Conservative Treatment Versus UltrasoundGuided Injection in the Management of Meralgia
Paresthetica: A Randomized Controlled Trial
Authors: Öztürk Gülcan 
Published: February 2021

Background: Meralgia paresthetica (MP) is an entrapment mononeuropathy of the lateral
femoral cutaneous nerve (LFCN), in which conservative treatment options are not always sufficient.
Objectives: The aim of this study was to evaluate the efficacy of ultrasound (US)-guided LFCN
injection in the management of MP by comparing with transcutaneous electrical nerve stimulation
(TENS) therapy and sham TENS therapy.
Study Design: A prospective, randomized, sham-controlled study.
Setting: Health Sciences University Training and Research Hospital in Turkey.
Methods: Patients diagnosed with LFCN compression with clinical and electrophysiological
findings were included in this study. Patients were randomly assigned to 3 groups: (1) USguided injection group, (2) TENS group, and (3) sham TENS group. The blockage of the LFCN
was performed for therapeutic MP management in group 1. Ten sessions of conventional TENS
were administered to each patient 5 days per week for 2 weeks, for 20 minutes per daily session
in group 2, and sham TENS was applied to group 3 with the same protocol. Visual Analog Scale
(VAS), painDETECT questionnaire, Semmes-Weinstein monofilament test (SWMt), Pittsburgh Sleep
Quality Index (PSQI), and health-related quality of life (36-Item Short Form Health Survey [SF36]) at onset (T1), 15 days after treatment (T2), and 1 month after treatment (T3) were used for
evaluation. Patients and the investigator who evaluated the results were blinded to the treatment
protocol during the study period.
Results: A total of 54 of the 62 patients (group 1 n = 17, group 2 n = 16, group 3 n = 21) completed
the study, 3 patients from group 1, 4 patients from group 2, and 1 patient from group 3 dropped
out during the follow-up period. The mean changes in painDETECT and SWMt scores showed a
statistically significant difference between groups in favor of group 1 at T2 and T3 compared with T1
(P < 0.05). There was no statistically significant difference between groups in terms of VAS, SF-36,
and PSQI scores (P > 0.05). In-group analysis of VAS scores showed a statistically significant decrease
in T2 and T3 compared with T1 in group 1 (P < 0.05). In-group analysis of the VAS scores statistically
significant decrease was shown in T2 compared with T1 in group 2 (P < 0.05). In-group analysis of
painDETECT scores statistically significant decrease was shown in T2 and T3 compared with T1 in all
groups (P < 0.05). In-group analysis of SWMt scores statistically significant decrease was shown in
T2 and T3 compared with T1 in group 1 (P < 0.05). In-group analysis of SF-36 and PSQI scores, there
was no statistically significant decrease in all groups (P > 0.05).
Limitations: The limitation of the study was a short follow-up period.
Conclusions: US-guided LFCN injection and TENS may be therapeutic options for MP treatment,
however, for patients with neuropathic pain symptoms, US-guided LFCN injection may be a safe
and alternative method to conservative treatment.
Key words: Meralgia paresthetica, ultrasound-guided injection, transcutaneous electrical nerve
stimulation