Lateral Femoral Cutaneous Nerve Block Injections

The lateral femoral cutaneous nerve is a branch of the lumbar plexus (a nerve bundle of the lower spine). The lateral femoral cutaneous nerve divides into two branches, anterior (towards the front)  and posterior (towards the back).The anterior branch supplies the skin of the anterior and lateral regions of the thigh to the knee, while the posterior branch supplies the lateral portion of the thigh, from around the hip to just above the knee. The lateral femoral cutaneous nerve is a sensory nerve, meaning it is not involved in muscle movement.

Meralgia paresthetica is a common condition associated with the lateral femoral cutaneous nerve and can be caused by avoidable actions such as wearing tight clothing or walking or cycling for extended periods of time. This condition is typically associated with entrapment of the lateral femoral cutaneous nerve under the inguinal ligament leading to a feeling of tingling, aching, or burning.


As with all types of chronic nerve pain, there are many treatment options available including cryotherapy (extreme cold), medications and nerve blocking injections. Nerve Block injections involve injection of a numbing solution into a selective nerve in an attempt to treat and manage pain. The injection can include a steroid (to reduce inflammation) and/or lidocaine or marcaine (to reduce pain). Nerve block injections are used to effectively “turn off” such nerves, and thus reduce any associated inflammation. The effect of these injections lasts between one and four weeks and can be repeated as required. With some conditions however, patients report a total reduction in pain since the initial over- activity of the nerve has been counteracted. In some instances, the patient may experience a more long term loss of pain as a result of localized anesthesia.

The types of medications used are not predetermined, since many options are available. Of course, ultrasound or fluoroscopy (image-guided injections) may work best, since surface anatomy may not be enough to target the extremely small surface area of the nerves in question.

Remember, nerve blocks are not the best treatment for all pain types. Even when they are appropriate, they are usually more effective as part of a more comprehensive treatment strategy.

Depending on the circumstances, complete destruction of the nerve (as opposed to temporary numbing through a local anesthetic) could be considered. This is referred to as a rhizotomy. Aside from the obvious complications of nerve destruction, permanently damaging a nerve may inadvertently and inevitably damage the soft tissue adjacent to that nerve as well.


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