Meralgia Paresthetica

Diagnosis

A healthcare professional can diagnose meralgia paresthetica based on your medical history and a physical examination. During the exam, you may be asked to describe your symptoms in detail, including the type of pain, tingling or numbness you feel.

You may also be asked to trace the area of numbness or pain on your thigh. A simple test to check sensation in the affected thigh is often performed.

Additional exams such as strength and reflex testing may be done to rule out other conditions that can cause similar symptoms.

In some cases, tests are used to check for problems related to the nerve root or damage to the femoral nerve, known as neuropathy.

Further diagnostic tests may include:

• Imaging studies
  Changes specific to meralgia paresthetica do not usually appear on standard X-rays. However, X-rays of the hip and pelvic region can help exclude other causes of symptoms.

  A CT scan or MRI may be recommended if a tumor or another structural issue is suspected.

• Electromyography
  This test measures electrical activity in muscles and helps evaluate muscle and nerve function. A thin needle electrode is inserted into the muscle to record signals. It is mainly used to exclude other nerve or muscle disorders.

• Nerve conduction study
  Small electrodes placed on the skin deliver mild electrical impulses to assess nerve function. The response helps identify nerve damage and often involves comparing the lateral femoral cutaneous nerve on both sides.

• Nerve block
  If pain relief occurs after an anesthetic injection where the lateral femoral cutaneous nerve enters the thigh, it can help confirm the diagnosis. Ultrasound imaging may be used to guide needle placement.

Treatment

For most people, symptoms of meralgia paresthetica improve within a few months. Treatment focuses on reducing pressure on the affected nerve and managing pain.

Conservative Measures

Initial treatment usually involves simple lifestyle changes, including:

• Wearing loose-fitting clothing

• Losing excess weight if applicable

• Taking over-the-counter pain relievers such as acetaminophen, ibuprofen or aspirin

Medications

If symptoms continue for more than two months or do not improve with conservative measures, additional treatments may be considered.

• Corticosteroid injections
  These injections can reduce inflammation and provide temporary pain relief. Possible side effects include infection, nerve damage, increased pain and lightening of the skin around the injection site.

• Tricyclic antidepressants
  These medications may help relieve nerve pain. Side effects can include drowsiness, dry mouth, constipation and sexual side effects.

• Anti-seizure medications
  Medicines such as gabapentin, phenytoin or pregabalin may help reduce nerve pain. Common side effects include dizziness, drowsiness, nausea, constipation and lightheadedness.

Surgery

In rare cases, surgery may be considered to relieve pressure on the nerve. This option is usually reserved for people who have severe, long-lasting pain that does not respond to other treatments