感觉异常性股痛

Meralgia paresthetica is a problem where a surface nerve to the outer thigh gets pinched, causing burning, tingling, numbness, or pain on the outside of the upper leg. It is usually uncomfortable rather than dangerous, and most people improve with simple, non‑surgical steps.​

1) What is this condition?

  • It involves irritation or squeezing of the lateral femoral cutaneous nerve, which gives feeling to the skin of the outer upper thigh.​

  • Symptoms include burning, tingling, buzzing, or numbness in a patch on the outer thigh; skin may feel very sensitive, with normal strength and hip/knee movement.​

  • It often comes from tight clothing or belts, weight gain, pregnancy, or pressure where the nerve passes near the front of the hip.​

2) How serious is it?

  • It does not damage deeper muscles or joints and does not threaten life, but pain can be annoying and limit walking, standing, or sleep.​

  • In most people, symptoms are mild to moderate and often fade over time, especially if the pressure cause is removed.​

  • Severe, long‑lasting cases can be function‑limiting but are uncommon.​

3) Non‑surgical treatments

  • Removing pressure on the nerve:

    • Lose excess weight if needed.​

    • Wear loose clothing; avoid tight waistbands, belts, corsets, tool belts, or heavy gear around the hips.​

  • Activity and posture changes:

    • Avoid prolonged standing/walking that worsens symptoms; take sitting breaks.​

  • Medicines: pain relievers, and for more persistent cases, nerve‑pain medicines (e.g., gabapentin, similar agents).​

  • Physical therapy: stretching, posture work, nerve “gliding,” TENS, and graded activity to reduce pressure and desensitize the area.​

  • Local steroid and/or numbing injections around the nerve to reduce inflammation and pain if basic measures are not enough.​

4) Types of surgery that may be needed

  • Nerve decompression (neurolysis): freeing the lateral femoral cutaneous nerve where it passes under or through tight tissues at the front of the hip.​

  • Nerve cutting (neurectomy): intentionally cutting the nerve to stop pain signals, leaving a patch of permanent numbness; reserved for the most stubborn, severe cases.​

5) Goals of surgery vs non‑surgical care

  • Non‑surgical goals:

    • Remove or reduce the cause of nerve pressure and ease symptoms enough for normal daily activities.​

    • Avoid permanent numbness or surgical risks in a condition that often improves on its own.​

  • Surgery goals:

    • Relieve persistent nerve entrapment when months of good conservative care and injections have failed.​

    • Decompression aims to keep sensation while reducing pain; neurectomy sacrifices sensation in exchange for pain relief.​

6) How surgery can “fix” the problem

  • Decompression surgery releases tight bands (ligaments, fascia) or repositions the nerve so it is no longer being squeezed as it crosses the front of the hip.​

  • Neurectomy removes or cuts a segment of the nerve so pain impulses from that skin patch can no longer reach the brain.​

7) Risks of surgery (general and specific)

  • General risks: infection, bleeding, blood clots, anesthesia reactions, and scar problems.​

  • Specific to this surgery:

    • Persistent or recurrent pain if decompression is incomplete or scar tissue forms.​

    • Permanent numbness over the outer thigh, especially after neurectomy.​

    • Rare nerve irritation leading to ongoing burning or sensitivity (neuroma).​

8) Chances this surgery will work

  • A large series found about 80% of patients improved after either nerve release or neurectomy.​

  • Decompression tends to preserve feeling but may have slightly lower or less durable success than full neurectomy.​

  • Because around 85–90% of people do well with non‑surgical care, surgery is reserved for the small group with severe, persistent symptoms.​

9) Possible complications from the surgery

  • Wound infection, bleeding, or painful scar at the groin/hip.​

  • Persistent pain despite surgery or return of symptoms months or years later.​

  • Permanent patch of numbness on the outer thigh, which can feel strange or bothersome for some people.​

10) Typical recovery from the condition

  • About 85–90% of people improve or fully recover with weight loss, clothing changes, and simple conservative care, sometimes without any procedure.​

  • Treatment‑related or pregnancy‑related cases often improve within about 3 months or after delivery.​

  • Left untreated, symptoms can persist or worsen and may limit walking distance or tolerance for standing.​

11) Typical recovery after surgery

  • Surgery is usually outpatient or a short stay; walking is typically allowed the same or next day, with some soreness at the incision.​

  • Many patients notice quick reduction in burning or tingling once pressure is relieved, though full settling of symptoms can take weeks to months.​

  • Light activities resume within days to a couple of weeks; higher‑impact activities may be delayed until cleared by the surgeon.​

12) How long in the hospital

  • Most decompression or neurectomy procedures are done as day surgery, with discharge the same day.​

  • Overnight stays are uncommon and generally related to other medical issues rather than the nerve surgery itself.​

13) Long‑term outlook

  • Overall outlook is very good; most cases resolve or improve greatly without surgery.​

  • For those who need surgery, many experience substantial long‑term pain relief, though some accept a numb patch of skin as a trade‑off.​

  • The condition does not affect lifespan and rarely leads to serious disability when managed properly.​

14) Need for outpatient follow‑up

  • Regular follow‑up with a primary doctor, neurologist, or pain/nerve specialist to track symptom change, weight, and activity adjustments.​

  • After injections or surgery, follow‑up visits assess wound healing, nerve symptoms, and need for physical therapy or further treatment.​

  • Long‑term, many people just need occasional review if symptoms flare or if weight, pregnancy, or new pressure factors appear.