I often get patients complaining of sciatica…but in the front part of their thigh?
This is a condition known as MERALGIA PARASTHETICA. it is caused by compression of the Lateral Femoral Cutaneous nerve. This nerve provides sensation to the antero-lateral part of the thigh. It often gets trapped under the inguinal ligament (although root impingement is also possible in manifesting symptoms) and produces pain and/or numbness in the front, outer part of the thigh.
Common causes for this impingement is being overweight, wearing tight jeans, carrying objects in front pocket, prolonged sitting, leaning against counters, etc.
By passively extending the hip or forcefully flexing the hip one should feel an increase in symptoms, this is do to traction and compression on the nerve.
Treatment entails the removal of compression on the nerve. One might start by loosening their belt, reduce their weight, avoid a prolonged sedentary position, remove objects from their front pocket. The use of Active Release Techniques has shown to be very successful, by stripping the inguinal ligament and allowing the Lateral Femoral Cutaneous nerve to pass underneath it without being compressed. Sometimes Cox decompression therapy is needed to remove the impingement at the nerve root itself.