Meralgia Paresthetica Treatment & Management

  • Author: Elizabeth A Sekul; Chief Editor: Nicholas Lorenzo, MD   more...
 
Updated: Feb 3, 2012
 

Medical Care

Removing the cause of compression is the best therapy.

  • In some patients, this entails weight loss and wearing loose clothing.[3]
  • Most patients with meralgia paresthetica will have mild symptoms that respond to conservative management.
  • When the pain is severe, a focal nerve block can be done at the inguinal ligament with a combination of lidocaine and corticosteroids. This should temporarily relieve the symptoms for several days to weeks. Ultrasound guidance for the blockade may be beneficial in patients with regional anatomical variations.[10, 11, 12, 13]
  • Neurogenic pain medications such as carbamazepine or gabapentin typically are not as helpful but may be beneficial in rare patients. If medication of this type is required, then surgical decompression should be considered.
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Surgical Care

In rare and particularly painful cases that are unresponsive to nerve block, surgical decompression may be warranted.

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Contributor Information and Disclosures
Author

Elizabeth A Sekul  MD, Associate Professor of Pediatrics and Neurology, Medical College of Georgia

Elizabeth A Sekul is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and Child Neurology Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Aashit K Shah, MD  Professor of Neurology, Director, Comprehensive Epilepsy Program, Program Director, Clinical Neurophysiology Fellowship, Detroit Medical Center, Wayne State University School of Medicine

Aashit K Shah, MD is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, American Epilepsy Society, and American Neurological Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Neil A Busis, MD  Chief, Division of Neurology, Department of Medicine, Head, Clinical Neurophysiology Laboratory, University of Pittsburgh Medical Center-Shadyside

Neil A Busis, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Selim R Benbadis, MD  Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association

Disclosure: UCB Pharma Honoraria Speaking, consulting; Lundbeck Honoraria Speaking, consulting; Cyberonics Honoraria Speaking, consulting; Glaxo Smith Kline Honoraria Speaking, consulting; Pfizer Honoraria Speaking, consulting; Sleepmed/DigiTrace Honoraria Speaking, consulting

Chief Editor

Nicholas Lorenzo, MD  Consulting Staff, Neurology Specialists and Consultants

Nicholas Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, and American College of Physician Executives

Disclosure: Nothing to disclose.

References

  1. Patijn J, Mekhail N, Hayek S, Lataster A, van Kleef M, Van Zundert J. Meralgia Paresthetica. Pain Pract. May-Jun 2011;11(3):302-8. [Medline].

  2. Carai A, Fenu G, Sechi E, Crotti FM, Montella A. Anatomical variability of the lateral femoral cutaneous nerve: findings from a surgical series. Clin Anat. Apr 2009;22(3):365-70. [Medline].

  3. Parisi TJ, Mandrekar J, Dyck PJ, Klein CJ. Meralgia paresthetica: relation to obesity, advanced age, and diabetes mellitus. Neurology. Oct 18 2011;77(16):1538-42. [Medline]. [Full Text].

  4. Nouraei SA, Anand B, Spink G, O'Neill KS. A novel approach to the diagnosis and management of meralgia paresthetica. Neurosurgery. Apr 2007;60(4):696-700; discussion 700. [Medline].

  5. Mondelli M, Rossi S, Romano C. Body mass index in meralgia paresthetica: a case-control study. Acta Neurol Scand. Aug 2007;116(2):118-23. [Medline].

  6. Chlebowski S, Bashyal S, Schwartz TL. Meralgia paresthetica: another complication of antipsychotic-induced weight gain. Obes Rev. Apr 1 2009;[Medline].

  7. Moucharafieh R, Wehbe J, Maalouf G. Meralgia paresthetica: a result of tight new trendy low cut trousers ('taille basse'). Int J Surg. Apr 2008;6(2):164-8. [Medline].

  8. Fargo MV, Konitzer LN. Meralgia paresthetica due to body armor wear in U.S. soldiers serving in Iraq: a case report and review of the literature. Mil Med. Jun 2007;172(6):663-5. [Medline].

  9. Cho KT, Lee HJ. Prone position-related meralgia paresthetica after lumbar spinal surgery : a case report and review of the literature. J Korean Neurosurg Soc. Dec 2008;44(6):392-5. [Medline].

  10. Hurdle MF, Weingarten TN, Crisostomo RA, Psimos C, Smith J. Ultrasound-guided blockade of the lateral femoral cutaneous nerve: technical description and review of 10 cases. Arch Phys Med Rehabil. Cctober 2007;77 (3):1362-4. [Medline].

  11. Tumber PS, Bhatia A, Chan VW. Ultrasound-guided lateral femoral cutaneous nerve block for meralgia paresthetica. Anesth Analg. Mar 2008;106(3):1021-2. [Medline].

  12. Fowler IM, Tucker AA, Mendez RJ. Treatment of Meralgia Paresthetica with Ultrasound-Guided Pulsed Radiofrequency Ablation of the Lateral Femoral Cutaneous Nerve. Pain Pract. Dec 7 2011;[Medline].

  13. Tagliafico A, Serafini G, Lacelli F, Perrone N, Valsania V, Martinoli C. Ultrasound-guided treatment of meralgia paresthetica (lateral femoral cutaneous neuropathy): technical description and results of treatment in 20 consecutive patients. J Ultrasound Med. Oct 2011;30(10):1341-6. [Medline].

  14. Grossman MG, Ducey SA, Nadler SS. Meralgia Paresthetica: diagnosis and treatment. Journal of the American Academy of Orthopaedic Sugeons. 2001;9:336-44. [Medline].

  15. Harney D, Patijn J. Meralgia paresthetica: diagnosis and management strategies. Pain Med. Nov-Dec 2007;8(8):669-77. [Medline].

  16. Jablecki CK. Postoperative lateral femoral cutaneous neuropathy. Muscle Nerve. Aug 1999;22(8):1129-31. [Medline].

  17. Seror P, Seror R. Meralgia paresthetica: clinical and electrophysiological diagnosis in 120 cases. Muscle Nerve. May 2006;33(5):650-4. [Medline].

  18. Turner OA, Taslitz N, Ward S. Lateral femoral cutaneous nerve of the thigh (meralgia paresthetica). Handbook of peripheral nerve entrapments. 1990;143-150.

  19. van Slobbe AM, Bohnen AM, Bernsen RM, et al. Incidence rates and determinants in meralgia paresthetica in general practice. J Neurol. Mar 2004;251(3):294-7. [Medline].

  20. Williams FH, Johns JS, Weiss JM, et al. Neuromuscular rehabilitation and electrodiagnosis. 1. Mononeuropathy. Arch Phys Med Rehabil. Mar 2005;86(3 Suppl 1):S3-10. [Medline].

 
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Anatomy of the lateral femoral cutaneous nerve.
Sensory distribution of the lateral femoral cutaneous nerve.
 
 
 
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