An unusual painful, burning sensation at the outside of the thigh may mean that one of the large sensory nerves to the legs (lateral femoral cutaneous nerve or LFCN) is being squeezed. Known as meralgia paresthetica this condition can start as a burning sensation accompanied by pain on the outer side of the thigh that sometime reaches down to the knee. In addition to the burning pain patients sometimes experience tingling, or numbness in the same area and aching in the groin. Occasionally the pain spreads over the buttocks. This usually affects only one side of the body.

Tight fitting clothing and weight gain are the more common causes of pressure leading to meralgia paresthetica. It is often seen in patients who wear tight stockings or a girdle, and in workers who wear a heavy tool belt. Meralgia paresthetica can also result from a car collision that involves a seatbelt injury.

Additional factors can include pregnancy, an accumulation of fluids in the abdomen and scar tissue from an injury or past surgery restricting the inguinal ligament. Nerve injury due to diabetes can also cause meralgia paresthetica.

When the more common causes are ruled out, X-rays can help identify any bone abnormalities that might be putting pressure on the nerve. A growth such as a tumor could put pressure on the nerve, in which case a magnetic resonance image or a computed tomography (CT) scan can help rule it out. In rare cases, a nerve conduction study may be advised.

Treatments for meralgia paresthetica will vary, depending on what the test reveals as to the source of the pressure. The goal of treatment is to remove the cause of the compression. In some cases, this can mean taking a break from an aggravating activity, losing weight, wearing loose clothing, or avoiding the use of a tool belt.

It may take time for the burning pain to completely subside. Although many patients experience symptom relief following treatment, for others numbness will continue to be a problem. Which symptoms are more troubling, an injection of a corticosteroid preparation may help to reduce inflammation and relieve symptoms for a period of time. In rare cases, surgery may be recommended to release the nerve.


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