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.
Cause
The lateral femoral cutaneous nerve most often becomes injured by entrapment or compression where it passes between the upper front hip bone (ilium) and the inguinal ligament near the attachment at the anterior superior iliac spine (the upper point of the hip bone). Less commonly, the nerve may be entrapped by other anatomical or abnormal structures, or damaged by diabetic or other neuropathy or trauma such as from seat belt injury in an accident.The nerve may become painful over a period of time as weight gain makes underwear, belting or the waistband of pants gradually exert higher levels of pressure. Pain may be acute and radiate into the rib cage, and into the groin, thigh, and knee. Alternately, weight loss or aging may remove protective fat layers under the skin, so the nerve can compress against underwear, outer clothing, and—most commonly— by belting. Long periods of standing or leg exercise that increases tension on the inguinal ligament may also cause pressure.The lateral cutaneous nerve of the thigh can occasionally be damaged during laparoscopic hernia repair, or scarring from 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.