Diagnosing and Treating Meralgia Paresthetica

Eric H. Williams MD
Specializing in reconstructive surgery and pain relief in the Greater Baltimore area.

Previously we looked at why meralgia paresthetica happens, so today let’s discuss what is entailed with professional diagnosis and various treatment options you may need to find relief.Man holding his outer thigh

In most cases, we can make a diagnosis of meralgia paresthetica based on your medical history and a physical exam. This can entail testing the sensation of the affected thigh, having you describe the pain, and perhaps asking you to trace the numb or painful area on your thigh. Additional examination including strength testing and reflex testing might be done to help exclude other causes for the symptoms.

To rule out other conditions, we might recommend imaging studies. Although no specific changes are evident on X-ray if you have meralgia paresthetica, images of your hip and pelvic area might be helpful in excluding other conditions as a cause of your symptoms.

If we suspect a tumor could be causing your pain, we may order a CT scan or MRI. Other potential diagnostic tests we might use include:

  • Electromyography. This test measures the electrical discharges produced in muscles to help evaluate and diagnose muscle and nerve disorders. A thin needle electrode is placed into the muscle to record electrical activity. Results of this test are normal in meralgia paresthetica, but the test might be needed to exclude other disorders when the diagnosis isn't clear.
  • Nerve conduction study. Patch-style electrodes are placed on your skin to stimulate the nerve with a mild electrical impulse. The electrical impulse helps diagnose damaged nerves. This test might be done primarily to exclude other causes for the symptoms.
  • Nerve blockade. Pain relief achieved from anesthetic injection into your thigh where the lateral femoral cutaneous nerve enters into it can confirm that you have meralgia paresthetica. Ultrasound imaging might be used to guide the needle.

For some people, the symptoms of meralgia paresthetica simply ease in a few months and treatment is focused on relieving nerve compression.

Conservative measures for treating symptoms include:

  • Wearing looser clothing
  • Losing excess weight
  • Taking OTC pain relievers such as acetaminophen, ibuprofen, or aspirin

If your symptoms persist for more than two months or you have pain that is severe, treatment might include corticosteroid injections, anti-seizure medications, or tricyclic antidepressants. These treatment options temporarily relieve pain and, for certain kinds, reduce inflammation. As is often the case, medicinal options may come with possible side effects.

Rarely, surgery to decompress the nerve is considered. This option is only for people with severe and long-lasting symptoms. If this describes your case, we would be happy to evaluate your condition and determine if we can possibly provide the right technique so you can find consummate relief.

The following self-care measures can potentially help to prevent meralgia paresthetica from developing in the first place:

  • Avoid wearing tight clothing.
  • Maintain a healthy weight, or lose weight if you're overweight.
If meralgia paresthetica sounds like a problem you are potentially experiencing, we may be able to help. Contact us today by calling (410) 709-3868 to speak with one of our team members and have your questions answered.
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