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General Sports Medicine

Understanding Meralgia Paresthetica

This week we’re going to review meralgia paresthetica (MP), a neuropathy of the Lateral Femoral Cutaneous Nerve (LFCN).

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Andrew Schleihauf
Sports Medicine Physician · September 20, 2020 · 3 min read

Overview

This week we’re going to review meralgia paresthetica (MP), a neuropathy of the Lateral Femoral Cutaneous Nerve (LFCN). The LFCN is responsible for cutaneous innervation of the anterolateral thigh and variable arises from the L1-L3 nerve roots. Overall, there is a paucity of research on MP which makes diagnosis and treatment challenging.

Symptoms

MP most commonly occurs among middle age males and is bilateral up to 20% of the time. The incidence is approximately 32-43 cases per 100,000 individuals which increases to 247 cases per 100,000 individuals among diabetics.MP is characterized by compression of the LFCN resulting in pain, paresthesias, and sensory loss in the same distribution. Etiology can roughly be broken down into two categories: idiopathic (or spontaneous) or iatrogenic due to surgical procedures.

Causes and Risk Factors

Idiopathic cases can be challenging to diagnose as there is often no clear cause in the history of physical exam. Generally, risk factors must be reviewed to help suggest the cause. Among athletes, cases have been documented in gymnastics, basketball, soccer, bodybuilding and strenuous exercise.

Treatment Options

Other commonly acknowledged risk factors include obesity, diabetes, advanced age, hypothyroidism, scoliosis and alcoholism. Occupations such as police and military are often noted where the occupation requires “tight garments” or a belt. Seat belts, muscle spasm and direct trauma have also been implicated.Iatrogenic cases are slightly different in that the absence of MP pre-operatively allows the physician to point to the surgery as the most clear cause.

Recovery

In general, MP is associated with total hip arthroplasty (THA), anterior hip resurfacing and lumbar spine surgery. In one study, 81% of patients developed MP following THA. Among spine surgeries, studies have shown 12-20% of patients go on to develop MP.

When to See a Doctor

If you are experiencing symptoms that may be related to a quick meralgia paresthetica, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.

*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*

General Sports Medicine
A
Andrew Schleihauf
Sports Medicine Physician
Sports Medicine Review contributor

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