Successful application of spinal cord stimulation in a patient with refractory bilateral meralgia paresthetica

Pain Manag. 2022 May;12(4):409-416. doi: 10.2217/pmt-2021-0099. Epub 2022 Jan 21.

Abstract

We present a 38-year-old morbidly obese male who presented with functionally limiting bilateral anterior thigh pain consistent with meralgia paresthetica. His symptoms had been unresponsive to conservative measures which included physical therapy, oral medications and multiple nerve blocks. Patient underwent a trial of spinal cord stimulation (SCS), experiencing 70% of pain relief. He then underwent permanent SCS implant. At subsequent follow-ups 3 and 6 months later, he continued to report 70% improvement of his pain, as well as improved function and quality of life. To our knowledge, this is only the second reported case of successful treatment of meralgia paresthetica with SCS, and the first in a morbidly obese patient.

Keywords: high frequency spinal cord stimulation; lateral femoral cutaneous nerve; lateral femoral cutaneous neuropathy; meralgia paresthetica; spinal cord stimulation; spinal cord stimulator.

Plain language summary

We report a case of a 38-year-old obese male who presented with meralgia paresthetica, a condition characterized by abnormal sensation and nerve pain to the outer aspect of the thigh, limiting his ability to perform activities of daily living. His pain was unresponsive to multiple treatment options such as physical therapy, oral medications and a series of injections with local anesthetic and corticosteroid medications. We then proceeded with spinal cord stimulation, which consists of implanting a device that provides low levels of electrical current to the spinal cord, in hopes of alleviating his pain. After implantation of the device, at 3- and 6-month follow-ups, he was able to achieve 70% improvement of his pain, with the ability to perform his daily activities. This is the second case reported of the use of spinal cord stimulation for this type of condition.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Femoral Neuropathy* / complications
  • Femoral Neuropathy* / therapy
  • Humans
  • Male
  • Nerve Compression Syndromes* / therapy
  • Obesity, Morbid*
  • Quality of Life
  • Spinal Cord Stimulation*