Meralgia Paresthetica

Medically Reviewed by Jabeen Begum, MD on April 09, 2024
Written by Kathryn Whitbourne
6 min read

 

Meralgia paresthetica is a condition that causes numbness, pain, or a burning feeling in your outer thigh. You might also hear it called Bernhardt-Roth syndrome. It happens when there’s too much pressure on or damage to one of the nerves in your leg, specifically the lateral femoral cutaneous nerve (LFCN). This nerve is the one giving sensation to the front and side of your thigh.

In most cases, there are simple ways to treat the condition, such as wearing looser clothing. Some people with more severe meralgia paresthetica may need medication or surgery.

With the right treatment and enough time to recover, you can ease your symptoms and feel better.

Usually, you’ll notice the warning signs of meralgia paresthetica only on one side of your body. You might feel:

  • Pain, tingling, numbness, or burning in the outside of your thigh
  • Sensitivity to light touch rather than to firm pressure
  • High sensitivity to heat
  • Worse pain after walking or standing for a time

Your symptoms may be mild at first, but as the condition gets worse, you might feel sharper, shooting pain. It may go away and come back for no clear reason.

Nerves travel throughout your body, carrying messages to and from your brain. A certain set of nerves, called the sensory nerves, gather and send signals to your brain about your skin, muscles, and other tissues.

In meralgia paresthetica, the LFCN nerve doesn’t have enough room to pass through your hip bone or joints. This may be due to swelling, trauma, or increased pressure in this area.

A lot of things can squeeze or damage the nerve, including:

  • Weight gain and obesity
  • Tight clothing, like pants, leggings, stockings, a belt, or a girdle
  • Pregnancy
  • Injury, such as trauma from a seatbelt during a car crash
  • Something heavy worn around your waist, like a tool belt or gun belt
  • A disease that can damage the nerves, like diabetes
  • Repetitive motions that could irritate the nerve, such as certain leg movements
  • Standing or walking for a long time

Your risk of getting the condition is higher if you:

  • Are overweight
  • Are pregnant
  • Have certain medical conditions, including diabetes, hypothyroidism, and alcoholism
  • Are between ages 30 and 60
  • Have been exposed to lead-based paint
  • Have legs that are different lengths

Meralgia paresthetica in pregnancy

Meralgia paresthetica is common during pregnancy. This is because the growing baby puts pressure on your groin area, pinching the LFCN in your thigh. Symptoms can start at any time during pregnancy or right after giving birth. These can be bothersome but usually go away on their own. Doctors can diagnose the condition with a simple exam and usually don't need expensive tests. 

Treatment usually consists of wearing loose clothing, taking pain relievers, and avoiding standing for long periods.

Your doctor will give you a physical exam and ask about your symptoms and your medical history -- especially about any recent injuries or surgeries. The doctor will touch your leg to find the affected area. They will check for any neurological abnormalities of the lower leg.

Meralgia paresthetica tests

Tests to diagnose this condition include:

  • Imaging tests. Your doctor may order pictures of the inside of your hip and pelvic area to look for other problems that could be causing your symptoms. You may get X-rays, a CT scan, or an MRI.
  • Electromyography. This measures the electrical activity in your muscles through a thin needle electrode. If you have meralgia paresthetica, the results will be normal. But it can reveal another cause of your pain.
  • Nerve conduction test. Electrode patches applied to your skin put out a small electrical impulse to see how well your nerve sends messages to the muscles.
  • Nerve blockade. Anesthesia is injected into your thigh at the point where your LFCN is likely to be compressed. If you have meralgia paresthetica, the pain will temporarily go away.
  • Blood tests. Your doctor may check for signs of diabetes, hormone or vitamin imbalances, anemia or lead exposure.

It can be hard to tell the difference between meralgia paresthetica and other back, hip, or groin conditions. Be patient as you work with your doctor to find the right diagnosis.

The goal of treatment is to ease the pressure on your nerve. The type of therapy you get depends on the cause of your condition.

Physical therapy

You may work with a physical therapist on stretching and strengthening exercises for your leg muscles or abs. They may also try phonophoresis, which uses ultrasound to help your body absorb a medication through your skin, or transcutaneous electrical nerve stimulation (TENS), which delivers electrical impulses through pads applied to your skin to block pain.

Medications

If your condition is more severe, you may need:

  • A corticosteroid shot to reduce swelling
  • Tricyclic antidepressants, which can help relieve nerve pain
  • Anti-seizure medications including gabapentin, phenytoin or pregabalin, which also work against nerve pain

It can take some time for your thigh pain to go away. Some people will still feel numbness even after treatment. In most cases, though, you should be able to recover within 4 to 6 weeks.

If no other treatment helps and you're in a lot of pain, your doctor may recommend surgery to ease pressure on the nerve.

 

Lifestyle changes and home care

For mild cases, your doctor may recommend:

  • Heat, ice, or taking over-the-counter pain relievers like acetaminophen, aspirin, ibuprofen, or naproxen for a few days
  • Weight loss
  • Wearing loose-fitting clothing, especially around your upper front hip

Meralgia paresthetica exercises

These exercises and stretches will help you to ease meralgia paresthetica pain.

Cat-cow (cat-camel).Get on your hands and knees with your hands shoulder-width apart and knees over your hips. Inhale deeply and curve your lower back and bring your head up, tilting your pelvis up slightly (cow/camel position). Exhale, pull your stomach in and arch your spine with your head and pelvis down (cat position). Do 10 times.

Clamshell. Lie on your left side with your hips and feet stacked and your head resting on your left arm. Keep your stomach pulled in. Slowly raise your top (right) knee as much as possible without taking your left foot or left knee off the ground. Hold for a couple seconds and lower your right knee to the left knee. Be sure to engage your buttocks muscles while doing this. Do 10 repetitions on one side and then turn over to the other side. 

Lunges. This works all the leg muscles. Start by standing up with legs together and hands on hips. Take a big step forward with your right foot and lower your body until your right knee reaches a 90-degree angle and your left knee is parallel to the ground. Then return to your starting position. Keep your back straight and stomach pulled in make sure your knee doesn't go beyond your toes.

If you can't lower your knee to a 90-degree angle, just go as low as you can. Do 10 repetitions and change sides. You can also change feet between lunges in what's known as a "traveling lunge."

Meralgia paresthetica sleeping positions

  • Don't sleep on the side where you're feeling the discomfort.
  • Sleep on the opposite side with a pillow between your legs. Hips and knees should be slightly bent so your hips are in alignment to ease pressure.
  • If you sleep on your back, put a pillow or two under your legs.

 

 

Meralgia paresthetica can cause numbness, pain, or a burning feeling in your outer thigh. People who are overweight, pregnant, or have medical conditions like diabetes are more likely to have it. Treatment usually includes doing hip and leg stretches, taking over-the-counter pain relievers, and wearing loose clothing. Rarely is surgery needed. 

What aggravates meralgia paresthetica?

Standing or sleeping with your hip extended can make symptoms worse. Some people also find sitting to be painful. 

Should you massage meralgia paresthetica?

Some people have found massage to be helpful in relieving pain. A physical therapist or chiropractor can show you the correct way to massage.