Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Dec 12;12(12):CD004159.
doi: 10.1002/14651858.CD004159.pub3.

Treatment for meralgia paraesthetica

Nofal Khalil  1 , Alessia Nicotra, Wojtek Rakowicz
Affiliations

Treatment for meralgia paraesthetica

Nofal Khalil et al. Cochrane Database Syst Rev. .

Abstract

Background: Meralgia paraesthetica is a clinical syndrome for which a number of treatments are in common use, including conservative measures, injection of corticosteroid with local anaesthetic and surgery. We aimed to examine the evidence for the relative efficacy of these interventions. This review was first published in 2008. Searches were updated in 2010 and 2012.

Objectives: To assess the relative efficacy of commonly used treatments for meralgia paraesthetica.

Search methods: We searched the Cochrane Neuromuscular Disease Group Specialized Register (1 October 2012), CENTRAL (2012, issue 9 in The Cochrane Library), MEDLINE (January 1966 to October 2012), EMBASE (January 1980 to October 2012) and CINAHL Plus (January 1937 to October 2012) for randomised controlled studies. Non-randomised studies were identified by searching MEDLINE (January 1966 to October 2012) and EMBASE (January 1980 to October 2012). We also inspected the reference lists of these studies.

Selection criteria: We were unable to identify any randomised controlled trials (RCTs) or quasi-RCTs. We therefore looked for high quality observational studies meeting the following criteria: (1) At least five cases of meralgia paraesthetica. (2) Follow-up of at least three months after intervention (if any). (3) At least 80% of cases followed up.

Data collection and analysis: Three authors independently extracted relevant data from each study meeting the selection criteria and transferred into a data extraction form.

Main results: We found no RCTs or quasi-RCTs in the original review or updates in 20011 and 2012. Cure or improvement have been described in high quality observational studies: (1) A single study describes spontaneous improvement of meralgia paraesthetica in 20 (69%) of 29 cases. (2) Four studies evaluating the injection of corticosteroid and local anaesthetic found cure or improvement in 130 (83%) out of a combined total of 157 cases. (3) Surgical treatments have been found to be beneficial in 264 (88%) out of 300 cases treated with decompression (nine studies); and 45 (94%) out of 48 cases treated with neurectomy (three studies). (4) Ninety-nine (97%) out of 102 patients with iatrogenic meralgia paraesthetica recovered completely (three studies).

Authors' conclusions: In the absence of any published RCTs or quasi-RCTs, the objective evidence base for treatment choices in meralgia paraesthetica is weak. High quality observational studies report comparable high improvement rates for meralgia paraesthetica following local injection of corticosteroid and surgical interventions (either nerve decompression or neurectomy). However, a similar outcome has been reported without any intervention in a single natural history study.

PubMed Disclaimer

Conflict of interest statement

None known.

Update of

References

Additional references

Amodei 1990
    1. Amodei C. [Analgesic treatment of paraesthetic meralgia. Observation of 12 clinical cases ]. Minerva Anestesiologica. 1990;56(6):225‐31. - PubMed
Antoniadis 1995
    1. Antoniadis G, Braun V, Rath S, Moese G, Richter HP. [Meralgia paraesthetica and its surgical treatment]. Nervenarzt. 1995;66(8):614‐7. - PubMed
Banwart 1995
    1. Banwart JC, Asher MA, Hassanein RS. Iliac crest bone graft harvest donor site morbidity. A statistical evaluation. Spine 1995;20(9):1055‐60. - PubMed
Benini 1992
    1. Benini A. Meralgia paraesthetica. Pathogenesis, clinical aspects and therapy of compression of the lateral cutaneous nerve of the thigh. Schweizerische Rundschau fur Medizin Praxis 1992;81(8):215‐21. - PubMed
Chhuttani 1966
    1. Chhuttani PN, Chawla LS, Sharma TD. Meralgia paraesthetica. Acta Neurologica Scandinavica 1966;42(4):483‐90. - PubMed
Dibenedetto 1996
    1. Dibenedetto LM, Lei Q, Gilroy AM, Hermey DC, Marks SC Jr, Page DW. Variations in the inferior pelvic pathway of the lateral femoral cutaneous nerve: implications for laparoscopic hernia repair. Clinical Anatomy 1996;9(4):232‐6. - PubMed
Ducic 2006
    1. Ducic I, Dellon AL, Taylor NS. Decompression of the lateral femoral cutaneous nerve in the treatment of meralgia paresthetica. Journal of Reconstructive Microsurgery 2006;22(2):113‐8. - PubMed
Dureja 1995
    1. Dureja GP, Gulaya V, Jayalakshmi TS, Mandal P. Management of meralgia paresthetica: a multimodality regimen. Anesthesia and Analgesia 1995;80(5):1060‐1. - PubMed
Ecker 1938
    1. Ecker AD, Woltman HW. Meralgia paraesthetica: a report of one hundred and fifty cases. Journal of the American Medical Association 1938;110:1650‐2.
Edelson 1994
    1. Edelson R, Stevens P. Meralgia paresthetica in children. Journal of Bone and Joint Surgery American Volume 1994;76(7):993‐9. [PUBMED: 8027128] - PubMed
Fisher 1987
    1. Fisher AP, Hanna M. Transcutaneous electrical nerve stimulation in meralgia paraesthetica of pregnancy. British Journal of Obstetrics & Gynaecology 1987;94(6):603‐4. - PubMed
Good 1981
    1. Good CJ. Meralgia paraesthetica as a complication of bone grafting. Injury 1981;13(3):260. - PubMed
Gupta 2004
    1. Gupta A, Muzumdar D, Ramani PS. Meralgia paraesthetica following lumbar spine surgery: A study in 110 consecutive surgically treated cases. Neurology India 2004;52(1):64‐6. - PubMed
Haim 2006
    1. Haim A, Pritsch T, Ben‐Galim P, Dekel S. Meralgia paraesthetica. A retrospective analysis of 79 patients evaluated and treated according to a standard algorithm. Acta Orthopaedica 2006;77(3):482‐6. - PubMed
Harris 1994
    1. Harris MB, Davis J, Gertzbein SD. Iliac crest reconstruction after tricortical graft harvesting. Journal of Spinal Disorders 1994;7(3):216‐21. - PubMed
Higgins 2011
    1. Higgins JPT, Altman DG, Sterne JAC. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org. Chichester (UK): John Wiley & Sons.
Hutchins 1998
    1. Hutchins FL Jr, Huggins J, Delaney ML. Laparoscopic myomectomy‐an unusual cause of meralgia paraesthetica. Journal of the American Association of Gynecologic Laparoscopists 1998;5(3):309‐11. - PubMed
Ivins 2000
    1. Ivins GK. Meralgia paresthetica, the elusive diagnosis: clinical experience. Annals of Surgery 2000;232(2):281‐6. - PMC - PubMed
Kalangu 1995
    1. Kalangu KK. Meralgia paraesthetica: a report on two cases treated surgically. Acta Orthopaedica Belgica 1995;41(7):227‐30. - PubMed
Kallgren 1993
    1. Kallgren MA, Tingle LJ. Meralgia paraesthetica mimicking lumbar radiculopathy. Anesthesia and Analgesia 1993;76(6):1367‐8. - PubMed
Keegan 1962
    1. Keegan JJ, Holyoke EA. Meralgia paresthetica. An anatomical and surgical study. Journal of Neurosurgery 1962;19(13):341‐5. - PubMed
Khalil 2001
    1. Khalil NM. Meralgia and cheiralgia paraesthetica. CPD Bulletin Neurology 2001;2(3):78‐80. [ISSN ‐ 1446‐142X, EMBASE accession ‐ 2002024270]
Kitchen 1972
    1. Kitchen C, Simpson J. Meralgia paraesthetica. A review of 67 patients. Acta Neurologica Scandinavica 1972;48(5):547‐55. - PubMed
Lagueny 1991
    1. Lagueny A, Deliac MM, Deliac P, Durandeau A. Diagnostic and prognostic value of electrodiagnostic tests in meralgia paraesthetica. Muscle & Nerve 1991;14(1):51‐6. [PUBMED: 1846938] - PubMed
Macnicol 1990
    1. Macnicol MF, Thompson WJ. Idiopathic meralgia paresthetica. Clinical Orthopaedics & Related Research 1990;May(254):270‐4. - PubMed
Malin 1979
    1. Malin JP. Familial meralgia paresthetica with an autosomal dominant trait. Journal of Neurology 1979;221(2):133‐6. [PUBMED: 92542] - PubMed
Massey 1980
    1. Massey EW. Meralgia paresthetica secondary to trauma of bone graft. The Journal of Trauma: Injury, Infection and Critical Care 1980;20(4):342‐3. - PubMed
Mirovsky 2000
    1. Mirovsky Y, Neuwirth M. Injuries to the lateral femoral cutaneous nerve during spine surgery. Spine 2000;25(10):1266‐9. - PubMed
Monesi 1965
    1. Monesi B, Laus S. Surgical treatment of Roth's paresthesic meralgia. Acta Orthopaedica Belgica 1965;31(5):762‐9. - PubMed
Moscona 1978
    1. Moscona AR, Sekel R. Post‐traumatic meralgia paresthetica ‐ an unusual presentation. The Journal of Trauma: Injury, Infection and Critical Care 1978;18(4):288. - PubMed
Myers 1996
    1. Myers KG, George RJ. Painful neuropathy of the lateral cutaneous nerve of the thigh in patients with AIDS: successful treatment by injection with bupivacaine and triamcinolone. AIDS 1996;10(11):1302‐3. - PubMed
Nahabedian 1995
    1. Nahabedian MY, Dellon AL. Meralgia paresthetica: etiology, diagnosis, and outcome of surgical decompression. Annals of Plastic Surgery 1995;35(6):590‐4. - PubMed
Nouraei 2007
    1. Nouraei SA, Anand B, Spink G, O'Neill KS. A novel approach to the diagnosis and management of meralgia paresthetica. Neurosurgery 2007;60:696‐700. - PubMed
Prabhakar 1989
    1. Prabhakar Y, Bahadur RA, Mohanty PR, Sharma S. Meralgia paraesthetica. Journal of the Indian Medical Association 1989;87(6):140‐1. - PubMed
Privat 1986
    1. Privat JM, Claustre J, Simon L, Gros C. Meralgia paraesthetica: an uncommon entrapment neuropathy (author's transl) [French]. Neuro‐Chirurgie 1980;26(3):239‐42. - PubMed
Puig 1995
    1. Puig L, Alegre M, Moragas JM. Treatment of meralgia paraesthetica with topical capsaicin. Dermatology 1995;191(1):73‐4. - PubMed
Roth 1895
    1. Roth VK. Meralgia paraesthetica. Berlin: Karger, 1895.
Shannon 1995
    1. Shannon J, Lang SA, Yip RW, Gerard M. Lateral femoral cutaneous nerve block revisited. A nerve stimulator technique. Regional Anesthesia 1995;20(2):100‐4. - PubMed
Siu 2005
    1. Siu TL, Chandran KN. Neurolysis for meralgia paresthetica: an operative series of 45 cases. Surgical Neurology 2005;63(1):19‐23. - PubMed
Stevens 1957
    1. Stevens H. Meralgia paraesthetica. Archives of Neurology and Psychiatry 1957;77:557‐74. - PubMed
Teng 1972
    1. Teng P. Meralgia paresthetica. Bulletin of the Los Angeles Neurological Societies 1972;37(2):75‐83. - PubMed
Thanikachalam 1995
    1. Thanikachalam M, Petros JG, O'Donnell S. Avulsion fracture of the anterior superior iliac spine presenting as acute‐onset meralgia paresthetica. Annals of Emergency Medicine 1995;26(4):515‐7. - PubMed
Theuvenet 1993
    1. Theuvenet WJ, Finlay K, Roche P, Soares D, Kauer JM. Neuritis of the lateral femoral cutaneous nerve in leprosy. International Journal of Leprosy & Other Mycobacterial Diseases 1993;61(4):592‐6. [PUBMED: 8151190 ] - PubMed
Trousdale 1995
    1. Trousdale RT, Ekkernkamp A, Ganz R, Wallrichs SL. Periacetabular and intertrochanteric osteotomy for the treatment of osteoarthrosis in dysplastic hips. Journal of Bone & Joint Surgery (American) 1995;77(1):73‐85. - PubMed
van den Broecke 1998
    1. Broecke DG, Schuurman AH, Borg ED, Kon M. Neurotmesis of the lateral femoral cutaneous nerve when coring for iliac crest bone grafts. Plastic & Reconstructive Surgery 1998;102(4):1163‐6. - PubMed
van Eerten 1995
    1. Eerten PV, Polder TW, Broere CA. Operative treatment of meralgia paresthetica: transection versus neurolysis. Neurosurgery. 1995;37(1):63‐5. - PubMed
van Slobbe 2004
    1. Slobbe AM, Bohnen AM, Bernsen RM, Koes BW, Bierma‐Zeinstra SM. Incidence rates and determinants in meralgia paresthetica in general practice. Journal of Neurology 2004;251(3):294‐7. - PubMed
Warfield 1986
    1. Warfield CA. Meralgia Paraesthetica: causes and cures. Hospital Practice (Office Edition) 1986;21(2):40A, 40C, 40I. - PubMed
Warner 2000
    1. Warner MA, Warner DO, Harper CM, Schroeder DR, Maxson PM. Lower extremity neuropathies associated with lithotomy positions. Anesthesiology 2000;93(4):938‐42. - PubMed
Weikel 1977
    1. Weikel AM, Habal MB. Meralgia paresthetica: a complication of iliac bone procurement. Plastic & Reconstructive Surgery 1977;60(4):572‐4. - PubMed
Williams 1991
    1. Williams PH, Trzil KP. Management of meralgia paraesthetica. Journal of Neurosurgery 1991;74(1):76‐80. [PUBMED: 1984510] - PubMed
Yang 2005
    1. Yang SH, Wu CC, Chen PQ. Postoperative meralgia paresthetica after posterior spine surgery: incidence, risk factors, and clinical outcomes. Spine 2005;30(18):E547‐50. - PubMed

References to other published versions of this review

Khalil 2003
    1. Khalil N, Legg N. Treatment for meralgia paraesthetica. Cochrane Database of Systematic Reviews 2003, Issue 2. [DOI: 10.1002/14651858.CD004159] - DOI
Khalil 2008
    1. Khalil N, Nicotra A, Rakowicz W. Treatment for meralgia paraesthetica. Cochrane Database of Systematic Reviews 2008, Issue 3. [DOI: 10.1002/14651858.CD004159.pub2] - DOI - PubMed

Publication types

LinkOut - more resources