Also called: Meralgia paresthetica; lateral femoral cutaneous nerve entrapment
Relief and prevention
Stretch
Strength
Massage
Burning, tingling and numbness over a patch on the outside of the thigh, with nothing weak. A purely sensory nerve is squashed where it passes under the outer end of the groin ligament - and it is routinely mistaken for a hip or a back problem.
How common: Roughly 4 per 10,000 people a year, rising to about 25 per 10,000 in people with diabetes; much commoner with a larger waist, in pregnancy, and in anyone wearing a tool belt, duty belt or body armour
What it is
Meralgia paraesthetica is compression of the lateral femoral cutaneous nerve, which passes under the outer end of the inguinal ligament near the front of the pelvis. It supplies sensation to a patch on the outer thigh and nothing else.
That last point is the whole diagnosis. The nerve is purely sensory, so nothing goes weak, no reflex changes and there is no back or hip involvement. Burning and numbness over an outer thigh patch with entirely normal strength is a characteristic picture, and recognising it saves people from being investigated for their spine.
What it feels like
- Burning, tingling or numbness over a patch on the outside of the thigh
- Sensitive to light touch - clothing or a hand resting on it can be unpleasant
- Worse standing and walking, better sitting
- No weakness at all, and no back pain
- Well demarcated to that patch, not spreading below the knee
What causes it
Most people have more than one of these at once, and they feed each other. Read the
list looking for the two or three that sound like your week rather than for the one
true answer — the ones that describe you are the ones worth acting on.
- Compression under the inguinal ligament
- The nerve passes through or under the outer end of the ligament near the bony point at the front of the pelvis. That is a tight, fixed point and it is where compression happens.
- Tight waistbands, belts and clothing
- Tight jeans, belts worn low, and compression garments press directly over the nerve. It is the most common and most easily removed cause.
- Tool belts and body armour
- Occupational belts, police and military kit, and heavy tool belts all load exactly the right spot. It is a recognised occupational cause.
- Weight gain and abdominal size
- Increased abdominal weight increases pressure at the inguinal ligament. It is one of the most consistent associations.
- Pregnancy
- Both the abdominal size and the change in pelvic position compress the nerve. It commonly appears in late pregnancy and resolves afterwards.
- Prolonged standing and walking
- Hip extension increases the tension on the nerve at the ligament, which is why symptoms are worse standing and better sitting.
- Surgery and injury
- Hip surgery, abdominal surgery, iliac crest bone graft harvesting and seatbelt injuries can all damage or scar the nerve.
- Diabetes
- Raises the vulnerability of all peripheral nerves to compression, and it is a common background factor.
- Being investigated for the wrong thing
- The most common experience. Outer thigh symptoms lead to hip and spine imaging, which finds incidental degenerative change, which then gets blamed.
Who tends to get it
- Anyone wearing tight belts, waistbands or occupational kit around the hips
- People who have gained weight around the abdomen
- Pregnant women, particularly in the third trimester
- Anyone with diabetes
- People who have had hip, abdominal or pelvic surgery
What makes it worse, and what settles it
Makes it worse
- Tight belts, waistbands and low-slung heavy kit
- Prolonged standing and walking
- Weight gain around the middle
- Hip extension positions held for long periods
- Being investigated and treated for a hip or spine problem instead
Settles it
- Removing the compression - looser waistbands, braces instead of a belt, adjusting occupational kit
- Weight loss where abdominal size is a factor
- Hip flexor stretching and soft tissue work around the front of the pelvis
- Nerve gliding exercises for the lateral femoral cutaneous nerve
- Getting the diagnosis right, which prevents a great deal of unnecessary investigation
What actually helps
The short version: A purely sensory nerve gets squashed where it passes under the outer end of the groin ligament. Nothing goes weak - it burns, tingles and goes numb over a patch on the outside of the thigh - and it is routinely mistaken for a hip or a back problem
Strength work: Abs: Transverse Abdominis; Glutes: Max; Glutes: Med; Hips: Flexors - trunk control so the pelvis is not parked in a tipped-forward position all day
Stretching: Hips: Flexors; Hips; Legs: Quads; Spine
Massage: Hips: Psoas; Hips: Tensor Fasciae Latae (TFL); Hips: Iliacus; Legs: Quads - around it, not on the numb patch itself
Also worth doing: This is the one where the fix is usually a belt. Loosen the waistband, move the tool belt, lose weight around the middle if that applies, and stop sleeping with the hip folded up hard
What the evidence says: Most cases settle within months once the compression is taken off, and that removal - clothing, belt, weight, sleeping position - does more than any exercise. The strength and mobility work is there to stop the pelvis holding the position that closes the tunnel.
The names above are the Targets qFIT tracks —
the Muscle Guide explains what each one does, and
Quick Add switches on the Exercises you
already have.
The qFIT routine for this
Ready-made routineHip Relief & Rotation
qFIT already has this one built. It runs massage first, then stretching, then
strength — the order that works on a body that is already sore — and every
activity in it carries the reason it is there.
The button below opens your Checklist with this routine already selected, so instead
of your whole list you land on just its Categories, Targets
and Exercises, each with its checkbox, ready to tick as you work through
them.
Have more than one problem? Tick yours under My Problems on
My Profile and your Checklist's Routine list gains
Recommended for my problems — every routine for the problems you picked, merged
into one. Your picks stay private; that filter is the only thing they feed.
Get it checked if…
Weakness, a foot that drops, numbness crossing to the front or inner thigh, or symptoms in both legs - that is not this nerve and needs assessing
And whatever the body part: chest pain or unusual breathlessness on
exertion; a fever alongside the pain; unexplained weight loss; pain that is constant and
unrelated to how you move; new numbness, weakness or loss of bladder or bowel control; or
one calf that is swollen, warm and painful. Any of those, stop and get assessed.
How it usually goes
Removing the compression resolves most cases over weeks to a few months, and pregnancy-related cases settle after delivery. Numbness can persist longer than the burning and is generally well tolerated. Persistent symptoms respond to nerve block or, occasionally, surgical release. Any weakness, reflex change or symptoms extending below the knee is not this condition and points elsewhere.
Prevalence basis: Population and hospital-based incidence studies
Others the same routine covers
These share the Hip Relief & Rotation routine, so the work is the same. If one of them also
sounds like you, that is a reason to expect more from it, not less.
This is general information, not a diagnosis, and it cannot examine you.
If it matches you, use it to ask better questions of a clinician rather than to replace one.