due to meralgia paresthetica: a case report. [casesjournal.biomedcentral.com]

  In three morbidly obese patients (mean weight 169 kg), severe hip pain developed immediately after gastroplasty. The differential diagnosis included thrombophlebitis, osteoarthritis and lumbar disc protrusion. [ncbi.nlm.nih.gov]

  References I have found your report on hip pain (“Evaluation and management of hip pain: An algorithmic approach,” J Fam Pract 2003; 52(8):607–617) very interesting for my daily clinical practice as a neurologist. [mdedge.com]

  Inability to return to work Inability to return to sport See Also Internal Hip Anatomy (Main) Physical Exam Hip Hip Pain (Main) Thigh Pain (Main) External Sports Medicine Review Hip Pain: https://www.sportsmedreview.com/by-joint/hip/ References ↑ Ecker [wikism.org]

  • Unable to participate in recreational activities Evaluation and Diagnosis Primary pathoanatomical diagnosis of MP was confirmed by burning pain and hypoesthesia in the LFCN distribution, pain with stretch of the LFCN (hip extension), relief with hip [kinetacore.com]

• Suggestibility

  The author presents a family with Meralgia in four generations, suggesting a distinctly autosomal dominant trait. [ncbi.nlm.nih.gov]

• Tingling

  Meralgia paresthetica (Greek for "painful tingling of the thigh") is a condition in which patients experience pain, tingling, burning sensations or numbness in an oval area over the front and side of the thigh; it does not result in weakness or difficulty [sharecare.com]

  Overview Meralgia paresthetica (also known as lateral femoral cutaneous nerve entrapment) is a condition characterized by tingling, numbness and burning pain in your outer thigh. [mayoclinic.org]

  […] durations Hip injury Symptoms of Meralgia Paresthetica Symptoms of meralgia paresthetica include: Shooting pain in the thigh Difficulty walking or standing for long durations Sensitivity to touch Pain in the groin area that radiates to the buttocks Tingling [indianahiparthroscopy.com]

  After his aerial yoga session, he started noticing some numbness and tingling on his thighs, particularly on the outer parts of his thighs. [medium.com]

  The tingling, burning pain and numbness in the thigh associated with meralgia paresthetica can be treated in a number of ways, depending on severity of nerve compression. [dfwregenerativemedicine.com]

• Paresthesia

  Meralgia paresthetica (MP) is generally caused by entrapment of the lateral femoral cutaneous nerve (LFCN), and presents with pain and paresthesia in the anterolateral thigh. [ncbi.nlm.nih.gov]

  Studies are showing that there may be more children dealing with meralgia paresthesia and previously thought. [nevadanervesurgery.org]

• Mononeuropathy

  […] of unspecified upper limb G56.91 Unspecified mononeuropathy of right upper limb G56.92 Unspecified mononeuropathy of left upper limb G56.93 Unspecified mononeuropathy of bilateral upper limbs G57 Mononeuropathies of lower limb G57.0 Lesion of sciatic [icd10data.com]

  Reference article, Radiopaedia.org (Accessed on 28 Mar 2023) https://doi.org/10.53347/rID-52249 Meralgia paraesthetica, also known as Bernhardt–Roth syndrome, refers to a mononeuropathy of the lateral femoral cutaneous nerve. [radiopaedia.org]

  Meralgia paresthetica is a mononeuropathy of femoral nerve seen in diabetes and obesity with an unclear etiopathogenesis. We studied the role of botulinum toxin in resistant cases of meralgia paresthetica in type 2 diabetes. [ncbi.nlm.nih.gov]

• Dysesthesia

  Meralgia paresthetica is a clinical condition that involves pain and dysesthesia in the anterolateral thigh associated with compression of the lateral femoral cutaneous nerve. [statpearls.com]

  Meralgia paresthetica is a syndrome of pain or dysesthesia or both in the anterolateral thigh, caused by entrapment of the lateral femoral cutaneous nerve at the anterior superior iliac spine. [ncbi.nlm.nih.gov]

• Neuralgia

  OBJECTIVES: To assess the incidence of postoperative lateral femoral cutaneous nerve (LFCN) neuralgia and to investigate its risk factors and clinical outcomes. [ncbi.nlm.nih.gov]

  It is known as the lateral cutaneous nerve of the thigh neuralgia. It is due to a lot of etiologies. It is characterized by neuropathic pain, tingling, paresthesia and numbness in the anterolateral aspect of the thigh. [clinicaltrials.gov]

  If the pain is eliminated after the injection, it proves that the nerve is causing the pain and the diagnosis is made of lateral femoral cutaneous neuralgia. This injection is usually done under ultrasound guidance. [completepaincare.com]

  Some types of antidepressant medications (tricyclic antidepressants) such as amitriptyline or anticonvulsant drugs can be useful for nerve-related pain (also called neuralgia or neuropathic pain). [medigoo.com]

  […] elsewhere classified ( R00 - R94 ) Diseases of the nervous system G50-G59 2019 ICD-10-CM Range G50-G59 Nerve, nerve root and plexus disorders Type 1 Excludes current traumatic nerve, nerve root and plexus disorders - see Injury, nerve by body region neuralgia [icd10data.com]

The diagnosis can be made clinically if the distribution and presentation are classic with absence of other neurologic abnormalities of the lower leg. Other tests may be required to rule out other associated factors.

• Tests for diabetes: Blood sugar levels, glucose tolerance test and HbA1c levels may be required to rule out diabetes.
• Imaging: Radiography is not usually important unless there is suspicion of lumber spine problems and the findings are not characteristic. Magnetic resonance imaging is rarely indicated.
• Nerve conduction studies: The results are variable and technically difficult, especially in obese patients, and are rarely required. Electromyography is not indicated as the nerve is a pure sensory nerve. If done it is almost always normal [7]. These test are only indicated when an alternate diagnosis is suspected such as femoral neuropathy.

This condition is usually self-limiting in most patients. Most patients respond to conservative management. The treatment is mainly directed towards reducing the pressure over the area of compression; for instance, in obese patients, weight loss is indicated. 

If the problem persists then drugs such as carbamazepine or gabapentin can be used to reduce the discomfort.

Surgery is rarely used but if indicated, decompression may be done. The success rates are variable. Nerve blocks may also be tried in unresponsive cases. There have been reports of use of radio-frequency ablation in resistant cases.

Treatment of associated factors such as diabetes is also advised [8] [9] [10].

The prognosis is excellent in over 90% of the patients. Improvements are seen if the right causes and associated factors are found and dealt with appropriately. Some patient may have persistent mild loss of sensation that is not uncomfortable.

Most of the patients have compression of the nerve on its course as it goes below the inguinal ligament. There are a number of causes or precipitants that may cause compression including tight belts and garments, scars near the Poupart’s ligament and pregnancy. There have been noted associations with obesity and old age. Iatrogenic causes secondary to surgery near the Poupart’s ligament and spinal surgery have been noted [2].

The incidence has been reported at 4.3 per 10,000 patient years. The incidence is much higher in the diabetic population with rates as high as 240 per 100,000 patient years. There is no gender or race predominance. The incidence rises with advancing age [3].

The anatomy and course of the nerve is important in understanding the condition. The lateral femoral cutaneous nerve has root innervations from L2-3. It runs along the lateral border of the psoas muscle to the lateral part of the inguinal ligament. It then passes in a tunnel made by the Poupart’s ligament and anterior superior iliac spine. It then crosses over into the thigh. This is the most common site of entrapment [4] [5].

Advice on avoidance of tight garments and weight loss strategies should be encouraged to prevent the development of meralgia paresthetica and other nerve compression syndromes.

Meralgia paresthetica (lateral femoral cutaneous nerve entrapment) is the term used to describe the clinical condition comprising of pain, dysesthesia or both of the area supplied by the nerve, particularly the lateral aspect of thigh. It is a benign condition usually caused by pressure on of the nerve [1].

Meralgia paresthetica is a condition when there is abnormal uncomfortable burning sensation, increased touch sensation or reduced sensation on the outer side of the thigh. The condition is not serious and does not indicate an ominous back problems. It is caused by pressure on the nerve that supplies the affected area. The compression may be due to tight clothes, garments or fat in obese people. It is also much more common in diabetics. There is also an association with pregnancy. It may also be caused by surgery around the groin area.

In the majority of the patients, the condition goes away on its own when the inciting event has been dealt with. In those cases that do not respond, drugs may be given to reduce the discomfort. The final step in difficult cases is surgery to relieve the pressure on the nerve.

1. Anderson BC. Office Orthopedics for Primary Care: Diagnosis and Treatment, 3rd Edition, Elsevier Company, Philadelphia 2005.
2. Parisi TJ, Mandrekar J, Dyck PJ, Klein CJ. Meralgia paresthetica: relation to obesity, advanced age, and diabetes mellitus. Neurology 2011; 77:1538.
3. Parisi TJ, Mandrekar J, Dyck PJ, Klein CJ. Meralgia paresthetica: relation to obesity, advanced age, and diabetes mellitus. Neurology. Oct 18 2011;77(16):1538-42
4. Carai A, Fenu G, Sechi E, Crotti FM, Montella A. Anatomical variability of the lateral femoral cutaneous nerve: findings from a surgical series. Clin Anat. Apr 2009;22(3):365-70.
5. Boyce JR. Meralgia paresthetica and tight trousers. JAMA 1984; 251:1553
6. Nouraei SA, Anand B, Spink G, O'Neill KS. A novel approach to the diagnosis and management of meralgia paresthetica. Neurosurgery. Apr 2007;60(4):696-700; discussion 700
7. Seror P, Seror R. Meralgia paresthetica: clinical and electrophysiological diagnosis in 120 cases. Muscle Nerve 2006; 33:650.
8. Parisi TJ, Mandrekar J, Dyck PJ, Klein CJ. Meralgia paresthetica: relation to obesity, advanced age, and diabetes mellitus. Neurology 2011; 77:1538.
9. Hurdle MF, Weingarten TN, Crisostomo RA, Psimos C, Smith J. Ultrasound-guided blockade of the lateral femoral cutaneous nerve: technical description and review of 10 cases. Arch Phys Med Rehabil. Cctober 2007;77 (3):1362-4
10. Fowler IM, Tucker AA, Mendez RJ. Treatment of Meralgia Paresthetica with Ultrasound-Guided Pulsed Radiofrequency Ablation of the Lateral Femoral Cutaneous Nerve. Pain Pract. Dec 7 2011