What is The Lateral Femoral Cutaneous Nerve?
The lateral femoral cutaneous nerve (LFCN) has no motor function and it’s a sensory nerve located in the thigh. The nerve branches off the spinal cord in between two vertebrae (L2 & L3). The nerve continues its journey down through the pelvis before passing below the iliac fascia and then exits under the inguinal ligament.
Next, the nerve splits into anterior and posterior divisions about ten centimeters below the spine and continues down to the thigh. The lateral femoral cutaneous nerve innervates the skin of the outer thigh. When the nerve is damaged it does not usually cause any mobility problems.
Lateral Femoral Cutaneous Nerve Injuries
The lateral femoral cutaneous nerve is injured in various ways which lead to both painful and unpleasant symptoms. When the nerve is injured, it causes problems that affect the patient’s quality of life.
Tight clothing, trauma, surgery, obesity and pregnancy are some of the causes of lateral femoral cutaneous nerve injuries.
Damage to the lateral femoral cutaneous nerve occasionally leads to a medical condition known as meralgia paresthetica.
Wearing tight jeans, trousers or leggings is one of the causes of meralgia paresthetica which is a result of nerve compression. The tightness of the clothing around the thigh puts pressure on the lateral femoral cutaneous nerve. Wearing heavy belts and holsters that are tight is another cause of thigh nerve compression.
A simple way to avoid damage to the lateral femoral cutaneous nerve is to wear loose fitting clothing. Not carrying items such as wallets and cell phones in pockets can help to avoid nerve damage. Putting less pressure on the nerve will avoid any nerve injuries and the associated symptoms.
Injuries to the lateral femoral cutaneous nerve as a result of surgery to the spine are common due to the location of the nerve.
Surgical procedures carried out near the L2 and L3 vertebrae put the nerve at high risk of injury. The nerve could get severed and it can be compressed during and after a surgical procedure.
The nerve is particularly susceptible to damage during hip surgery and hip replacement operations. The nerve is sometimes damaged when the surgeon makes a skin incision to perform a surgical procedure.
Medical studies have concluded that the lateral femoral cutaneous nerve could get damaged during hip surgery.
Hernia repair surgery puts the lateral femoral cutaneous nerve at risk. Around 2% of patients suffer nerve injuries during this kind of surgery. The damage is not usually serious and no long term problems are experienced by patients.
Scar tissue as a result of surgery can injure the nerve leading to pain and discomfort. Scar tissue is fibrous and not as elastic as normal tissue which is why it damages nerves. The scar tissue compresses the lateral femoral cutaneous nerve which leads to symptoms developing.
A pelvic fracture is another cause of lateral femoral cutaneous nerve damage. Due to the fact that the nerve passes through the pelvis it often gets damaged following a pelvic fracture.
The fracture can sever the nerve and in some cases, could compress the nerve due to the bones moving. The nerve damage is not usually permanent and symptoms ease when the fracture has healed.
People that are obese risk injury to the lateral femoral cutaneous nerve due to being overweight. Being obese puts unnecessary pressure on the abdomen and pelvis. The pressure causes nerve entrapment which leads to complications such as numbness and tingling.
Losing excess body weight reduces the pressure on the nerve which will ease the symptoms and prevent further nerve damage.
Obesity often leads to disease such as diabetes and people with type 2 diabetes have a high chance of developing meralgia paresthetica.
High blood sugar levels damage nerves in the arms and legs. High blood sugar weakens the walls of blood vessels which prevents nerves from getting oxygen. Insulin used to control diabetes can lead to weight gain in some people which could also damage the lateral femoral cutaneous nerve.
Pregnant women are at risk of developing meralgia paresthetica whilst carrying the baby. During pregnancy weight gain and pressure on the groin area will compress the lateral femoral cutaneous nerve. The symptoms usually ease after giving birth and no long term damage is done to the nerve.
Any kind of blunt trauma to the lower spine, pelvic area, hips or thigh could cause damage to the lateral femoral cutaneous nerve. A heavy blow due to an injury will cause skin bruising and deep tissue damage.
Seat belts can cause blunt trauma damage to the LFCN in a vehicle accident. The lower part of the seat belt passes over the abdomen and pelvic area. When a vehicle comes to an abrupt halt the belt pulls tight and puts pressure on that area damaging the nerve.
Penetrating trauma such as a laceration of the thigh puts the lateral femoral cutaneous nerve at risk. IV injections in the lower back, groin and thigh may damage the nerve. This type of injury will usually heal but symptoms can develop until the nerve has repaired itself.
Abdominal and pelvic tumors can compress the lateral femoral cutaneous nerve. Benign and malignant tumors grow at varying rates and put pressure on nerves in the affected area. Both types of tumor will usually be removed and the symptoms of the nerve damage will then ease.
If the tumor is attached to the lateral femoral cutaneous nerve it could cause damage. Compression resulting from the removal of a tumor on the nerve is another risk. In some cases the surgeon may have to remove some of the nerve which leads to permanent loss of feeling.
Sports And Physical Activities
Playing certain sports such as soccer, baseball and basketball can cause damage to the lateral femoral cutaneous nerve. Furthermore, strenuous workouts and bodybuilding puts stress on various nerves in the body.
The symptoms associated with an injury to the lateral femoral cutaneous nerve include:
How is a Lateral Femoral Cutaneous Nerve Injury Diagnosed?
When a patient has any of the symptoms associated with a lateral femoral cutaneous nerve injury a physician will carry out an examination. They will ask the patient about their lifestyle and if the injury cannot be diagnosed the doctor will refer the patient for some imaging tests.
Various imaging tests are used to diagnose nerve injuries including X-rays, MRI scans and electromyography (EMG) tests. These tests are an effective way to diagnose damage to the lateral femoral cutaneous nerve. When the injury has been diagnosed an appropriate course of treatment will be decided on.
Another way that doctors check nerve damage is to carry out a nerve conduction test. This test is used to check the electrical activity in nerves to see if they are functioning correctly. If the nerve is damaged, the electrical activity will be reduced which indicates a compressed nerve.
How is a Lateral Femoral Cutaneous Nerve Injury Treated?
Most cases of meralgia paresthetica do not need any medical intervention. The damage to the nerve will heal naturally and the symptoms will ease.
Resting until the symptoms have ceased also helps the nerve to repair. If symptoms persist for more than 3 months there are some treatment options that can be considered.
Corticosteroid injections given by a physician in order to reduce inflammation and ease pain. Furthermore, there are some antidepressant medications that are effective for treating pain associated with nerve damage.
In rare cases nerve decompression surgery will be necessary to treat injuries to the lateral femoral cutaneous nerve.
Damage to the lateral femoral cutaneous nerve is occasionally treated with pulsed radiofrequency stimulation (PRF). PRF is an effective way to treat the pain that’s associated with nerve injuries and medical evidence suggests that PRF can successfully alleviate pain in people with lateral femoral cutaneous nerve injuries.
Exercise may help to ease the symptoms associated with lateral femoral cutaneous nerve injuries. Stretching and relaxation exercises help to release a trapped nerve and reduce pain. Exercises such as lunges and working the quadriceps are an effective way to ease thigh pain and discomfort.
Is Lateral Femoral Cutaneous Nerve Damage Permanent?
Lateral femoral cutaneous nerve damage is rarely permanent and symptoms ease when the injury has healed. It’s worth noting that a nerve will never fully recover after an injury and will be susceptible to damage in the future. Maintaining a healthy weight and keeping fit aids the prevention of thigh nerve damage.
Although the lateral femoral cutaneous nerve has no motor function it’s still important that it is healthy. Some of the injuries to the nerve can be avoided by being sensible and taking care of your body. Nerve damage due to surgery or pregnancy cannot be avoided but the good news is the damage is not usually permanent.