Lateral femoral cutaneous nerve of the thigh

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 entrapment with associated clinical signs

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