the operation can lead to meralgia paraesthetica. Diagnosis Diagnosis is largely based on patient description and relevant details about recent surgeries, hip injuries, or repetitive activities that could irritate the nerve. Examination checks for sensory differences between the affected leg and the other leg. Differentiation of meralgia paraesthetica from a second lumbar root lesion remains the greatest problem in diagnosis and relies on the careful delineation of the paraesthetic area, the degree of numbness and a negative MR scan of the lumbar spine. Although the L2 area and the area supplied by the lateral cutaneous nerve correspond well laterally, the second root also contributes to the innervation of the groin and the inner aspect of the thigh. Furthermore, in L2 root lesions the analgesia is very slight because of the overlap between L2 and L3, whereas in lesions of the lateral cutaneous nerve, there is almost full anaesthesia, with a clear-cut border. Accurate diagnosis may require an abdominal and pelvic examination to exclude problems in those areas. Electromyographic (EMG) nerve-conduction studies may be required. X-rays may be needed to exclude bone abnormalities that might put pressure on the nerve; likewise CT or MRI scans to exclude soft tissue causes such as a tumor. Treatment Treatment varies. In most cases, the best treatment is to remove the cause of compression by modifying patient behavior, in combination with medical treatment to relieve inflammation and pain. Whatever the cause, typical treatment takes several weeks to months—depending on the degree of nerve damage. Typical treatment options include: Active Release Technique (ART) soft tissue treatment Wearing looser clothing and suspenders rather than belts Weight loss if obesity is present Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammatory pain if pain level limits motion and prevents sleep Reducing physical activity in relation to pain level. Acute pain may require absolute bed rest Deep tissue massage to reduce tension in the gluteal muscles, most commonly the gluteus maximus. The tensor fasciae latae may also be implicated. For lower pain levels, treatment may involve having the patient: Seek appropriate physical therapy, such as stretching and massage, which plays a large role in the management of pain Learn to perform inguinal ligament stretching (from a physical therapist) which can rapidly relieve symptoms Use rest periods to interrupt long periods of standing, walking, cycling, or other aggravating activity Lose weight, and exercise to strengthen abdominal muscles Wear clothing that is loose