What is the name of the condition causing cold and warm sensations on the anterolateral thigh due to a tight belt?

Meralgia Paresthetica

The condition causing cold and warm sensations on the anterolateral thigh due to a tight belt is called meralgia paresthetica, an entrapment neuropathy of the lateral femoral cutaneous nerve (LFCN) 1, 2.

Clinical Presentation

Meralgia paresthetica manifests with characteristic symptoms localized to the anterolateral thigh 3, 4:

• Burning sensation, tingling, and aching pain in the anterolateral thigh region 2, 5
• Paresthesias and dysesthesias (abnormal sensations including cold and warm feelings) 1, 3
• Numbness or altered sensation (hypersensitivity or hyposensitivity) in the affected area 2, 4
• Crucially, no motor weakness or loss of reflexes, which distinguishes it from other neurological conditions 1, 5

Etiology Related to Belt Wear

The lateral femoral cutaneous nerve is particularly vulnerable to compression as it exits the pelvis, typically near the anterior superior iliac spine 4. Tight-fitting garments, including belts, are a well-established mechanical cause 1, 2, 3:

• Body armor and duty belts (police officers, soldiers, carpenters) have been documented as causative factors 1, 3
• Tight low-cut trousers ("taille basse") represent a modern fashion-related cause 2
• The condition results from chronic, repetitive compression rather than acute traumatic injury 1, 4

Diagnosis

The diagnosis is primarily clinical, based on the characteristic symptom distribution and exacerbating factors 3, 4:

• Diagnostic injection test: Relief of symptoms after injecting local anesthetic around the LFCN confirms the diagnosis 2
• Sensory nerve conduction velocity studies are useful adjunctive tools, with sensitivity of approximately 83% 2, 3
• The condition must be differentiated from lumbar radiculopathy, which follows dermatomal patterns and may include motor deficits 4, 5

Management Approach

Conservative management is first-line and usually successful 2, 3, 4:

1. Remove the compressive agent (loosen or discontinue tight belts, change clothing) 2, 3
2. Weight reduction if obesity is a contributing factor 2, 3
3. NSAIDs for symptomatic pain relief 4, 5
4. Local corticosteroid infiltration around the LFCN if symptoms persist despite conservative measures 2, 4
5. Surgical intervention (neurolysis or nerve transection) should only be considered when all nonoperative therapies have failed to provide relief 3, 4

Clinical Course

The natural history typically involves lifelong intermittent flare-ups, but these can usually be managed successfully with conservative measures 5. Idiopathic meralgia paresthetica usually improves with nonoperative treatment 4.