Meralgia Paresthetica

Meralgia Paresthetica is a rare syndrome that results in acute pain and inflammation in the thigh. Read and know all about the causes, symptoms, diagnosis and treatment of this disorder.

What is Meralgia Paresthetica?

It is a condition that arises when any one of the two lateral cutaneous nerves of the femur gets compressed. It is a rare case of Sensory Mononeuropathy.

Picture 1 – Meralgia Paresthetica               Source – rhihealth.com

Meralgia Paresthetica is also referred to as Lateral Femoral Cu Syndrome, meaning Lateral Femoral Cutaneous Nerve syndrome.

Meralgia Paresthetica Incidence

This is a rare condition. As per a recent study, this syndrome is found to arise in approximately 4 out of 10,000 individuals every year.

Meralgia Paresthetica Causes

This condition may arise due to a number of factors like

Pregnancy

During pregnancy, the weight of the uterus puts the nerve under increased pressure. This can compress the nerve and result in this condition.

Obesity

Overweight people are also highly susceptible to this condition. High body weight can put excessive pressure on any of the lateral femoral cutaneous nerves and lead to their pinching or compression.

Tight clothes

Tight garments that constrict the nerves can put excessive pressure on the cutaneous nerves and result in their pinching (compression). Wearing tight clothes or belts for extended periods of time can also result in this condition. Pain can arise in the nerve over a period of time and become acute under constant pressure. The pain may spread into the rib cage as well as the groin and the thigh.

Ageing

Ageing can also lead to the development of this problem. The protective fat layer under the skin becomes less and less with increasing age. This can compress the nerve lying under underwear and belts. Continuous pressure for extended time period can lead to pinching of the nerve.

Leg Exercises for Prolonged Duration

The condition may also result from standing or performing leg exercises for long periods. This can put excessive pressure on the inguinal ligament and make it compressed.

Some other causative factors for this condition include sitting or biking for extended periods. Trauma (or injury) of the nerve or diseases like diabetes are also held as causative factors. The condition has also been found to originate after a surgical operation or as a result of Plexopathy due to hemorrhage. The condition is also more frequently seen in individuals suffering from Carpal Tunnel Syndrome. This suggests that MP has a predisposition to people with Nerve Entrapment Syndromes.

Meralgia Paresthetica Symptoms

This condition is the cause of a number of discomforting physical symptoms. Some of the main symptoms of Meralgia Paresthetica are

• Tingling and burning sensation in the affected nerve
• Numbness in the same nerve
• Pain on the outer edge of the thigh that occasionally extends to the external edge of the knee
• Stinging pain in the impacted nerve
• Pain originating occasionally in the groin region that spreads across the buttocks
• Extreme sensitivity of the affected nerve to heat (contact with water during warm shower can produce extreme burning sensations)
• Extreme sensitivity to light finger touch

The lateral cutaneous nerve in the thigh typically gets injured when it gets compressed or injured while descending through the ilium (bone in upper front area of the hip bone) and the inguinal attachment close to the attachment at the upper region of the hip bone (anterior superior iliac spine).

In less common cases, the nerve may get damaged by seat belt during an accident, impaired by diabetes or caught between unusual anatomical structures.

Burning Thigh Pain and Meralgia Paresthetica

This disorder often leads to a burning sensation in the external area of the thigh. This is accompanied by pain that can range from moderate to severe with passing time. During diagnosis, a physician may apply some amount of finger pressure over the affected area to reproduce the pain. Pelvic and abdominal examinations may also be carried out to exclude any other underlying cause in the region.

Meralgia Paresthetica Diagnosis

The diagnosis of this condition is mainly performed on the basis of the description provided by the sufferer. Details about any recent surgery are also taken into account. It is also checked whether the affected individual has suffered any recent hip injury or performing any activity that can lead to irritation of the nerve.

Diagnosis, particularly in the initial stages, involves a physical examination. The aim of physical examination is to detect any differences in sensation between the impacted leg and the other leg. An examination of the pelvis and the abdomen is also made in some cases to rule out any problem in those regions.

In some cases, Electromyography (EMG) nerve conduction tests may be needed. X-ray examinations may also be required to rule out abnormalities of the bone that might put the nerve under stress. Similarly, MRI (Magnetic Resonance Imaging) or CT (Computerized Tomography) scans may also be needed to rule out soft tissue disorders such as a tumor.

Meralgia Paresthetica Treatment

The treatment for Meralgia Paresthetica generally aims at curing the underlying cause for this condition. This can be done by medications as well as lifestyle modifications. Medications involve administering local cortisone injections at points where the nerve intersects with the crease in the groin.

Lifestyle modifications for this disease involve

• Regular exercises to lose weight
• Wearing loose clothing
• Adding foods high in Vitamin C to the diet to boost the immune system

In some cases, this condition resolves without treatment. This typically occurs when there is a resolution of the underlying cause, such as at the end of a pregnancy.

Meralgia Paresthetica Surgery

In acute cases where the condition fails to improve despite medicines and lifestyle changes, surgery may be necessary for remedy. Local surgery can alleviate physical compression of the swollen Lateral Cutaneous Nerve. Surgical operation is however, carried out only rarely. Most cases of this syndrome improve without surgery.

Physical Therapy for Meralgia Paresthetica

This syndrome can be treated effectively with multiple physical therapy sessions. Physical therapy can help to strengthen the muscles of the buttocks and legs. It may also help to lower the rate of injury to the hips. This condition can be beneficially treated by a combination of heat, ice, ultrasound and electrical stimulation. A combination of these methods can bring about a significant improvement in the condition of an irritated Lateral Cutaneous Nerve.

Meralgia Paresthetica Exercises

Patients of this condition may be asked to gently perform light stretching exercises for improving strength and flexibility in the impacted region. Some common exercises for Meralgia Paresthetica include

Quadriceps Stretches

This workout involves pulling the heel of the impacted foot back towards ones buttocks in a standing position. Stretching should be performed until the point at which pain arises.

Hip Exercises

This exercise involves lying down on the floor and tightening the gluteals while lifting up the legs. This exercise does not usually produce any thigh pain.

With effective treatment, Meralgia Paresthetica can go away within a short time. However, treatment should be followed up with proper management such as wearing appropriate clothing and avoiding injuries to the impacted area for a complete recovery of the disorder without recurrence.