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Meralgia Paresthetica

Categories
  • Hip
  • Joint/Tendon
Tags
  • Hip injuries
Hip

Meralgia paresthetica
(Lateral femoral cutaneous nerve entrapment)

Sensory cutaneous nerves

Anatomy

Lateral femoral cutaneous nerve of the thigh

Lateral femoral cutaneous nerve of the thigh

Meralgia paresthetica

Meralgia paresthetica is compression of the Lateral femoral cutaneous nerve of the thigh and it is characterized by tingling, numbness, and burning in the nerve distribution down the outer thigh area. The nerve is purely sensory and can be entrapped at the inguinal ligament.

Causes:

  • Tight clothing or any compression devices around the hip area such as belts
  • Obesity/weight gain
  • Pregnancy
  • Injury to nerve
  • Space occupying lesions close to the nerve

Risk factors:

  • Weight gain
  • Pregnancy with increased pendulous abdomen with fluid retention
  • Nerve injury especially in Diabetic related nerve injury

Presentation:

  • Tingling and numbness and burning outer thigh area aggravated by activity
  • Clinically nerve entrapment in the distribution of Lateral femoral cutaneous nerve distribution

Investigations:

  • X-rays of hip and pelvis to exclude other causes when indicated
  • Nerve conduction studies
  • Nerve blockade will confirm the diagnosis. Ultrasound guidance is useful to confirm the injection site.
Lateral femoral cutaneous nerve of the thigh

Lateral femoral cutaneous nerve of the thigh entrapment with associated clinical signs

Management

Conservative:

  • Avoid aggravating factors
  • Medication such as pregabalin (Lyrica) may help with neuralgia pain
  • Nonsteroidal anti-inflammatory medication
  • Corticosteroid injections: reduces inflammation and temporary relief of the pain

Surgery

  • Seldom indicated
  • For intractable syndrome not responsive to conservative measures
  • Release of entrapped nerve at inguinal area

Surgery Technique

Surgery

Surgery

Surgery

Rehabilitation

  • Stretching of hip flexor tendons focusing on Sartorius.
  • Core strength exercises.
Stretching of hip flexor tendons focusing on Sartorius
Core strength exercises

Download ASSIC Performance Fingerprint or Strength & Conditioning apps for rehab guideline routines or create own under professional supervision

apple app store  google play store

References

  1. Meralgia paresthetica: finding an effective cure. Ardo Sanjaya. Postgrad Med. 2020 Jan; 132(1): 1-6.
  2. Treatment for meralgia paraesthetica. Nofal Khalil, Alessia Nicotra, Wojtek Rakowicz. Review Cochrane Database Syst Rev. 2012 Dec 12;12(12): CD004159.
  3. Ultrasound-guided diagnosis and treatment of Meralgia Paresthetica. Sule Sahin Onat, Ayse Merve Ata, Levent Ozcakar. Pain Physician. 2016 May;19(4): E667-9.

Contributor:

Prof S Maqungo

Learn More

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