Tight pants and packed pockets may cause tingling, numbness

DEAR DR. ROACH » I have had meralgia paresthetica for two and a half years. I have all the classic symptoms: tingling, pins and needles, some numbness and stinging in the top and side of my left thigh. I have tried numerous exercises and been treated by a physical therapist and an acupuncturist. Nothing has helped. My doctor has suggested the possibility of medication and/or an injection.

I am 70 years old, do not smoke, am not overweight and am extremely active. This condition has made it difficult to get a good night’s sleep. What are your thoughts?

— K.B.

DEAR READER » Meralgia paresthetica is caused by pressure on the lateral femoral cutaneous nerve. This causes the symptoms you mention, usually on the front and outside of the upper thigh. I often see it in people who have recently gained weight — and occasionally in those who have recently lost weight.

I have never had a patient with symptoms that have lasted as long as yours. Fortunately, 90% of the time, the symptoms will go away by themselves.

Patients should avoid excessively tight clothing and belts, and consider weight loss, if appropriate.

Only once have I sent a patient to an anesthesiologist for a nerve block, which was successful. If the nerve block were unsuccessful at providing adequate long-term relief, a person could consider referral to a surgeon to decompress the nerve. As a last resort, the nerve can be cut, but that would leave permanent numbness on the thigh.

Patients should avoid excessively tight clothing and belts, and consider weight loss, if appropriate.

Contact Dr. Roach at ToYourGoodHealth@med. cornell.edu.