Meralgia Paresthetica- Diagnosis and Treatment

Meralgia Paresthetica

Introduction

Meralgia Paresthetica is a neurological condition that causes pain, tingling, burning, or numbness in the front and sides of your thigh. The main cause of Meralgia Paresthetica is the compression of the nerve that supplies sensation to the skin of your thigh. This nerve is known as the Lateral Femoral cutaneous nerve.

Wearing tight-fitting clothing, and activities, like walking, standing, or cycling for long periods, can bring the condition of Meralgia Paresthetica. People suffering from Diabetes are also more prone to develop Meralgia Paresthetica.   

Causes of Meralgia Paresthetica:

Meralgia Paresthetica occurs when the lateral femoral cutaneous nerve of your outer thigh becomes compressed or pinched. Common causes of this compression include:

  • Tight clothing such as tight pants, belts, and corsets
  • Wearing a heavy tool belt around your waist.
  • Obesity or weight gain
  • Pregnancy
  • Scar tissue due to injury around the waist

Symptoms of Meralgia Paresthetica:

Meralgia Paresthetica affects the outer and front part of your thighs. Symptoms mainly occur on one side of the body. They may get worse after walking or standing for a long period. Symptoms include:

  • Pain
  • Burning
  • Tingling
  • Aching in the groin area
  • Partial loss of sensation or increased sensation in the outer thigh 

Who are at risk?

You may be at an increased risk of experiencing Meralgia Paresthetica if you:

  • Are pregnant
  • Overweight
  • Are between the ages of 30 to 6o
  • Have diabetes (people with diabetes are  seven times more likely to develop the condition of Meralgia Paresthetica, which can be caused by a diabetes-related nerve injury.)
  • Wear a tool belt for work

How it is diagnosed?

To diagnose Meralgia Paresthetica, a doctor will ask you details about your symptoms and conduct a physical examination. You might be asked questions about your clinical history, including some other conditions you may have, and any medication history.

Your physician may likewise ask you questions about your lifestyle, for example, if you wear a heavy tool belt for your work, or if you often wear tight stockings or corsets. During a physical examination, your doctor may test the sensation on your thigh and ask you to pinpoint the spot on the thigh that is painful or numb.

Investigations like MRI of Lumbosacral spine may be advised. EMG and NCV tests of Lateral Femoral Cutaneous nerve may be advised in some cases. 

Blood tests like Thyroid function tests, Blood sugar levels, Hemogram, and others may be advised based on the case scenario.

Treatment

Meralgia Paresthetica responds very well to treatment provided it is diagnosed early. 

  • Lifestyle changes: Some changes in lifestyle are required to release the compression on the nerve. If you are overweight, you will need to lose weight. If you wear a tool belt for work, you will have to stop doing it. You will have to avoid wearing tight-fitting clothes at the waist. You will also need to control your blood sugar levels if you are a diabetic.
  • Medications: This condition will not respond to conventional painkillers. Gabapentin and Pregabalin are drugs will suppress the firing of the irritated nerve. These drugs will help in Meralgia Paresthetica. 
  • Physiotherapy: Physiotherapy aims at relieving the pressure on the Lateral Femoral Cutaneous Nerve. This is done by an experienced physiotherapist by utilizing nerve flossing and mobilization techniques.
  • LFCN Injection: An injection is given around the groin along the Lateral femoral cutaneous nerve. This injection consists of a mixture of local anesthetic and steroid. This helps to confirm the diagnosis of Meralgia Paresthetica. This injection also reduces the pain of Meralgia Paresthetica. 
  • Radiofrequency denervation: Nerve conduction in Lateral Femoral Cutaneous Nerve is blocked by the Pulse RF technique. The responsible nerve is stunned by means of electric current in this procedure. This technique gives you long term relief from pain.