From the Research
The optimal treatment for Meralgia Paresthetica (MP) typically begins with conservative measures, including lifestyle modifications and pain management with over-the-counter NSAIDs or prescription medications, with surgery reserved for severe cases that don't respond to conservative treatment after 6-12 months. The treatment approach for MP should prioritize minimizing morbidity, mortality, and improving quality of life. Key considerations in managing MP include:
- Avoiding tight clothing and belts that compress the lateral femoral cutaneous nerve
- Losing weight if needed
- Modifying activities that worsen symptoms
- Using over-the-counter NSAIDs like ibuprofen (400-600mg three times daily) or naproxen (500mg twice daily) for pain management
- Prescribing medications such as gabapentin (starting at 300mg daily and gradually increasing) or pregabalin (starting at 75mg twice daily) for neuropathic pain
- Utilizing physical therapy focusing on stretching and strengthening exercises for the hip and thigh
- Considering local corticosteroid injections near the nerve at the inguinal ligament for persistent cases
- Reserving surgery to decompress or transect the nerve for severe cases that don't respond to conservative treatment after 6-12 months, as supported by recent studies 1. It's essential to note that while various treatment options are available, including peripheral nerve stimulation 2, the most effective approach often involves a stepwise progression from conservative to more invasive treatments, with a focus on individualized patient care and minimizing potential complications, as highlighted in recent reviews 3, 1.