EMed

Meralgia paraesthetica

Clinical

Irritation of Lat. Cut. N. of Thigh (L2,L3, purely sensory) as it passes through inguinal ligament
Radicular type pain and or paraesthesia over the anterior and lateral thigh (worse on standing)

Diagnosis

Risks include middle age and diabetes
Dx clinical (DDx femoral neuropathy, lumbar plexopathy, lumbosacral disc/lesion)
Trigger point 1cm along inguinal lig. from ASIS
No motor signs
Rarely, conduction studies [requested by GP] are required to confirm

Treatment / prognosis

70% cases resolve spontaneously in 1 year
Injections of steroid (± local anaesthetic) effective in 80%
Surgery (decompression or neurectomy) effective in 90%
97% of patients with iatrogenic meraglia paraesthetica (3 studies) recovered completely

Links/References

Khalil N, Nicotra A, Rakowicz W. Treatment for meralgia paraesthetica. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD004159. DOI: 10.1002/14651858.CD004159.pub2

Content by Dr Íomhar O' Sullivan. Last review Dr ÍOS 31/10/22.