What it isStrong evidence
The lateral femoral cutaneous nerve carries feeling from the skin of the outer thigh. It crosses the inside of the pelvis and leaves it close to the bony point at the front of the hip, passing under or through the inguinal ligament, the band that runs along the groin crease. If it's squeezed or stretched there, the skin it supplies burns, tingles or goes numb. That is meralgia paresthetica, which means thigh pain with pins and needles.
The nerve carries only feeling, with no branches to muscles, so it can't make the leg weak or change the knee reflex. Its path varies: anatomy studies describe five different routes out of the pelvis, which may be one reason some people get it and others don't.
Sources 1, 2, 3, 4
How it feels
Burning, tingling, numbness, aching, buzzing or stabbing on the outer thigh, sometimes reaching the outer knee. Light touch, such as clothing brushing the skin, can feel worse than firm pressure. An NHS Scotland guide describes a painful patch of numbness that people can draw around with a finger.
It's often worse after standing or walking for a long time, or with the hip stretched backwards, and eased by sitting. It's usually on one side; about 1 in 5 people have it on both.
Sources 1, 4, 3, 2, 5
Who gets itEmerging evidence
It isn't rare. A US population study found about 33 new cases per 100,000 people a year, and a Dutch study found 4.3 per 10,000 a year in general practice, enough for every practice to see at least one case a year. It's most common between 41 and 60, and slightly more common in men.
Higher weight, pregnancy and diabetes all go with it. People with it had an average body mass index (BMI) of 30.1, against 27.3 in people of the same age and sex. In the Dutch study, the odds were about 12 times higher in pregnancy, though with a very wide margin of error, and most cases had no clear cause. In people with diabetes it was about 7 times as common, and people with meralgia were twice as likely to develop diabetes later, so a GP may check your blood sugar.
Sources 6, 7, 2
Causes
From outside: tight trousers, belts and shapewear, heavy tool belts, body armour and police kit, and seat-belt injuries. From inside: weight gain, pregnancy, a swollen tummy and, rarely, a growth in the pelvis. Diabetes, alcohol and lead can affect the nerve itself.
Operations can stretch or press on it: surgery at the front of the hip, taking bone from the pelvis, hernia repair, caesarean section, and long spells lying face down. A review reports thigh numbness or tingling in most people a year after a hip replacement done from the front (81% in one series), usually mild and not limiting, and in about 1 in 8 people after back surgery lying face down.
Sources 2, 4, 1, 8
How it's recognised, and when tests matter
NHS Borders' referral guidance says the diagnosis is made from the typical story and where the numbness is, and that no further tests are needed. A clinician checks that the leg muscles and reflexes are normal and that the numb area fits the nerve. Pressing down on the side of the pelvis for 45 seconds can ease the symptoms (the pelvic compression test); in one small series it picked up most cases.
Nerve tests, an ultrasound scan or a numbing injection near the nerve help when the picture isn't clear. X-rays, computed tomography (CT) or magnetic resonance imaging (MRI) look for something pressing on the nerve, or a problem in the back, when there are warning signs.
Sources 3, 2, 9, 1, 8
What else it can be
A trapped nerve root high in the lower back is the most important look-alike. Others are the femoral nerve, which also weakens the front of the thigh, hip problems and, rarely, a growth in the pelvis or tummy. A review of 66 reports listed the clues that point away from ordinary meralgia: sudden onset, numbness outside the usual area, back pain, a fever, a swelling in the groin, a history of cancer and constant severe pain. In one surgical series, a patient's symptoms turned out to come from a pelvic tumour that hadn't been found.
Pain over the bony point on the outside of the hip when you lie on it, without numbness, is more often gluteal tendon pain, covered in the hip bursitis guide.
Sources 8, 2, 10, 11
How it usually goesEmerging evidence
Most cases improve. In the one study of untreated meralgia in a Cochrane review, 20 of 29 people (69%) got better without treatment, and 97% of 102 people whose nerve was injured during surgery recovered fully. Pregnancy cases usually settle after the birth. Numbness can linger even when the burning goes.
A 2025 review quotes 91% getting better with treatment that doesn't involve surgery, but that figure comes from a series in which about half also had injections.
Sources 12, 2, 11, 5, 13, 1
