Treatment for meralgia paraesthetica, a condition causing numbness and sometimes pain in the thigh

Khalil N, Nicotra A, Rakowicz W

Published Online:

February 16, 2011

Meralgia paraesthetica is a common clinical condition caused by damage to the lateral cutaneous nerve of the thigh, resulting in pain, numbness and tingling in the front and outer side of the thigh. The diagnosis is easy to make clinically. Although not life-threatening, the condition can cause a lot of discomfort to the affected individual. A number of interventions are in common use and we wanted to examine the evidence in the literature for their efficacy. No randomised controlled trials were found. Local injections of corticosteroid and surgical operations were found to be effective treatments in observational studies. However, a single observational study also showed that meralgia paraesthetica improved spontaneously in the majority of cases. Randomised controlled trials of treatments for meralgia paraesthetica are needed. This is an updated review. An updated search was undertaken in which no new studies were found.

Abstract (click to read)

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 is an updated review. An updated search was undertaken in which no new studies were found.

Objectives:

To assess the relative efficacy of commonly used treatments.

Search strategy:

We searched the Cochrane Neuromuscular Disease Group Specialized Register (5 October 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (11 October 2010, issue 4, 2010 in The Cochrane Library), MEDLINE (January 1966 to September 2010), EMBASE (January 1980 to September 2010) and CINAHL Plus (January 1937 to September 2010) for randomised controlled studies. Non-randomised studies were identified by searching MEDLINE (January 1966 to September 2010) and EMBASE (January 1980 to September 2010). We also inspected the reference lists of these studies.

Selection criteria:

We were unable to identify any randomised controlled or quasi-randomised controlled trials. 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 randomised controlled or quasi-controlled trials. 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 randomised controlled or quasi-randomised controlled trials, 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.

This record should be cited as:

Khalil N, Nicotra A, Rakowicz W. Treatment for meralgia paraesthetica. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD004159. DOI: 10.1002/14651858.CD004159.pub2

Assessed as up to date:

October 5, 2010

Find the research

Get full text at The Cochrane Library

Primary Review Group:

Neuromuscular Disease Group

Health topics:

Neurology > Peripheral neuropathy > Entrapment neuropathy

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Treatment for meralgia paraesthetica, a condition causing numbness and sometimes pain in the thigh

More like this

Copyright © 2011 - The Cochrane Collaboration