What is meralgia paresthetica?
Are you experiencing leg numbness during pregnancy? Are you frequently experiencing tingling or burning on your outer thigh? Does the lightest touch send you cringing? Do symptoms get worse after you’ve been standing or walking around? It could be meralgia paresthetica.
It’s helpful to know a bit about the abdomen, thigh, and pelvis anatomy, specifically, the lateral femoral cutaneous nerve and the inguinal ligament, when talking about meralgia paresthetica.
The inguinal ligament is a set of two bands that support tissues in and around the pelvic floor. They run from the abdomen to the upper thigh along the groin, connecting the stomach and the pelvis.
The lateral femoral cutaneous nerve is what gives sensation to the outside of the thigh and runs under the inguinal ligament, typically without issue.
Symptoms and causes of meralgia paresthetica
Usually, the nerve passes under the inguinal ligament without difficulty. With meralgia paresthetica, the nerve becomes compressed and painful. Symptoms typically occur in the outer portion of the thigh and include:
- Tingling
- Numbness
- Decreased sensation
- Increased sensitivity to touch
Fortunately, the lateral femoral cutaneous nerve is strictly a sensory nerve, so the movement of the leg is not typically impacted. Common causes of meralgia paresthetica include the following:
- Direct trauma to the groin (like a seatbelt during a car accident)
- Pregnancy
- Tight clothing, work belts, or corsets
- Scar tissue from a prior abdominal surgery, hernia repair, or cesarean
- Diabetes or obesity
Diagnosing meralgia paresthetica
Diagnosing MP often requires diagnostic imaging to rule out other conditions. These tests may include an X-RAY, CT scan, MRI, electromyography, or nerve conduction study. Most of these diagnostic tests will be more to rule out other diagnoses rather than rule in MP. A nerve block injection can be an excellent way to diagnose MP while reducing pain.
How is meralgia paresthetica treated?
In some cases, MP may go away within a few months with no intervention. However, conservative treatment, such as physical therapy and medications, can help relieve symptoms and prevent further worsening. Delivery might relieve symptoms if the pregnancy was the cause of your MP. There are severe cases where more intervention, such as surgery, is required, although this is unlikely.
Is physical therapy recommended?
Yes! Physical therapy is often a treatment option. Specifically, some treatments might include:
- Myofascial release to the connective tissues of the abdomen, inguinal region, anterior and lateral thigh, and glutes.
- Scar tissue mobilization to any scars from previous abdominal surgeries or injuries.
- Dry needling to the anterior and lateral thigh.
- Neuromuscular re-education to strengthen weak muscles and/or address any muscular imbalances.
- Joint mobilization to the hip, low back, or SI joints.
- Education on activity modification to reduce direct pressure or stress to the nerve.
Medications used for meralgia paresthetica
Physical therapy is often beneficial. However, there are times medication may be needed. For example, if your pain persists for more than a few months and is not resolved with PT, your physician may recommend one or more of the following medications:
- Corticosteroid injections reduce inflammation surrounding the nerve and may reduce pain.
- Gabapentin, Lyrica, or Dilantin are anti-epileptic medications used to treat chronic nerve pain.
- In severe cases, a doctor may use isolated nerve cryotherapy. This treatment utilizes cooling technology to “freeze” or disable sensory-specific sensory nerves to reduce pain and can potentially prevent the need for surgery.
What can I do at home?
You can do things at home to reduce tingling, pain, and leg numbness during pregnancy. Some at-home treatment options are as easy as wearing loose fitting clothing around your abdomen and hips and using ice packs over the area. In addition, some mobility training and stretches are going to include:
- Hip flexor stretch
- Quadricep stretch
- Open books
- Quadruped hip circles
- Gentle cobra pose
Some gentle strength training exercises you can perform include:
- Quadruped hip extension
- Clamshells
- Lunges
What happens if meralgia paresthetica goes untreated?
Untreated meralgia paresthetica will further compress the nerve. Meralgia paresthetica can lead to chronic pain, severe numbness, and burning sensations. These symptoms can limit your participation in functional mobility, recreational activity, and daily life.
Visit your doctor right away if you have leg numbness or any other signs of meralgia paresthetica as they will be able to order the proper tests to rule out any other causes.
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