Compression of the femoral nerve (meralgia paresthetica)

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What is it about ?

Meralgia paresthetica is usually caused by a pinching of a cutaneous nerve in the groin (the lateral femoral cutaneous nerve). In more than 30% of cases, the problem is due to the abnormal course of this nerve. In some cases, it is not possible to find a precise origin. Wearing tight clothing or certain movements can make symptoms worse. In rare cases, the problem can be bilateral. Usually symptoms go away on their own.

Where does it occur?

Meralgia paresthetica is a rather rare condition that mainly affects middle-aged people who are overweight.

How to recognize it?

The main symptoms are decreased tenderness, tingling (paraesthesia) or a painful burning sensation on the front and / or side of the thigh. Meralgia paresthetica does not cause loss of muscle strength in the thigh.

How is the diagnosis made?

The doctor makes the diagnosis based on a physical examination. He will try to trigger the symptoms by moving the thigh backward (with the knee bent), possibly simultaneously exerting pressure on the suspected pinch area in the groin. It will rule out other conditions that can cause problems in the same place, such as hip bursitis, a condition affecting the tendons, compression of the nerve roots, or osteoarthritis of the hip. Usually, no further examination is required. If there is any doubt as to the diagnosis, a nerve conduction examination is performed by a specialist in physical medicine or a neurologist.

What can you do ?

If excess weight is the trigger, you are advised to lose weight. Do not wear tight clothes and limit the movements that cause symptoms. Symptoms often go away as soon as the load decreases.

What can your doctor do?

In addition to the above advice, your doctor may prescribe an anti-inflammatory drug and advise you to apply cold packs to the pinch site. Physical therapy sessions with stretching exercises for the hip flexors can also be helpful.
If all these efforts do not provide enough relief, the doctor will consider an injection of cortisone and a local anesthetic. If, despite all these measures, the condition continues to bother you, it is possible to consider an operation (which eliminates the nerve compression) or a drug against this type of pain (neuralgia, neuropathic pain).

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Source

Foreign clinical practice guide ‘Meralgia paresthesique’ (2000), updated on 24.07.2017 and adapted to the Belgian context on 01.07.2017 – ebpracticenet

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