501: PRF of LFCN for Refractory Meralgia Paresthetica: A Case Series from a Resource-Constrained Setting

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic neuropathic pain, Treatment/management

Background and Aims: Meralgia paresthetica is a neuropathic pain syndrome caused by lateral femoral cutaneous nerve (LFCN) entrapment, resulting in burning pain and dysesthesia over the anterolateral thigh. While most cases respond to conventional therapies like medication or injections, some remain refractory. In lower middle-income countries (LMICs), as defined by the World Bank, access to surgical or implantable neuromodulation is limited. Pulsed radiofrequency (PRF) offers a minimally invasive alternative.

Methods: Eighteen adult patients with persistent meralgia paresthetica unresponsive to pharmacologic therapy and diagnostic nerve blocks underwent ultrasound-guided PRF of the LFCN (42°C, 120 seconds per cycle, two cycles). Pain intensity (Numeric Rating Scale, NRS), analgesic use, and adverse events were recorded at baseline, 1, 3, and 6 months. Statistical analysis was performed using repeated-measures ANOVA with post-hoc Bonferroni correction; p < 0.05 was considered significant.

Results: All patients completed 6-month follow-up. Mean NRS decreased from 7.0 ± 0.8 at baseline to 3.0 ± 1.0 at 1 month, 2.0 ± 0.9 at 3 months, and 3.0 ± 1.1 at 6 months (p < 0.001). Clinically significant pain relief (≥50% NRS reduction) was achieved in 70% of patients at 6 months. Analgesic requirements decreased in the majority. No major complications, motor deficits, or persistent sensory loss were observed.

Conclusions: Ultrasound-guided PRF of the LFCN is a safe, effective, and cost-conscious neuromodulation strategy for refractory meralgia paresthetica in LMIC settings. Pain reduction was sustained at 6 months, supporting PRF as a viable minimally invasive option where implantable therapies are inaccessible. Larger controlled studies are warranted.

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Presenting Author: Dr Muhammad Zubair
Submitting Author: Muhammad Zubair

Senior Author: Dr Muhammad Zubair

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Dr Sajida Iqbal: MBBS,DGO, FCPS - Biovision Diagnostic Center