A novel approach to the diagnosis and management of meralgia paresthetica

To review the results of conservative and surgical treatment of meralgia paresthetica (MP), with particular reference to the use of a simple clinical test for diagnosing this condition and the outcome of primary nerve decompression surgery.

Records of all patients with a diagnosis of MP were reviewed. Information was obtained about clinical presentation and risk factors, diagnostic evaluation, management, and outcome. Actuarial analysis was used to determine the intervention-free interval after surgical decompression.

Between 2000 and 2005, MP was diagnosed in 45 patients. There were 27 men and 18 women, and the average age at presentation and duration of symptoms were 47 and 1.9 years, respectively. The pelvic compression test had a sensitivity of 95% and a specificity of 93.3% for this condition. Twenty-five patients were managed conservatively and 20 required operative intervention, which was bilateral in two patients. The average follow-up period was 25 months, and the actuarial 2- and 5-year intervention-free rates were 91 and 78%, respectively, with no specific risk factors for revision surgery.

The pelvic compression test is a sensitive and specific test for MP, helping to distinguish it from lumbosacral radicular pain. Most patients with this condition can be managed successfully with conservative measures, and those requiring surgery can be treated effectively with nerve decompression.