About 1 year ago i had burning,tingling,pins/needles on the outer left thigh just about the knee, which resulted in numbness (about 2 inches in length). As of recent, same sensations front of same thigh with numbness comes and goes. I have no back pain, and no loss of function in muscle, seems topical and very irritating. Past history includes carpel tunnel(no surgery) not bothersome I do sleep in splints when it is. One inguinal hernia repair, 10 years ago no compliants, Im very active and have no other apparent health issues at the moment. I do smoke. Any help greatly appreciated.
Dr. Joshua’s Answer:
You’d have to see your primary care physician in order to have this diagnosed, but one possibility is meralgia paresthetica, which is an impingement of the femoral nerve, specifically the lateral femoral cutaneous nerve (LFCN).
Entrapment of the lateral femoral cutaneous nerve is not rare, and often occurs in physically active individuals, especially when there is a recent increase in training and exertion. Symptoms include numbness in thigh, tingling, and pain, which can be severe sometimes. The symptoms are limited to the outer/front aspect of the thigh. There is no motor involvement, which means that muscle weakness is not a part of lateral femoral cutaneous nerve syndrome because the nerve is purely sensory.
Other predisposing factors of meralgia paresthetica include obesity, diabetes and tight clothing.
If the inguinal hernia operation was on the left side, there could be some scarring that would predispose you to impingement of the lateral femoral cutaneous nerve. Inguinal hernia occurs in the region of the inguinal ligament, which is also the exact spot where the lateral femoral cutaneous nerve is typically entrapped.
The diagnosis is usually clinical, which means that a doctor can diagnose this condition by taking a thorough history and performing a physical examination. Other possible causes can be thus excluded, such as lumbar spine nerve root compression and regional tumors / enlarged lymph nodes and so on.
Sometimes, the doctor may order further studies such as an ENMG to verify the finding by electrophysiological testing. If a different cause is suspected, appropriate examinations are done.
Treatment of meralgia paresthetica is conservative (no surgery) in the vast majority of cases. The key is to remove the cause of the lateral femoral cutaneous nerve impingement, and also give it some time. Anti-inflammatory drugs and rest may be used at first, and in some cases, injections of corticosteroids and anesthetic at the location of the impingement may provide relief. In severe cases, surgery is considered, and in the rare cases of a chronic unmanageable pain, drugs for neuropathic pain are used.
More often than not, with some rest and supportive treatment, the problem will go away with time. In your case, if the surgery was done on the left side, you may be prone to getting meralgia paresthetica periodically, and maybe at the first sign of the symptoms appearing you should decrease physical exertion for a week or so, and see if it goes away.
Please remember that meralgia paresthetica is only one possible cause for your symptoms, so you’ll need to see your doctor before such a diagnosis can be made.
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