eMedicine Specialties > Physical Medicine and Rehabilitation > Lower Limb Musculoskeletal Conditions

Meralgia Paresthetica: Follow-up

Author: Christopher Luzzio, MD, Clinical Assistant Professor, Department of Neurology, University of Wisconsin at Madison
Contributor Information and Disclosures

Updated: Mar 18, 2009

Follow-up

Prognosis

  • Prognosis depends on the etiology of the lateral femoral cutaneous nerve (LFCN injury). Simple meralgia paresthetica caused by external or benign mechanical injury often remits spontaneously. In one study where the surgical candidates were selected carefully, most patients who chose nerve decompression for chronic discomfort experienced relief. Factors that indicate excellent surgical outcome are outlined in Surgical Intervention.
  • For most patients, this condition is self-limiting, and with education, patients learn to tolerate symptoms and modify activity, thus avoiding surgery or other aggressive treatments.

Patient Education

  • Instruct patients to avoid activities that injure the lateral femoral cutaneous nerve.

Miscellaneous

Medicolegal Pitfalls

  • The practitioner should not assume that a patient has benign meralgia paresthetica (MP) and overlook early plexopathy caused by tumor invasion. Not all patients with MP-like discomfort require MRI or CT scans of the pelvis. Each individual's situation dictates those clinical decisions. Major red flags that help in recognizing this condition are progressive worsening of symptoms, nonsensory abnormalities in the neurologic examination, and severe, deep pain. Electromyography can help to differentiate benign MP from other problems.
 


More on Meralgia Paresthetica

Overview: Meralgia Paresthetica
Differential Diagnoses & Workup: Meralgia Paresthetica
Treatment & Medication: Meralgia Paresthetica
Follow-up: Meralgia Paresthetica
Multimedia: Meralgia Paresthetica
References
Further Reading
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References

  1. Carai A, Fenu G, Sechi E, et al. Anatomical variability of the lateral femoral cutaneous nerve: findings from a surgical series. Clin Anat. Jan 27 2009;22(3):365-370. [Medline].

  2. Otoshi K, Itoh Y, Tsujino A, et al. Case report: meralgia paresthetica in a baseball pitcher. Clin Orthop Relat Res. Sep 2008;466(9):2268-70. [Medline].

  3. Schestatsky P, Llado-Carbo E, Casanova-Molla J, et al. Small fibre function in patients with meralgia paresthetica. Pain. Oct 15 2008;139(2):342-8. [Medline].

  4. Knight RQ, Schwaegler P, Hanscom D, et al. Direct lateral lumbar interbody fusion for degenerative conditions: early complication profile. J Spinal Disord Tech. Feb 2009;22(1):34-7. [Medline].

  5. 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].

  6. Alberti O, Wickboldt J, Becker R. Suprainguinal retroperitoneal approach for the successful surgical treatment of meralgia paresthetica. J Neurosurg. Oct 31 2008;[Medline].

  7. van Eerten PV, Polder TW, Broere CA. Operative treatment of meralgia paresthetica: transection versus neurolysis. Neurosurgery. Jul 1995;37(1):63-5. [Medline].

  8. Liveson JA, Ma DM. Lumbar plexus. In: Laboratory Reference for Clinical Neurophysiology. New York, NY: Oxford University Press; 1998:165-8.

  9. Massey EW. Sensory mononeuropathies. Semin Neurol. 1998;18(2):177-83. [Medline].

  10. Nahabedian MY, Dellon AL. Meralgia paresthetica: etiology, diagnosis, and outcome of surgical decompression. Ann Plast Surg. Dec 1995;35(6):590-4. [Medline].

  11. Streiffer RH. Meralgia paresthetica. Am Fam Physician. Mar 1986;33(3):141-4. [Medline].

  12. Travell JG, Simons DG. Tensor fasciae latae muscle and sartorius muscle. In: Myofascial Pain and Dysfunction: The Trigger Point Manual for the Lower Extremities. vol 2. Baltimore, Md: Williams & Wilkins; 1999:230-2.

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Further Reading

Clinical guidelines:
EFNS guidelines on pharmacological treatment of neuropathic pain.
European Federation of Neurological Societies - Medical Specialty Society.  2006 Nov.  17 pages.  NGC:005495

Clinical trials:
 Effectiveness of Lumbar Facet Joint Nerve Blocks
Freedom Lumbar Disc in the Treatment of Lumbar Degenerative Disc Disease

Related eMedicine topics:
Meralgia Paresthetica [Neurology]
Meralgia Paresthetica [Orthopedic Surgery]
Nerve Entrapment Syndromes
Nerve Entrapment Syndromes of the Lower Extremity

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Keywords

meralgia paresthetica, nerve entrapment, paresthesia, meralgia, dysesthesia, thigh pain, lateral femoral cutaneous nerve, Bernhardt-Roth syndrome, lateral femoral cutaneous neuropathy

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Contributor Information and Disclosures

Author

Christopher Luzzio, MD, Clinical Assistant Professor, Department of Neurology, University of Wisconsin at Madison
Christopher Luzzio, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Medical Editor

Everett C Hills, MD, MS, Medical Director, Penn State Hershey Rehabilitation Hospital, Assistant Professor of Orthopaedics and Rehabilitation, Assistant Professor of Neurology, Penn State Milton S. Hershey Medical Center and Penn State University College of Medicine
Everett C Hills, MD, MS is a member of the following medical societies: American Academy of Disability Evaluating Physicians, American Academy of Physical Medicine and Rehabilitation, American College of Physician Executives, American Congress of Rehabilitation Medicine, American Medical Association, American Society of Neurorehabilitation, Association of Academic Physiatrists, and Pennsylvania Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Michael T Andary, MD, MS, Residency Program Director, Professor, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine
Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, and Association of Academic Physiatrists
Disclosure: allergan Honoraria Speaking and teaching

CME Editor

Kelly L Allen, MD, Regional Medical Director, IMX-Medical Management Services
Disclosure: Nothing to disclose.

Chief Editor

Consuelo T Lorenzo, MD, Consulting Staff, Department of Physical Medicine and Rehabilitation, Alegent Health Care, Immanuel Rehabilitation Center
Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation
Disclosure: Nothing to disclose.

 
 
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