Meralgia Paresthetica

Meralgia paresthetica is a nerve problem which causes pain, tingling and numbness in the outer thigh.

It is caused by compression in one of the nerves as it passes across the front of the hip and down the thigh.

Common causes include wearing tight clothing, hip injuries and previous hip surgery.

Unlike other nerve injuries, meralgia paresthetica only affects the sensation in the thigh, muscle strength and leg movements are unaffected.

Meralgia paresthetica can be quite unpleasant but it is generally not serious, and responds well to home treatments.

What Is Meralgia Paresthetica?

What Causes Meralgia Paresthetica?

Meralgia paresthetica occurs when the lateral femoral cutaneous nerve is compressed, typically as it passes under the inguinal ligament near the groin. Common meralgia paresthetica causes include:

• Tight Clothing: such as belts, corsets, or skinny jeans
• Heavy Work Belts: worn by tradesmen to hold their tools
• Prolonged Standing Or Walking: which can lead to irritation of the nerve over time
• Leg Length Discrepancy: having one leg longer than the other can place increased pressure on the nerve
• Trauma Or Surgery: previous hip surgeries e.g. hernia repair or hip replacement, seat belt injuries from car accidents, or sports injuries can cause scar tissue to form near or around the nerve
• Tumor: a benign lump (non-cancerous) known as a neuroma may develop near the nerve, causing compression. Occasionally there may be a cancerous tumor although this is rare.

Other rare causes of Bernhardt Roth syndrome include lead poisoning and pubic symphysis defects, and there is an increased risk if you have carpal tunnel syndrome.

Meralgia paresthetica can affect people at any age but is most common in people aged 40-60. It is more prevalent in women than men.

Risk Factors

Certain factors increase your likelihood of developing meralgia paresthetica:

• Obesity Or Weight Gain: excess fat can increase pressure on the nerve
• Pregnancy: hormonal changes and weight gain can contribute to nerve compression
• Diabetes: nerve damage associated with diabetes may increase the risk

Meralgia Paresthetica Symptoms

Common meralgia paresthetica symptoms include:

• Burning or aching pain on the outer thigh which may extend to the knee
• Tingling or numbness in the same area
• Increased sensitivity to light touch and pressure
• Symptoms often worsen with standing or walking and improve with sitting

Bernhardt Roth syndrome typically affects only one side of the body and there is no muscle weakness or pain radiating below the knee.

Bernhardt Roth Syndrome Diagnosis

Doctors usually diagnose meralgia paresthetica based on your symptoms and physical exam. They may also:

• Ask about your medical history and lifestyle habits
• Perform a sensory exam to test feeling in your thigh: including light touch and pin prick testing
• Perform the pelvic compression test. Lying on your unaffected side, the doctor applies downward pressure through your pelvis/ilium for 45 seconds. If symptoms decrease, it indicates meralgia paresthetica.
• Order imaging tests (MRI, X-ray, Ultrasound) to rule out other conditions
• Use nerve conduction studies to assess how well the LFCN is working
• Inject a local anesthetic near the nerve to see if it relieves symptoms
• Blood tests may be ordered to check thyroid, glucose and vitamin B levels, or to rule out lead poisoning

Hip and back movements, muscle power and deep tendon reflex testing will all be normal with meralgia paresthetica.

When to See a Doctor

You should seek medical advice if:

• Symptoms last longer than a few weeks
• The pain becomes severe or disabling
• Numbness or tingling spreads beyond the thigh or into the saddle area
• There are any changes in your bladder or bowel control

Treatment For Meralgia Paresthetica

In most cases symptoms will improve with conservative meralgia paresthetica treatment such as:

• Lifestyle Modifications: avoiding tight clothing, losing excess weight and changing standing or walking habits are often effective for meralgia paresthetica treatment at home
  
  
• Medications: NSAIDs for pain relief, and nerve pain medications like gabapentin or amitriptyline help to reduce Bernhardt Roth syndrome symptoms – talk to your doctor before starting any new medication
  
  
• Physical Therapy: a physical therapist can advise on meralgia paresthetica exercises and posture correction and may use kinesio-taping to off-load the nerve or acupuncture to reduce pain. Meralgia paresthetica exercises usually consist of:
  Strengthening Exercises: focus on glute strengthening to improve strength, stability and control
  Meralgia Paresthetica Stretches: such as hip flexor stretches and quad stretches

• Nerve Blocks: corticosteroid or anesthetic injections to reduce nerve inflammation and pain
  
  
• Surgery: in rare, severe cases where symptoms don’t improve, nerve decompression or resection (neurectomy) may be considered

Recovery

Recovery times from meralgia paresthetica vary but the prognosis is good, with around 85% of people making a full recovery without the need for surgical intervention. Some people feel better in a few weeks, while others may take several months, and in some cases there may be some mild ongoing altered sensation long-term.

For those who need surgery, recovery usually takes around 3 months. And for people with meralgia paresthetica in pregnancy, symptoms usually stop once you have delivered.

With proper treatment and avoidance of aggravating factors, most people experience significant improvement or complete resolution of meralgia paresthetica symptoms.

Frequently Asked Questions (FAQs)

Meralgia Paresthetica Summary

Meralgia paresthetica is a nerve compression condition that causes pain, numbness, or tingling on the outer thigh. It’s often caused by pressure on the lateral femoral cutaneous nerve from tight clothing, obesity, or prolonged activity. It is also known as Bernhardt Roth syndrome or lateral femoral cutaneous neuralgia.

Diagnosis is typically straightforward, and most cases respond well to lifestyle changes, physical therapy, and medications. If symptoms persist, more advanced interventions like nerve blocks or surgery may be necessary. Early recognition and treatment are key to a smooth recovery.

You may also be interested in the following articles:

• Pain Above The Knee
• Upper Thigh Pain
• Hip Bursitis
• Burning Knee Pain

Related Articles

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References

Meralgia Paresthetica. National Library Of Medicine

Meralgia Paresthetica: A Review Of The Literature. International Journal Of Sports Physical Therapy

Meralgia Paresthetica: A result of tight new trendy low cut trousers (‘taille basse’). International Journal Of Surgery

Meralgia Paraesthetica. Radiopaedia

Last Updated: April 30th, 2025
Next Review Due: April 30th, 2027