Meralgia Paresthetica

Meralgia paresthetica (Meros= thigh, Algos = pain) is a sensory mononeuropathy. This condition is characterized by pain, paresthesia, or sensory impairment along the distribuition of the lateral femoral cutaneous nerve. 

Meralgia paresthetica is caused by compression or entrapment of the nerve as it crosses the anterior superior iliac spine and runs beneath the inguinal ligament to enter the thigh.

Causes

The most common cause of damage to the lateral cutaneous nerve is entrapment at the level of the inguinal ligament, often seen in association with obesity or pregnancy, in which the nerve may be compressed by the bulging abdomen.

However  wearing tight trousers (such as jeans), tight belt, trauma to the groin area where the nerve passes posterior to the inguinal ligament, avulsion of ASIS,  surgical operations, pelvic mass or neuropathies (such as diabetis) also could cause this condition.

Diagnosis

The patient complains of sensory disturbance over the anterolateral aspect of the thigh (anesthesia, pain or hyperesthesia of anterior thigh). Palpation of the nerve near the ASIS may increase pain or paresthesia. Light touch may be decreased on the lateral thigh and pinprick response may be increased.

There is no motor loss (positive in L2-L3 radiculopathy).

Nerve conduction velocity studies are rarely needed and may help to exclude L2-L3 radiculopathy, femoral neuropathy, etc.

When a structural lesion is suspected a X-Ray, MRI, pelvic ultrasound or CT scanning may be needed.

Treatment 

Most patients with meralgia paresthetica achieve satisfactory pain relief from conservative treatment by correcting the causes listed above, such as weight loss, correcting posture, avoiding external compressive and traumatic factors etc.

Physiotherapists/osteopaths/chiropractors may perform:

  • pelvic, low back and hips manipulations or mobilization. 
  • massage therapy, myofascial release
  • acupuncture
  • taping

Administration of analgesic and anti-inflammatory drugs may help.

Pulsed radiofrequency has shown some success if conservative treatment fails.

Surgical decompression  or transection of the nerve as a last resort.

 

Dott. Emanuele Luciani
Osteopathphysiotherapist, hatha yoga teacher
Osteopath registered with the General Osteopathic Council (GOsC)
(number 8232http://www.osteopathy.org.uk/home/)
 "Centro Studi Tre Fontane"
Via Luigi Perna 51, Rome

 

Morton's neuroma
Sever's Disease (Heel pain in children)
 

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Monday, 23 September 2019
Dott.Luciani
18 March 2017
Lateral epicondylitis (also called tennis elbow) is an overuse injury occurring in the lateral side of the elbow region, where the tendons of the forearm muscles attach (see picture below). Repeating...
Dott.Luciani
24 June 2017
Meralgia paresthetica (Meros= thigh, Algos = pain) is a sensory mononeuropathy. This condition is characterized by pain, paresthesia, or sensory impairment along the distribuition of the lateral femo...

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Dott. Emanuele Luciani - Via Luigi Perna 51 Cap 00142 Rome - Cell 3488977681 - P.I  12195241000 - emanuele_luciani@yahoo.it
 

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