Meralgia paresthetica

by James
(New Orleans )

Hello Dr Lewis
The reason I entered this as the subject is due to what my newest chiropractor told me which is that my lateral femoral cutaneous nerve is being pinched by my very tight psoas muscle on the right. He did not tell me this exactly though but just happened to show me on a chart of the nervous system. I then came home and started looking around on the web.

My previous chiropractor thought I had piriformis syndrome or a very tight hamstring on that side which turned out to be wrong. Sitting seems to be my biggest problem as well as going to a standing position. I usually have to stop about 3/4 of the way up to prevent a stabbing pain in the area where the gluteus transitions to the back of my leg and then continue to erect position very slowly. Getting dressed in the morning is also a real challenge. Just changing position while sitting can cause a sudden pain in the back of the knee or gluteus although I will be pain free until doing so.

Ibuprofen seems to help but I must take it at least 2 times a day, 400 mg. I've also been applying ice to the gluteus and back of the leg which also helps for a little while. Standing and walking are not really a problem at all once I get moving in the morning and the ibuprofen starts to work. I am hoping the new chiro I"ve got is going to help me but I'm losing hope. I will say that he worked on me more than any other chiropractor has by massaging all kinds of knots out of my upper gluteus, lower back and right hamstring. He is listed as a trained active release technique provider in the new orleans area. If I had insurance I think at this point that I would be making an appt with a doctor to get an injection or surgeon to fix this once and for all.

I continue to see that this is more of a disorder with overweight people but I am not at all nor do I wear tight clothes. At 5'8'' I weigh about 135 pounds and have always been in good shape now age 46. I've read your page on this subject and see that you seem to recommend stretches and exercises for another syndrome although I am not sure this is what you are doing (MAIGNES SYNDROME EXERCISES). Thank you for any input you have for me,

Hello James,
I'm reminded of the Chinese curse: may you live in interesting times! You have interesting signs and symptoms, and I'm sure you'd rather be plain James!

Obviously I'm not there to examine you, so I won't be presumptious. But, meralgia paresthetica causes pain either on the side of the leg, or the front of the thigh. As I understand it, your pain is more in the butt and back of the thigh.

I'm inclined to think that tight hamstring on the right is very significant. It's more likely a tight sciatic nerve.

So, a few questions:
1. If you bend forward, is your right hamstring much tighter than the left?
2. Take the slump test, and let me know the result:

If the answer is yes in both cases, I would be focusing more on the lower lumbar joints, and a sacral fixation, and less on the higher lumbars, where both meralgia paresthetica and maignes originate.

With mer paresth pressure in the groin is usually excruciatingly tender, though you may have to prod around to find it. So, yes it may well be related to the psoas muscle. If it's meral paresth. From what you tell me, I suspect it's not.

Have you had xrays? Do they show anything significant. When I'm struggling with a back I often ask three questions:

1. Are you faithfully doing a simple basic back exercise programme before getting out of bed every morning?

2. Should I be adjusting the sacrum instead of the ilium?

3. Do you have a short leg, and should be wearing a heel lift, or inner in the sole of your shoe?

Biggie: is the Slump test positive? Then it's sciatica.

I hope this has contributed. Keep me updated. Don't feel alone, there are thousands of people exactly where you are. I know, because I'm struggling with some of them too!
By the way, if your chiro is open to it, invite him to give us his thoughts. That art on the hamstring will often help with a tight sciatica.

Try sitting a lot less. Especially the car and so called comfortable chairs. Dr Barrie Lewis DC

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May 20, 2018
Meralgia Paresthetica
by: eyedi

Mine started in 1995 when I was 6.5 months pregnant with first child. At 5’7" and I weighed 142 (the day it started). 125 before pregnant. I was working and felt like I’d been STABBED in the lateral thigh. Then freezing pain. The nerve ( LCFN) didn’t regenerate. I had to give up jogging and 100 sit ups per day. My outer leg usually stays numb unless I sit or stand too long then I have pins & needles, hot iron pain and freezing pain. It was very painful during my second pregnancy after about 6 months. Chiro usually hyper extends my leg and makes me scream. I sleep with a pillow under my knees. Walking exercise... no more jogging or running or cycling. Taking 600- 1000 Mg Magnesium daily along with multi vitamin helps decrease Paresthetica. Tizanidine ( muscle relaxant at night). Rx for codeine when it’s really bad. I can sometimes manipulate the LFCN at the iguneal ligament with a percussion spot vibrator for relief... after I’ve hyperextended after mowing the lawn or a wrong move. I’ve seen two neurosurgeons and cutting the nerve wasn’t recommended.

Dr. Barrie Lewis Dr. Barrie Lewis

It is a complex syndrome, often difficult to diagnose. Important is that it doesn't affect the knee jerk reflex or strength of the quadriceps muscle; then it's not MP.

Sit ups are not my favourite exercise; I fear that may be the cause, and I wouldn't go back to them.

But daily exercises for the lower back are vital. I like the hip hike, and a pelvic tilt when your place your hands under your spine, beginning at T12, and then moving down to the sacrum segment by segment, and up again. Ask your chiro for help with this. Do them before getting out of bed.

That hyperextension of the hip is a very positive femoral nerve stretch; no wonder you are sore. Again, definitely no change in the knee jerk?

Does your chiropractor adjust the mid lumbar spine? That's often where the problem is.

I hope this contributes in some small way.

Jan 22, 2017
Merlagia paresthetica???
by: Anonymous

Well, I have pain in the outer upper right thigh since I had a lipoma removal in 2013. I have been to numerous doctors & none of them can tell me a diagnosis.

Finally I think this is what I have. I am on light pain medication & 600 motrin. It takes the edge off but that's about it.

Please if someone can advise what to do about this. Been in pain for almost 4 years now & it's getting worse😞😞😞.

Dr. Barrie Lewis Dr. Barrie Lewis

Hello Ty,
Alas, someone should have warned you that removing a lipoma is a dead loss, unless it's affecting a vital structure.

Where was this limpoma? On the side of your leg? Then the pain is more likely coming from the site of the surgery.

Gently run your finger down the side of your thigh, and compare with the other side; repeat using a needle. Is there a distinct difference?

Find the ASIS, part of your pelvis, using Google; run your finger down through the groin and inner thigh; is it very tender?

Do you have mid to upper lumbar discomfort or pain? Read our meralgia paresthetica page.

Sep 15, 2016
Meralgia Parestetica?
by: CK

I am a 40 year old man.When I read about all the symptoms you mentioned in the MP page, they exactly matches to my current condition. my right outer thigh is having issues of tingling, sensitivity and burning.
Basically, I have noticed tingling on my right thigh 25 years ago during my high school. But it never bothered me. I can say it was on/off over the time. but never had burning sensation or issues.
10 months ago, when I bought my Fitbit , I used to walk a lot, during that time, I had pain and tenderness in right buttock, for which I have consulted orthopedics(thinking it is a joint problem). After X-ray and other tests, Dr mentioned it is Piriformis Syndrome and suggested some exercises. When I am back to my normal routine by reducing walk, it faded away and never bothered me again.
In last few weeks we had a long flight trip to Asia and had very less sleep some nights. Since then this burning and sesitivity statrted on my outer thigh and been causing lot of discomfort.

Piriformis and MP are both on my right side(buttock and outer thigh). Are they related? What would give me relief from MP? Do I need to see a Chiropractor or a physician or acupuncture specialist? Please suggest!

Oct 10, 2014
Pain in outer thigh
by: Anonymous

Hi I am 25 year old women. Since an year, I am having burning and tingling sensation in my outer thigh. When I researched online, it showed me as Meralgia Paresethetica. I get this pain only when I sit for long hours - like in work, long driving. I started doing exercise but still I am having pains. Basically weekends I will be at home not sitting for long hours, so that time I wont be having any pain. But I get mostly when I am at work. I wont be able to sit more than 20-30mins. I have to either stand or walk. Can you please help what can I do to ease out my pain.

Thank you.

Dr. Barrie Lewis Dr. Barrie Lewis

Start by taking a look at our meralgia paresthetica page at ... type it into the search this site engine.

Usually this is a double entrapment syndrome; in the groin and in the upper lumbar spine. Both have to be addressed for a successful resolution.

Start phoning around to see if any chiros in your area have ever heard of MP, and treat it.

May 31, 2013
Meralgia Paresthetica
by: Jess

Meralgia Paresthetica

I am a 26 year old female and have been having the burning and numbness on my right outer thigh on and off for about 3 years. It has been worse more recently.

Now I have a stabbing pain in my right ovary and it seems when that is worse the pain in my thigh is worse. Could they be related?

Also, I spend a lot of my day standing and walking. Sitting sometimes relieves the pain. Is the pain from Meralgia Paresthetica constant or is it normal to not feel it for weeks at a time?

Dr. Barrie Lewis Dr. Barrie Lewis

Hello Jess,
I'm not sure about your ovary question. Ask your gynae. It's a problem of the Lateral Femoral Cutaneous Nerve being pinched usually in two places, in the groin and in the high lumbar spine.

It's very treatable but your chiropractor will have to address both of these areas and the treatment in the groin can be quite painful. Take a friend partner with you.
If you have a short leg then standing and loitering can certainly aggravate it.

Start by doing the Maignes syndrome exercises, a different but related condition.

Go from Meralgia Paresthetica to Chiropractic Tips

Dec 20, 2011
meralgia paresthetica
by: cathy feeney

I am a forty four old woman i have had this now three months and is gettin worse the pain is so bad i cant sleep of a nite what can i do to stop this pleas help.hope yuo have andwers for me

Dr. Barrie Lewis Dr. Barrie Lewis

Hello Cathy,
I need a lot more details. You may have noticed that James was diagnosed with meralgia paresthetica, but in fact it seems the problem was a sciatic nerve impingement.

To get a helpful answer, you need to give me far more details. Where does it hurt, what aggravates it, what caused it in the beginning, old injuries etc.

let me know.

Nov 14, 2010
Reply to Meralgia Paresthetica / not MP
by: James S

Hello James,
It's now three years. I was wondering if you have an update? There's been quite a lot of interest in your case.

Dr Barrie Lewis

My right leg is the problem leg. On part 2 of the slump test I am not even able to fully extend that leg . The pain seems to focus on the right side of my tail bone. Most of my pain seems to occur when standing and now when getting into the vehicle . I have to find just the right driving position and then after awhile the leg adjusts. This is when it shoots down the leg and the pain focuses in different areas depending on the position - sometimes down the outer back side of thigh , other times inside back of thigh or focuses in the back of the knee. It never goes any further than this . I have no numbness or tingling to speak of . The only tingling is mainly in the center of the right gluteal are and some in the tailbone area. I am able to walk and stand alright though. I have since been doing some more reading and wonder if this isn't SI dysfunction and if one of those belts wouldn't help me out . I know that you did refer to the ileum in your response . I finally went to my GP and he put me on methylprednisone, medrol dose pack, which is not helping at all so stopped taking them . Thanks much for providing help to me!

Dr. Barrie Lewis Dr. Barrie Lewis

Dear James,

If the slump test is positive at 2, and your pain is primarily at the back of the leg, then you have sciatica not MP. A different nerve. And yes it comes from the lower lumbar spine, near your tailbone, whereas MP is from the upper lumbar spine.

You have what chiropractors deal with all day long. Start shopping around for a thorough, conscientious chiro. Every sciatica is a challenge, but the vast majority respond very well to chiro.

Sit less, don't bend, and if you have trouble standing ask your chiro to consider whether you have a short leg; leg length inequality.

There's heaps on this at chiropractic help. Go browsing, and good luck. I hope this has contributed.

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

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