Meralgia paresthetica, or Bernhardt-Roth syndrome, is a nerve condition caused by compression of the lateral femoral cutaneous nerve, which is one of the major sensory nerves of the leg. It is responsible for detecting feelings on the skin on the lateral thigh below the inguinal ligament to the knee. Numbness, tingling, pain, or burning sensation on the lateral thigh due to compression of the nerve can impair ease of activities of daily living and mobility.

Accurate diagnosis of the aetiology of nerve compression is imperative to provide an appropriate treatment. It can be achieved with the help of physical therapy, weight reduction, nerve blocks, injections, or surgery, based on the severity. Detection of meralgia paresthetica causes, symptoms, and risk factors will facilitate early diagnosis and complication prevention. 

Also, if you are a future NEET PG medical student, it is good to be informed about this condition so that you can improve your clinical competence and patient care.

Keep reading to learn more about this condition.

What is Meralgia Paresthetica?

Meralgia paresthetica is a neurological disorder that causes pain and abnormal sensations of aching, burning, numbness, or stabbing pain in the thigh area. It occurs when the lateral femoral cutaneous nerve (LFCN), an essential sensory nerve, is compressed, squeezed, or pinched. This nerve is responsible for transmitting sensation to the front and outer portions of the thigh.

The words “meralgia” describe pain in the thigh, and “paresthetica” burning, paraesthesia, or itch. While the condition is troublesome and can impact daily comfort, it is benign and poses no serious threat to general well-being.

What are Meralgia Paresthetica Symptoms?

Most often, symptoms are limited to one side of the body. Some signs that you may experience are:

• Tickling, burning, numbness, or pain on the outside of the thigh.
• Hypersensitivity to light touch, while deeper pressure may not cause as much discomfort.
• Increased sensitivity to heat or warm environments.
• Pain that increases after prolonged standing or walking.

Initially, the pain will be minimal and intermittent. When the disease takes on a more progressive course, it causes more acute, piercing pain. The symptoms also may recur, vanishing for a time and reappearing without apparent cause.

What are the Causes of Meralgia Paresthetica?

Meralgia paresthetica occurs when the lateral femoral cutaneous nerve is compressed or pinched. This sensory nerve provides sensation to the skin on the lateral thigh and does not affect the function of muscles in movement.

Usually, the nerve runs through the groin region into the thigh. However, in this disorder, the nerve gets entrapped, most often by the inguinal ligament, a band of tissue running from the lower abdomen to the upper thigh.

Several items that press against the groin can lead to compression, such as:

• Sitting while wearing garments that are tight around the waist, such as belts, corsets, or tight-fitting pants
• Weight gain or obesity
• Wearing a heavy work or utility belt
• Pregnancy, which raises intra-abdominal pressure
• Ascites, or fluid in the abdomen, which may lead to groin pain
• Development of scar tissue within the region of the inguinal ligament following trauma or surgery

In certain instances, the condition results from direct nerve injury. This is a result of diabetic neuropathy, surgical trauma, or seat belt trauma from automobile accidents.

What are Meralgia Paresthetica’s Risk Factors?

Anyone can develop meralgia paresthetica. However, you’re more likely to develop this condition in case you:

• Have diabetes, hypothyroidism and/or alcohol use disorder
• Are overweight or obese
• Have lead poisoning
• Are injured by your seatbelt during a car accident
• Are pregnant
• Had recent surgery around your hip area
• Wear tight clothing, girdles or stockings, or wear a heavy utility belt (like a tool belt)
• Have legs of two different lengths
• Have scoliosis

How is Meralgia Paresthetica Diagnosed?

Your doctor will start by taking into account your symptoms in detail and performing a physical examination. They may ask questions about your medical history, such as any existing health conditions, the medications you are currently taking, and whether you have undergone recent surgeries.

Your physician will also enquire about your daily habits. As an example, they may ask questions regarding whether your job requires you to wear a heavy tool belt or tight devices such as a belt, corsets, or stockings on a regular basis.

In the physical examination, the doctor might examine the sensitivity of your thigh by tapping or pressing lightly on the skin. There is also a chance that you will be asked to point at the precise location of the pain, numbness, or tingling.

If your medical history and symptoms cannot independently bring about a diagnosis, your physician can have you perform some other tests, which might include:

• Imaging tests, such as X-rays or MRIs, are used to examine the hip and pelvis.
• Nerve conduction studies, where tiny electrical impulses are used to test the function of your nerves and identify if there is any damage.
• Electromyography (EMG) is used to measure the electrical activity in nearby muscles and determine if other conditions are contributing to the symptoms.
• Nerve block injection, where a local anaesthetic is injected into the area through which the lateral femoral cutaneous nerve travels into the thigh. If pain relief is immediate for some 30–40 minutes following this injection, it is diagnostic of meralgia paresthetica.

What is the Treatment of Meralgia Paresthetica?

In many cases, symptoms improve within a few months without the need for aggressive intervention. The primary goal of meralgia paresthetica treatment is to relieve pressure on the affected nerve.

Conservative Measures

Nonoperative treatments that can be effective include:

• Wearing less tight, relaxed clothing to loosen up pressure in the groin area.
• Weight loss to eliminate pressure on the nerve.
• Taking prescription or over-the-counter painkillers such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB), or aspirin to eliminate pain.

Medications

If your symptoms persist for longer than two months or fail to improve with conservative management, your physician may prescribe:

• Corticosteroid injection is employed for lessening nerve inflammation and for short-term pain relief. Nerve damage, pain at the injection site, infection in the joint, and skin staining are the possible side effects.
• Tricyclic antidepressants can bring relief from nerve pain but have side effects like dry mouth, constipation, sexual dysfunction, and fatigue.
• Medications for seizures, such as gabapentin (Gralise, Neurontin), phenytoin (Dilantin, Phenytek), or pregabalin (Lyrica), can decrease nerve pain. Nausea, lightheadedness, drowsiness, and constipation are potential side effects.

Surgical Treatment

Surgery to release the nerve is rarely required and is typically reserved for severe, persistent cases that do not respond to other treatments.

FAQs About Meralgia Paresthetica

1. How long does meralgia paresthetica last?

In most people, the symptoms disappear in a few months, especially if it is diagnosed early. Treatment is less about curing and more about managing nerve compression and preventing recurrences.

2. Does heat cure meralgia paresthetica?

Heat and ice packs may be helpful for curing meralgia paresthetica. Ice reduces swelling, and heat enhances blood flow in the affected area.

3. Is meralgia paresthetica rare?

Meralgia paresthetica is thought to be a rare but not exceedingly rare condition. It is probably underdiagnosed since its manifestations can be confused with other disorders.

4. Can meralgia paresthetica happen on both legs?

The disease most commonly involves one thigh, but in approximately 20% of cases, it affects both sides. Pain usually worsens on standing, walking, or lying flat with legs extended straight and lessens with sitting.

5. How to cure meralgia paresthetica at home?

Home relief can be achieved by icing to decrease irritation of the nerves, using nonsteroidal anti-inflammatory drugs (NSAIDs), or using local remedies like capsaicin cream or lidocaine patches. Wearing loose-fitting dresses, not staying in one position for an extended period, and maintaining a good weight will also help with long-term recovery.

Conclusion

Meralgia paresthetica is a condition that causes pain, aching, burning, numbness, or stabbing pain in the thigh area. While usually not a major health condition, it can be uncomfortable and painful. If the condition is affecting the quality of your life, see a medical practitioner who can diagnose the cause and provide the advice and treatment required.

Being a NEET PG aspirant, one should have a comprehensive idea of this topic, as it will enhance clinical reasoning, along with enabling you to cover your exam syllabus. To help students in this regard, DocTutorials offers quality learning materials that include high-yield video lectures, concise notes, discussion sessions with experts, etc.

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