If you experience pain or numbness on the outside of your thigh, it is likely caused by one of several things. Dr. Robert Shmerling of Harvard Health examines the common causes of thigh pain and possible remedies.
Q: Shortly after having surgery on my shoulder, I have been experiencing numbness and a burning sensation on the outside of my right thigh, especially at night. Do you think it is related to the surgery? If not, what else might be causing it?
A: Numbness is usually a symptom of a nerve problem. Compression, inflammation, injury, or diseases associated with nerve damage (especially diabetes) are the most common causes of nerve disease (the medical term is neuropathy. In some cases, neuropathy develops without an identifiable cause.
A common example of a nerve problem is when your “foot falls asleep.” This usually follows a prolonged period of sitting or lying in one position, when a nerve that brings sensation to the foot is compressed. Fortunately, this type of nerve trouble is quite temporary.
The most common cause of thigh numbness without other symptoms is compression or irritation of the nerve that supplies the skin of the upper, outside part of the thigh, called the lateral femoral cutaneous nerve. This condition is called meralgia paresthetica.
Common triggers for causes of thigh pain include:
- Obesity
- Trauma, including surgical injury
- Constrictive clothing, such as a heavy equipment belt
- Diabetes
During your recent surgery, it’s possible you were placed in a position that put pressure on the lateral femoral cutaneous nerve (such as the fetal position); if that’s the cause, symptoms should resolve within a few days or weeks.
Other possible causes of thigh numbness include problems with nerves that connect to the lateral femoral cutaneous nerve. For example, nerves in the lower back connect to the nerves of the thigh, so disc disease that compresses nerves in the lower back may cause numbness in the thigh.
It’s likely that your doctor can determine the cause of your numbness just by reviewing your symptoms and performing a physical examination. No special tests are necessary to diagnose meralgia paresthetica. However, an MRI of the lower back or nerve conduction testing may be helpful if the cause is not clear after your doctor performs a physical exam.
Treatment depends on the cause and the duration of symptoms. Common initial treatments include removing or avoiding compression of the lateral femoral cutaneous nerve, wearing loose clothing and loss of excess weight. For prolonged symptoms, medications, including gabapentin (Neurontin), carbamazepine (Tegretol), or amitriptyline (Elavil) may help. For painful or particularly bothersome symptoms, a nerve block—an injection of a corticosteroid mixed with a Novocaine-like numbing medication intended to interrupt nerve signals — may be recommended. For the most severe cases, surgery to decompress the nerve is a treatment of last resort.
Robert H. Shmerling, M.D., is a senior faculty editor and Editorial Advisory Board member, Harvard Health Publishing. For additional consumer health information, please visit www.health.harvard.edu.
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