It can be a scary feeling when out of nowhere your leg goes numb or starts burning. You didn’t injure yourself, have an accident, or are able to put your finger on any incident where this sensation-change happened.
Luckily, there may be a straight-forward answer for this strange predicament.
Crazy name, right?
It comes from the Greek term “meros algos,” which means “thigh pain.” We’ve adopted this name into our English language to describe what happens when we irritate a nerve in our body called the lateral femoral cutaneous nerve.
You may know it by its other name, Bernhardt-Roth Syndrome.
There are many possibilities as to how we may damage this nerve, but (thankfully) there are many potential solutions as well.
Let’s dive into what exactly meralgia paraesthetica is, talk about its symptoms and causes, and then discuss how get your leg feeling normal again.
As I mentioned, the lateral femoral cutaneous nerve (AKA the lateral cutaneous nerve of the thigh) is the culprit here in terms of what structures are affected with meralgia paraesthetica.
It’s a long nerve that originates in your lower back, from your lumbar plexus, which is a combo of nerves originating from your lower spine — the posterior divisions of the nerves coming out of your second and third lumbar segments combine and create this nerve.
It’s a cutaneous nerve, which means that it supplies the sensation in your skin. More specifically, it supplies the outer thigh, which explains why you may feel sensation changes in that area.
The nerve passes through the psoas major muscle, which is the “tenderloin” of humans and attaches from your lower spine to the inside of your femur near your pelvis.
It also passes under the inguinal ligament, which starts at the anterior superior iliac spine (the top-front of your hip bone) and ends at your pubic tubercle (your hip bone by your groin).
As you may imagine, a nerve that runs through and around so many structures has a higher chance of becoming “impinged” or “entrapped.”
This entrapment can happen anywhere along its length, but usually happens at the level of the inguinal ligament.
Now that we have an understanding of the lateral femoral cutaneous nerve and how it relates to meralgia paraesthetica, let’s dive into the causes of this condition.
Causes of Meralgia Paraesthetica
There are many ways that the nerve can become irritated, with some requiring an active fix and others solving themselves spontaneously.
Obviously, being pregnant creates some weight gain — after all, there’s a baby growing inside you!
This growing miracle creates extra pressures in your body, as the baby squishes against different internal structures.
One thing that those pressures may create is nerve impingements — it’s quite common for someone who is pregnant to develop carpal tunnel syndrome, for example.
With the lateral femoral cutaneous nerve being so close to the stomach, it’s at risk, and further kinks and twists may happen while giving birth.
This sounds terrible, but it’s very uncommon for it to be a serious issue. In fact, it often resolves itself!
If your wardrobe consists of skinny jeans and tight tops, you may need to change up your style for a bit.
Wearing tight clothing or heavy belts can lead to compression of the lateral femoral cutaneous nerve, resulting in irritation. Nerves need to breathe too!
Repetitive Leg Movements
Doing any repetitive motions at any part of the body can cause irritation, that much is straight-forward. Things like running or jumping, especially when done for longer periods of time, can irritate the nerve or cause muscle tightness around the nerve, compressing it.
Now, this doesn’t mean that you need to stop running or playing the sport or doing whatever it is that you do. It just means that this may be a cause, or at least a part of the puzzle, but not something you need to become sedentary for — we’ll talk more about solutions later.
Similar to pregnancy, weight gain or increased bodyweight causes stresses on our body that can irritate different structures over time.
Carrying more weight than our body is comfortable with puts it in a position where it is constantly overloaded, and much like repetitive movements, this constant overload will cause different structures in our body to take more of a beating than it is designed for.
Surgery is a tough thing to go through, and sometimes can cause longer-lasting complications.
My goal is not to scare you here, but it’s good to be aware of the fact that hip/back surgeries may cause some compression in the lower back or the hips, either through swelling or injury, and that could irritate the lateral femoral cutaneous nerve for a while.
With meralgia paraesthetica affecting a cutaneous nerve, it’s important to note that symptoms will only affect sensation.
This means that you may feel a numbness, burning, tingling, prickling, or buzzing feeling in the outer part of your thigh, but shouldn’t have any issues with moving your leg.
That being said, if your irritation is high, you may feel pain, which may cause you to have problems moving around.
However, this is because you have pain or discomfort, not because your muscles aren’t working when you tell them to — that’s an important differentiation.
How To Fix Meralgia Paraesthetica
Now the fun part: let’s talk about fixing this stuff.
The first step of meralgia paraesthetica rehab is conservative treatment.
Conservative treatment generally means treatment without surgery — such as exercises, massage, heat/ice, etc.
The goal here is to find the factors that may be contributing to the nerve entrapment, and then to directly target those factors.
There are plenty ways of doing that. Let’s check them out.
Weight management can be tricky, and there are several ways to go about it. First of all, you want to look at your habits with things such as physical activity and nutrition — although it’s tough to evaluate yourself, you’ll learn a lot about yourself and find ways to improve!
Looking at these habits, we can identify a couple of potential barriers. These barriers are our priority to overcome.
Talking to a nutritionist or a personal trainer could prove to be very helpful in setting up a plan that works for you and your lifestyle. Our article on what to look for in an online personal trainer is a great starting point if you’re looking to find a trainer online, especially if your access to gyms is limited.
If you want a couple of healthy snack options, check out our article on our favourite fitness meals to help you become lean, and stay that way!
Wearing Looser Clothing
As simple as it may seem, your clothes may just be a bit too tight, or your belt may be a bit too heavy. Even if it doesn’t fit your style, there may be wisdom (and relief) in wearing some looser clothing for a bit of time, at least until your symptoms decrease.
Manual therapy is when a health professional uses different techniques to help mobilize joints, release tension in muscles, or help reduce pressure in different parts of the body. One type of manual therapy you may be familiar with is massage.
A health professional will usually use these techniques to decrease the compression and pressure on the lateral femoral cutaneous nerve around the low back and hip, as this is usually where the tension originates from.
Getting relief from your symptoms is a good sign that this is working, and a good therapist will teach you ways to do this at home (we’ll talk about a couple specific exercises later).
TENS, or Transcutaneal Electric Nerve Stimulation, has been shown to be an effective technique in helping with meralgia paraesthetica.
In a nutshell, TENS is where you place two or more electrodes on your skin, usually running along the nerve or muscle that you’re trying to target.
Then, an electrical current runs through those patches from a small machine.
The purpose of TENS is to activate receptors in your body that act as analgesics — AKA pain-relievers.
You don’t need to have a doctor do this for you — in fact, many people own their own TENS machine and use it for a variety of reasons.
Exercises for Meralgia Paraesthetica
Now, my personal favourite way of dealing with pain and problems in the body.
Exercise can come in many different forms. The nice thing about this is that we don’t have to force any exercises to work, but rather can modify them to work for you.
With meralgia paraesthetica, we usually want a combination of aerobic, strength, flexibility, and balance exercises. Let’s check out a good exercise to try for each.
With aerobic training, we want to focus on low-impact exercises that don’t bring on further symptoms. This can mean different things to different people, where you may be able to do one of these symptom-free, but your neighbour who also has meralgia paraesthetica can’t.
Some examples are:
- Walking — the goal is to find a comfortable pace that you can keep up for 20-30 minutes
- Swimming — being in the water takes a load off of your joints and may actually give you some relief!
- Cycling — taking your bike out or hopping on a stationary bicycle is a great way to get some low-impact exercise in, especially if you have joint pain
Strengthening has long shown to have many benefits, from chronic pain-relief to long-term bulletproofing of your body.
Again, we don’t want to aggravate our symptoms further, and should find a comfortable level to push at.
With meralgia paraesthetica, a good strengthening exercise would be some sort of a leg/hip movement, such as a squat.
Now, you don’t have to get under a barbell and start tossing weights around. Rather, find a squat-like exercise, such as:
- barbell squat
- leg press
- hack squat
- goblet squat
The point is to find something that you’re able to do comfortably, and then progress with. Progression comes in many ways, such as through increasing reps and sets or adding a bit of weight every or every couple of workouts.
The goal is doing these 2-3 times per week, and as long as you’re progressing and getting stronger, you’re doing awesome.
Flexibility is another way we can relieve some tension in those muscles around the lateral femoral cutaneous nerve, and potentially get some relief.
Generally, stretching a muscle should be combined with strength training. This is because you can stretch a muscle as much as you want, but if it doesn’t get strong enough to handle the new range you gave it, it will tighten right back up.
With these, we need to make that important distinction between pain and discomfort — some discomfort is ok with stretching, but we shouldn’t push into pain. I usually recommend not going past a 3/10 on the pain scale.
We’ll usually want to do some stretching for both the front and back of the thigh. An example for the front of your thigh, or your quad muscles, is standing upright holding on to something sturdy in front of you with one hand. Then, bend your knee up towards your glutes, and grab that foot with your other hand. The harder you pull the knee back, the bigger of a stretch you’ll get at the front of your thigh.
Looking at the back of your thigh, or your hamstring muscles, you’ll want to take a small step forward with your heel propped up on a small step. Keeping your legs straight and your front ankle bent up, slowly bend forward at the hips until you feel a stretch in the back of your leg that’s up on the step.
Hold each stretch for 20-30 seconds, doing 2 to 3 sets per day.
If you want to take a full-body approach and help your muscles relax, check out our calisthenics stretches to help improve your flexibility.
Balancing can help you out by improving your neuromuscular control, which shows good results with pain relief.
It can be as simple as practicing balancing on one leg, and making it harder by making the surface you stand on progressively more unstable (e.g. start on a hardwood floor, move to carpet, stand on a pillow, stand on a half-BOSU ball, etc.)
The goal is to stand for 60 seconds without holding onto anything. This can take time and discipline, just make sure to have something sturdy beside you just in case you need to grab onto something!
This is last resort, and only needs to become an option if the above doesn’t help or if you experience long-term symptoms without relief. Your doctor will give you some options regarding nerve-relief surgery — but again, this is uncommon and rarely needed.
Let’s go over what we learned today:
- Meralgia Paraesthetica is when the lateral femoral cutaneous nerve gets entrapped, usually by your inguinal ligament
- It causes sensation changes in your outer thigh
- It usually improves on its own, or with conservative treatment that may include weight management, exercise, or wearing looser clothing
In the end, it’s all about understanding your body and learning what works for you. Often, this can take a bit of time, but is a worthwhile pursuit and will serve you well for years to come. Want to learn more about health, fitness, and injury prevention? Book a consultation today with one of our expert calisthenics coaches.
Hi, I’m Eric Richter. I am a licensed Physical Therapist and Strength & Conditioning Coach. With 7+ years of experience, I’ve continuously challenged myself to learn more about the human body and the way it functions. My passion lies in helping people understand their pain and take control of their body, mainly through the wonders of exercise and self-management.