Can medical cannabis help meralgia paraesthetica?
There is no study of cannabis-based medicines in meralgia paraesthetica, and there is unlikely ever to be one. What exists is the wider neuropathic pain evidence, and a condition that often resolves without any of this.
The short answer
- No trial exists of any cannabis-based medicine in meralgia paraesthetica specifically.
- It is a compression neuropathy of the lateral femoral cutaneous nerve, causing burning, numbness or tingling in the outer thigh.
- It often improves on its own, or once the cause of compression is removed.
- Reversible causes come first — tight clothing, belts, weight change, pregnancy, recent surgery.
- Any consideration here is by analogy to neuropathic pain generally, and that evidence is itself low quality.
What meralgia paraesthetica is
Compression of the lateral femoral cutaneous nerve, usually where it passes near the front of the hip. It produces burning, tingling, numbness or sensitivity over the outer thigh, on one side, in a patch with fairly clear edges. It is a sensory nerve, so it does not cause weakness.
It is also spelled meralgia paresthetica, and both spellings refer to the same condition. Common contributors are anything that presses on the nerve: tight waistbands and belts, heavy tool belts, body armour, obesity, pregnancy, abdominal surgery, and sometimes diabetes affecting the nerve directly.
The reason that list matters is that removing the cause is frequently the treatment. A condition that resolves when a belt is loosened does not need an unlicensed medicine.
What the evidence says
Nothing directly. No randomised trial, and no observational series, has examined a cannabis-based medicine in meralgia paraesthetica. Anyone who tells you otherwise is describing the general neuropathic pain literature.
That general literature is worth knowing about, and worth not overstating. The Cochrane review of cannabis-based medicines for chronic neuropathic pain found that they may increase the number of people achieving substantial pain relief compared with placebo, while also increasing withdrawals due to adverse events, and rated the evidence low to very low quality.
Applying that to a specific compression neuropathy that usually resolves is a further step again, and it is a step the evidence does not take for you.
The fuller picture is in medical cannabis for neuropathic pain.
What is normally tried first
Conservative measures, because they work often enough to be the sensible starting point, and because they address the cause rather than the sensation.
- Removing the source of compression, including clothing, belts and equipment
- Weight loss where that is a contributing factor
- Time, since many cases settle over weeks to months
- Where symptoms persist, the medicines NICE recommends for neuropathic pain — amitriptyline, duloxetine, gabapentin or pregabalin
- Local injection or, rarely, surgical decompression, in persistent cases
A specialist considering an unlicensed medicine will expect that ground to have been covered, and the convention that two standard treatments have been tried applies here as everywhere else.
The general requirements — age, a documented diagnosis, the convention that two standard treatments have been tried, and access to your medical records — are covered in What are the requirements?
An honest assessment
This is a condition where a careful specialist may well say no, and where saying no is the right answer more often than not.
The combination of no condition-specific evidence, low-quality evidence in the wider category, and a natural history that frequently resolves without treatment makes this a weak case for an unlicensed medicine. Where meralgia paraesthetica sits alongside a broader chronic neuropathic pain problem, the assessment is really about that broader problem.
If a clinic tells you it treats meralgia paraesthetica with cannabis, ask what evidence that is based on. There is not any.
If you want to take this further
The useful next step is a proper assessment, not a longer reading list. Gather your diagnosis, the treatments you have already tried and what happened with each, and a current list of your medicines — that is what a specialist needs in order to give you a straight answer.
The consultation itself, and what happens after it, is set out in What is the process to get a medical cannabis prescription? If meralgia paraesthetica is not the only thing you are being treated for, say so early: other conditions and other medicines change the assessment.
Frequently asked questions
Is there evidence for medical cannabis in meralgia paraesthetica?
No. No randomised trial or observational series has studied a cannabis-based medicine in this condition. Any discussion is by analogy to neuropathic pain generally, where the Cochrane review rated the evidence low to very low quality.
What is meralgia paraesthetica?
Compression of the lateral femoral cutaneous nerve, producing burning, tingling or numbness in a patch on the outer thigh. It is a sensory nerve, so it does not cause weakness. It is also spelled meralgia paresthetica.
Will it go away on its own?
Often, particularly once the source of compression is removed — a tight waistband, a belt, equipment worn at the hip — or after pregnancy or weight change. Many cases settle over weeks to months.
Would a specialist prescribe for it?
Possibly not. With no condition-specific evidence, low-quality evidence in the wider category and a condition that frequently resolves, a careful specialist may conclude that treatment is not appropriate.
Sources and further reading
Every factual statement on this page is drawn from the following public sources. Links open in a new tab and are not affiliated with Flora House.
- NICE guideline CG173: Neuropathic pain in adults — pharmacological management
- Mücke M, et al. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews (2018)
- NICE guideline NG144: Cannabis-based medicinal products
- NHS: Medical cannabis (and cannabis oils)
- MHRA: The supply, manufacture, importation and distribution of unlicensed cannabis-based products for medicinal use