Background Meralgia Paraesthetica (MP) (meros = thigh, algos = pain) is an under diagnosed fairly condition caused by entrapment of the lateral femoral cutaneous nerve. Paraesthesiae, numbness or burning typically affect the thigh. I noticed that acupuncture produced a rapid improvement and invited referrals from rheumatology consultants.
Objectives I had treated several rheumatology patients  and decided to do a case series of MP, using a series of tender and traditional Chinese acupuncture points. I found that all patients were tender over GB31 acupuncture point on the affected lateral thigh (7 inches proximal to the popliteal crease).
Methods A series of 10 patients, including two who had refused surgery (excluding those with significant lumbar spine problems), were treated. Xray/MRI scans were taken if relevant. Acupuncture points used were UB25, GB30, GB34, Ex21 lumbar facet trigger points, GB31+ “Ah chi” tender buttock and Chinese points using an infra-red lamp. Electro-acupuncture (using a dense-disperse mode), was used after the first treatment if significant benefit was not obtained. VAS pain scores were collected weekly from patients prior to treatment by a nurse or receptionist Analgesic intake was recorded.
Results Without exception patients were tender over GB31 point on the thigh.
The pain scores improved for all 10 patients by at least 50% with an average of 3–4 treatments. At follow up (3–36 months), improvement was nearly 100%. They were all able to reduce or stop their medication
Conclusions A series of 10 patients all improved, including a patient with a 20 year history. Two patients had refused surgery and three were misdiagnosed. The patients had no signs of radiculopathy. Nerve conduction studies were considered to be non feasible. Electroacupuncture appears to be a good treatment for this debilitating condition.
A Cochrane review in 2008 found observational studies only, not RCTs . Many patients appear to improve spontaneously but 10–15% may need local steroid/anaesthetic injections. Decompression or resection of the nerve may be necessary . In this series 50% of patients needed surgery. I found one paper only discussing two case reports of the treatment of MP with acupuncture . Acupuncture is a safe non-invasive treatment for this debilitating condition. Tenderness of GB31 acupuncture point on the lateral side of the thigh was consistently present, which may aid diagnosis.
Rosemary Alexander, Adrian White “Acupuncture in a Rheumatology Clinic” Acupuncture in Medicine, Dec 2000 VOL 18(2)
Khalil N, Nicotra A, Rakowicz W. Treatment for meralgia paraesthetica. CochraneDatabase of Systematic Review 2008, Issue 3.Art.No:CD004159
Ivins GK (August 2000).”Meralgia Paraesthetica The Elusive Diagnosis”.Annals of Surgery 232 (2) 281–286.
Aigner N et al. Schmertz 1997 Apr 18; 11(2):113–5
Disclosure of Interest None declared
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