Dear Dr. Roach: I have had meralgia paresthetica for two and a half years. I have all the classic symptoms: tingling, pins and needles, some numbness and stinging in the top and side of my left thigh. I have tried numerous exercises and been treated by a physical therapist and an acupuncturist. Nothing has helped. My doctor has suggested the possibility of medication and/or an injection.
I am 70 years old, do not smoke, am not overweight and am extremely active. This condition has made it difficult to get a good night’s sleep. What are your thoughts?
— K.B.
Answer: Meralgia paresthetica is caused by pressure on the lateral femoral cutaneous nerve. This causes the symptoms you mention, usually on the front and outside of the upper thigh. I often see it in people who have recently gained weight — and occasionally in those who have recently lost weight. I have never had a patient with symptoms that have lasted as long as yours.
Fortunately, 90% of the time, the symptoms will go away by themselves. Patients should avoid excessively tight clothing and belts, and consider weight loss, if appropriate.
Only once have I sent a patient to an anesthesiologist for a nerve block, which was successful. If the nerve block were unsuccessful at providing adequate long-term relief, a person could consider referral to a surgeon to decompress the nerve. As a last resort, the nerve can be cut, but that would leave permanent numbness on the thigh.
