Lateral Femoral Cutaneous Nerve Radiofrequency Ablation for the Treatment of Meralgia Paresthetica: A Retrospective Case Series.

INTRODUCTION

Meralgia paresthetica is a chronic pain condition that is becoming more common due to increases in obesity and diabetes across the general population. This condition results from damage to or dysfunction of the lateral femoral cutaneous nerve (LFCN). Sensory dysfunction without motor impairment is a hallmark of meralgia paresthetica due to the LFCN being a sensory-only nerve. Symptoms affect the anterolateral to lateral thigh and include pain, tingling, burning, and numbness. Current management options include weight loss, loose clothing, physical therapy, oral medications, corticosteroid injections, and surgery. Radiofrequency ablation (RFA) may be a minimally invasive treatment option used before surgery. Although RFA has demonstrated efficacy for other nerve targets, there is currently insufficient evidence for LFCN RFA. The objective of this retrospective study was to add to the existing evidence by examining the safety and efficacy of thermal LFCN RFA for the treatment of meralgia paresthetica during a short-term follow-up of < 2 months.

METHODS

This was a single-site retrospective case series that obtained data from electronic medical records of all patients who underwent thermal LFCN RFA between 2014 and 2025. Other RFA types (cooled and pulsed) were excluded. The 10-cm visual analog scale (VAS) was used to assess pain at baseline and post-procedurally. Statistical analysis was performed using a paired t test in SPSS version 30.

RESULTS

Thirteen cases involving eight patients were included in this analysis, three of whom underwent the procedure multiple times. VAS scores decreased from 5.77 ± 1.92 to 3.23 ± 2.09 (p = 0.007) after the procedure. A reduction in pain was noted in 9/13 cases. For patients with a reduction in pain, the mean improvement was 62.04%, and pain relief was sustained for 6.43 ± 4.65 months. There were no instances of adverse events.

CONCLUSION

Our study found thermal LFCN RFA to be safe and effective for a high proportion of patients with meralgia paresthetica who have exhausted conservative management options. Future studies should include prospective data, additional parameters, larger sample sizes, and long-term fixed follow-ups.