The lateral femoral cutaneous nerve is a purely sensory nerve supplying the outer thigh skin, with no motor component. Its passage under the inguinal ligament just medial to the ASIS makes it susceptible to compression in tight clothing, obesity, pregnancy, and prolonged hip flexion, producing meralgia paraesthetica, the burning lateral thigh numbness and tingling that is one of the most recognisable peripheral nerve entrapment syndromes.
| Origin | Lumbar plexus (L2, L3) |
|---|---|
| Course | Emerges from the lateral border of the psoas, crosses the iliacus under the iliac fascia, passes under or through the inguinal ligament just medial to the ASIS, and enters the thigh to supply the lateral skin |
| Motor |
|
| Sensory |
|
Meralgia paraesthetica produces burning, numbness and hypersensitivity over the lateral thigh that is worse with standing and walking and eased by sitting or hip flexion. There is no weakness because the nerve is purely sensory. Most cases arise where the nerve passes under or through the inguinal ligament just medial to the ASIS, and pressure there reproduces the tingling. Less often the nerve is damaged higher up in the pelvis, by retroperitoneal haematoma, psoas abscess or tumour, iliac crest bone graft harvest, or lateral and retroperitoneal spine approaches, so imaging is needed when the history suggests this. Weight loss, avoiding tight belts and positional changes resolve most cases; persistent ones are treated by local anaesthetic and steroid injection or, rarely, surgical decompression or neurectomy.
Lateral femoral cutaneous nerve compression producing burning lateral thigh numbness without weakness, aggravated by standing and tight waistbands, managed with weight loss, loose clothing, and nerve block injection.
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