Meralgia Paresthetica

Key Features

• The lateral femoral cutaneous nerve, a sensory nerve arising from the L2 and L3 roots, may be compressed or stretched in obese or diabetic patients and during pregnancy

• Hyperextension of the hip or increased lumbar lordosis—as during pregnancy—leads to nerve compression by the posterior fascicle of the ligament

• However, entrapment of the nerve at any point along its course may cause similar symptoms, and several other anatomic variations predispose the nerve to damage when it is stretched

Clinical Findings

• Symptoms are usually mild and commonly settle spontaneously

• Pain, paresthesia, or numbness occurs about the outer aspect of the thigh, usually unilaterally, and is sometimes relieved by sitting

• Pain stops at the knee, unlike the pain from lower lumbar sciatica that radiates to the foot

Diagnosis

• Examination shows no abnormalities except in severe cases when cutaneous sensation is impaired in the affected area

Treatment

• Hydrocortisone injections medial to the anterosuperior iliac spine often relieve symptoms temporarily

• Nerve decompression by transposition may provide more lasting relief but is rarely indicated