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[Conditions](https://durgical.com/en/conditions/) · [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/)

# Meralgia paresthetica

Meralgia paresthetica is burning, tingling or numbness of the outer thigh from a pinched [skin](https://durgical.com/en/anatomy/skin/) nerve near the front of the [hip bone](https://durgical.com/en/anatomy/hip-bone/).

Updated 2026-10-29

## Structures involved

Tap one to see what it is and open it in 3D.

- [Lateral femoral cutaneous nerve](https://durgical.com/en/anatomy/lateral-femoral-cutaneous-nerve/)
- [Inguinal ligament](https://durgical.com/en/anatomy/inguinal-ligament/)
- [Hip bone](https://durgical.com/en/anatomy/hip-bone/)
- [Tensor fasciae latae](https://durgical.com/en/anatomy/tensor-fasciae-latae/)
- [Sartorius](https://durgical.com/en/anatomy/sartorius-muscle/)
- [Iliacus](https://durgical.com/en/anatomy/iliacus-muscle/)
- [Fascia lata](https://durgical.com/en/anatomy/fascia-lata/)

## Why it happens

- [Peripheral nerve: endoneurium, perineurium, epineurium; myelin](https://durgical.com/en/histology/peripheral-nerve-endoneurium-perineurium-epineurium-myelin/)

## What it is

Burning pain, tingling and numbness of the outer front thigh caused by compression of the [lateral femoral cutaneous nerve](https://durgical.com/en/anatomy/lateral-femoral-cutaneous-nerve/), usually where it passes under or through the [inguinal ligament](https://durgical.com/en/anatomy/inguinal-ligament/) near the anterior superior iliac spine.

## Who gets it

Seen mostly in adults between middle age and older age and is more frequent with obesity, diabetes and pregnancy.

## Causes

- Compression by tight belts, waistbands, tool belts or body armor
- Raised abdominal pressure: obesity, pregnancy, ascites
- Injury during hip, pelvic or spinal surgery, iliac crest bone graft harvest or prone positioning
- Seat-belt trauma
- Rarely a pelvic or retroperitoneal mass

## Risk factors

- Obesity
- Pregnancy
- Diabetes
- Tight clothing and belts
- Recent hip or pelvic surgery
- Prolonged standing or walking

## Pathophysiology

The nerve carries only skin sensation from the L2 and L3 roots. It makes a sharp turn at the anterior superior iliac spine as it leaves the [pelvis](https://durgical.com/en/anatomy/region/pelvis/), so external pressure or stretch at this point irritates it and causes local demyelination. Because it has no motor fibers, there is no weakness.

## Symptoms and signs

- Burning pain, tingling or numbness over the anterolateral thigh
- Skin sensitive to touch or clothing in that area
- Worse with standing, walking or hip extension and better with sitting
- No weakness and normal knee reflex

## Red flags

- Weakness of the quadriceps or hip flexors, or a reduced knee reflex (suggests [femoral nerve](https://durgical.com/en/anatomy/femoral-nerve/), plexus or root lesion)
- Weight loss, night pain or abdominal symptoms (suspect a pelvic or retroperitoneal mass)
- Bladder or bowel changes

## Diagnosis

**Clinical**
Diagnosis is mainly clinical: sensory change limited to the nerve territory, tenderness or Tinel sign just medial to the anterior superior iliac [spine](https://durgical.com/en/anatomy/region/spine/), symptoms reproduced by pelvic compression, normal strength and reflexes.

**Tests**
A nerve block with local anesthetic that relieves symptoms supports the diagnosis. Nerve conduction studies are technically hard; glucose testing looks for diabetes.

**Imaging**
Ultrasound can show the nerve and guide injections. Lumbar or pelvic MRI or CT only when the history suggests a root lesion or mass.

## Differential diagnosis

- L2–L3 lumbar radiculopathy
- Femoral neuropathy
- Lumbar plexopathy, including diabetic amyotrophy
- Greater trochanteric pain syndrome
- Hip osteoarthritis
- Pelvic or retroperitoneal mass

## Goal of treatment

Remove the source of compression and control neuropathic pain; most cases settle without surgery.

## Treatment

**Lifestyle**
Looser clothing, avoiding tight belts and weight loss.

**Medical**
NSAIDs, topical anesthetics and neuropathic pain agents such as gabapentinoids or tricyclic antidepressants.

**Procedure**
Local anesthetic with corticosteroid injected around the nerve, usually ultrasound-guided; pulsed radiofrequency in refractory cases.

**Surgical**
Decompression (neurolysis) or division of the nerve (neurectomy) when pain persists despite conservative care.

## Complications

- Chronic neuropathic pain
- Permanent numbness of the outer thigh, expected after neurectomy
- Sleep disturbance and reduced activity

## Prognosis

Most patients improve with removal of compression and conservative treatment, often within months. Surgery is reserved for a minority.

## Prevention

- Avoiding tight belts and waistbands
- Healthy body weight
- Careful padding and positioning during prone surgery

## Test yourself

Think of the answer, then tap the question to see it.

## Which nerve is affected in meralgia paresthetica?

The lateral femoral cutaneous nerve (L2–L3), a purely sensory nerve.

## Where is the lateral femoral cutaneous nerve usually compressed?

Under or through the inguinal ligament, just medial to the anterior superior iliac spine.

## Why is there no weakness in meralgia paresthetica?

The nerve carries only sensory fibers; weakness or a reduced knee reflex points to another lesion.

## What are two everyday risk factors for meralgia paresthetica?

Tight belts or waistbands and obesity; pregnancy and diabetes are others.

## Which test supports the diagnosis when the picture is unclear?

A diagnostic nerve block with local anesthetic that temporarily relieves the symptoms.

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## Related conditions

- [Obesity](https://durgical.com/en/conditions/obesity/)
- [Type 2 diabetes mellitus](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)
- [Lumbar Disc Herniation](https://durgical.com/en/conditions/lumbar-disc-herniation/)
- [Greater Trochanteric Pain Syndrome](https://durgical.com/en/conditions/greater-trochanteric-pain-syndrome/)
- [Hip Osteoarthritis](https://durgical.com/en/conditions/hip-osteoarthritis/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Meralgia Paresthetica](https://www.ncbi.nlm.nih.gov/books/NBK557735/) (StatPearls (NCBI Bookshelf), 2023).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/conditions/meralgia-paresthetica/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/meralgia-paresthetica/