Medically, burning thigh pain is referred to as meralgia paraesthetica. The condition is caused by compression of the lateral femoral cutaneous nerve which supplies feeling to the upper leg. It can start as slightly uncomfortable, but grow to become extremely painful and debilitating. Many brush off the feeling as something they get when they wear something tight or overdo it. However, it is important not to ignore the symptoms, but to have them checked by expert and experienced orthopedic specialists like those at Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado. If the diagnosis is late or missed entirely, pain can keep increasing, and leaving it untreated can lead to permanent disability.
OVERVIEW
Meralgia paraesthetica is a condition that causes tingling, numbness, and burning pain in the outer thigh. It is also known as lateral femoral cutaneous nerve entrapment. “Meralgia” means “pain in the thigh”, and “paraesthetica” means “burning pain, tingling or itch”. One might also hear it referred to as Bernhardt-Roth Syndrome. Burning thigh pain is relatively common, but it is frequently misdiagnosed. Although spontaneous meralgia paraesthetica can occur in any age group, it is most frequently seen in those 30 to 40 years old. Symptoms are typically on one side, seen in about 78% of cases, but it may be on both sides.
ABOUT THE LATERAL FEMORAL CUTANEOUS NERVE
Nerves are like cables that carry electrical impulses between the brain and the rest of the body. The lateral femoral cutaneous nerve branches off the lumbar plexus, a network of nerves that connect the spinal cord in the lower back with the motor and sensory nerves of the legs and lower body. It provides sensation to the front and sides of the thigh. This is a pure sensory nerve and does not operate any muscles.
WHAT IS BURNING THIGH PAIN?
Meralgia paraesthetica results from the compression of the lateral femoral cutaneous nerve (LFCN). The lateral femoral cutaneous nerve is susceptible to compression as it courses from the lumbar plexus, through the abdominal cavity, under the inguinal ligament (a set of 2 bands that connect the oblique muscles of the abdomen to the pelvis, deep in the groin) and into the subcutaneous tissue (the deepest layer of skin made up mostly of fat cells and connective tissue) of the thigh. For nerves to deliver information from the surrounding environment to the brain, they must pass over, under, around, and through the joints, bones, and muscles. Usually, there is enough room to permit easy passage. In meralgia paraesthetica, swelling, trauma, or pressure can narrow these openings and squeeze the nerve. When this happens, it may cause many symptoms and even lead to paralysis or other dysfunction.
CAUSES
A variety of factors can lead to compression of the LFCL including external and internal causes. One is more likely to develop this condition if they:
- Wear tight clothing such as pants, leggings or stockings
- Wear something heavy worn around the waist, like a tool belt
- Are overweight or obese
- Are pregnant
- Were injured by a seatbelt during a car crash
- Had recent surgery around the hip area
- Have scoliosis
- Have a tumor near the LFCN
- Have medical conditions such as diabetes, hypothyroidism, and alcoholism
- Do one activity for a long time or over and over can be standing, sitting, running, or biking
SYMPTOMS
- Pain
- Tingling
- Decreased feeling or numbness
- Burning on the outside of the thigh
- Sensitivity to light touch rather than to firm pressure
- High sensitivity to heat
- Symptoms may be mild at first, but as the condition worsens, the pain may be sharper or shooting
- It may go away and come back for no clear reason, or it may become chronic
NON-SURGICAL TREATMENT
Treating burning thigh pain involves treating the underlying cause to ease pressure on the nerve. The majority of cases improve with conservative treatment such as losing weight, managing diabetes, wearing looser clothing, or avoiding anything restrictive around the waist. Many people benefit from other interventions:
- Icing the area
- NSAIDS and topical medications such as lidocaine can help symptoms
- Medications like gabapentin, pregabalin, or duloxetine may help treat neuropathic pain
- Nerve blocks—the injection of a local anesthetic close to a targeted nerve or group of nerves to lessen pain
WHEN IS SURGERY INDICATED?
Rarely, surgery is necessary to correct compression on the lateral femoral cutaneous nerve. Healthcare providers usually only recommend surgery for people who try other treatments but still experience symptoms.
GETTING THE RIGHT DIAGNOSIS. GETTING THE RIGHT DOCTOR.
Burning thigh pain is often misdiagnosed as it can be hard to tell the difference between meralgia paraesthetica and other back, hip, or groin conditions. It could be mistaken for lumbar radiculopathy (compression or inflammation of a nerve in the spine), chronic appendicitis, uterine fibroids, or many other conditions. Symptoms of those problems can be almost identical on the surface and it takes immensely skilled and knowledgeable orthopedic specialists to differentiate them. You’ll find this level of excellence at Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado.
After a thorough medical history and physical exam, your doctor will run many tests to rule out other issues. They may order blood tests to check for signs of hypothyroidism, hormone or vitamin imbalances, anemia, or diabetes. X-rays can help rule out tumors. Other imaging tests such as a CT scan or MRI can check for other spinal or nerve issues like a herniated disc. It is also possible that your doctor may use electromyography (EMG) to help make the diagnosis. EMG records electrical activity when a nerve stimulates a muscle and can be used to identify and diagnose neuromuscular abnormalities. The test requires inserting one or more small needles into a muscle and EMG can distinguish meralgia paraesthetica from radiculopathy or pain emanating from the hip. They will do whatever it takes. If you want exceptional treatment and an excellent outcome, CCOE is where to go.
