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Meralgia Paresthetica

Meralgia paresthetica is a specific type of nerve pain that affects the outer thigh, usually just on one side. In meralgia paresthetica, the lateral femoral cutaneous nerve is compressed, usually by a ligament called the inguinal ligament in the groin region. People who are obese are more likely to develop meralgia paresthetica. It can also develop during a pregnancy because of the extra pressure on the groin region. People who have had a surgery or an injury in the groin area may develop nerve compression due to scar tissue formation. Wearing tight pants may be related to this condition in some cases. The nerve can also be directly injured in an accident or damaged from uncontrolled diabetes.The lateral femoral cutaneous nerve goes to the skin of the outer thigh and carries sensory information to and from that region. The lateral femoral cutaneous nerve does not go to any of the thigh muscles, so damage to this nerve does not cause muscle weakness. Nerve compression can manifest as a pins-and-needles tingling feeling, numbness, or pain that feels like burning. Some people with meralgia paresthetica report dull pain in the groin area or buttocks region, but this is not always present.

To diagnose meralgia paresthetica, a doctor may take an X-ray of the affected hip and thigh. A nerve conduction study can be used to check how the lateral femoral cutaneous nerve is functioning. A nerve conduction study uses electrodes placed on the skin to apply an electrical impulse and record the nerve’s response. A test called an EMG may be run in some cases to test to see if the muscles supplied by the nerve are working normally. People with meralgia paresthetica will have normal muscle responses, but the test can help to rule out the involvement of other nerves.

In most cases, conservative treatment measures like weight loss, using over-the-counter pain medications and wearing clothing that doesn’t compress the groin region can help the condition go away within weeks or months. However, cases that do not go away or involve severe pain may require additional treatments, such as corticosteroid injections to reduce inflammation and medications. Tricyclic antidepressants and anticonvulsant medications like gabapentin are both used for treating nerve pain. Surgery to remove pressure from the lateral femoral cutaneous nerve is sometimes used as a last-resort treatment when other treatment options are not effective.

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