MERALGIA PARASTHETICA
Overview
This disorder is also known as lateral femoral cutaneous neuralgia. It is defined as the itching, tingling, burning or other unusual sensations moving across the skin at the top or outer side of the upper portion of the thigh. The patient will experience more or less sensitivity to light touch. The disorder is caused by a disruption in the normal function of the nerve that originates near the pelvis and moves across the top of the thigh, quite close to the surface. Research shows the condition is caused by a sudden traumatic injury or by constant pressure on the lateral femoral cutaneous nerve, which passes along the front of the hip and thigh. Patients with large, protuberant abdomens may develop this problem from compression of the nerve while sitting. Alternatively, patients can develop this problem while standing with their hips pressed against a hard object, like a barber or hair stylist who leans on the armrest of a client’s chair. Extending the hip can aggravate the pain, and some patients will describe numbness at the top or side of the affected thigh. Though the symptoms are troubling, they are usually due to superficial irritation and do not affect the deeper muscles.
Diagnosis
A physical examination will help confirm the patient has decreased sensitivity to light touch over the affected thigh. Many doctors will use electronic nerve conduction tests also. Doctors who specialize in pain management can use injections or nerve block treatments that are placed around the affected nerve to confirm the diagnosis.
Treatment
Some patients can find temporary relief with the use of nonsteroidal anti-inflammatory medications. If applicable, patients will be asked to not wear tight garments, like corsets or belts, which can compress the nerve as it emerges from the hip on its course to the top of the thigh. Obese patients will be asked to lose weight. If the disorder is linked to a specific activity, a physical therapist or occupational therapist will assist with developing alternative methods of performing the activities that are less likely to cause repeated irritation of the affected nerve. Long-term relief of meralgia paresthetica can be found through the use of nerve block treatments containing an anesthetic medication along with anti-inflammatory medications that are injected around the nerve. The injections are usually given in a series of three to five treatments over several weeks for maximum effect. Occasionally nerve stimulation measures, such as a TENS unit, are utilized. Surgery is only considered as a last resort in the most difficult cases.
Prevention
- Maintain ideal body weight
- Avoid compressing the hip area
- Proper diet