Meralgia ParestheticaNCT07089472
Dry Needling Versus Cyriax Technique on Pain, Paraesthesia and Functional Disability in Patients With Chronic Low Back Pain
A study testing Dry Needling Therapy and Cyriax Technique in people with Meralgia Paresthetica and Chronic Low-back Pain (cLBP), run by University of Lahore at 1 site in Pakistan.
Trial summary
This study is designed to compare the effectiveness of two physiotherapy techniques-Dry Needling and the Cyriax Technique-in people suffering from chronic low back pain (CLBP) that radiates to the outer thigh, a condition commonly known as meralgia paresthetica. Read more about this study
- Who is it for?
- Ages 30 to 50 years
- Conditions the study is for
- Meralgia Paresthetica, Chronic Low-back Pain (cLBP)
- What is being tested?
- Dry Needling Therapy and Cyriax Technique
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 80 participants
- Where
- 1 sitePakistan
- Study dates
- 25 Nov 2024to 19 Jul 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 30 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Diagnosed with chronic low back pain (time to onset ≥ 3 months) (Erbay, 2002).
- Roland Morris Disability Questionnaire score ≥ 4 (Lara-Palomo et al., 2022).
- CLBP radiating to Anterolateral thigh with symptoms of numbness tingling (de Ruiter et al., 2023).
Who cannot join
- Patients with sensory and/or coagulation disorders (Lara-Palomo et al., 2022).
- A history of spinal surgery, heart complications, concurrent severe central or peripheral nervous system disease (de Ruiter et al., 2023).
- Epilepsy, needle phobia, serious pathologies that can be the main cause of chronic low back pain other than meralgia parasthetica (Lara-Palomo et al., 2022).
Trial locations and contacts
1 site in 1 country.
About this study
This study is designed to compare the effectiveness of two physiotherapy techniques-Dry Needling and the Cyriax Technique-in people suffering from chronic low back pain (CLBP) that radiates to the outer thigh, a condition commonly known as meralgia paresthetica.
Meralgia paresthetica occurs when a nerve called the lateral femoral cutaneous nerve (LFCN) gets compressed, leading to pain, numbness, tingling, or burning sensations in the front or side of the thigh. Many patients also experience difficulty in performing daily activities because of these symptoms.
Read more
Dry Needling is a modern treatment where fine, sterile needles are inserted into specific muscles to relieve tension and improve nerve function. It is believed to release natural pain-relieving chemicals and reduce inflammation.
On the other hand, the Cyriax Technique is a manual therapy approach involving deep friction massage and gentle mobilizations targeted at the affected nerve area to reduce pressure and pain.
In this study, 80 participants between the ages of 30 and 50 years, who have had low back pain for more than three months and symptoms of nerve entrapment in the thigh, will be randomly divided into two groups. One group will receive Dry Needling therapy, and the other will receive Cyriax treatment. Both groups will also receive standard physiotherapy, including heat therapy, muscle stimulation, and stretching exercises. Treatment will continue for 8 weeks (2 sessions per week).
The aim is to evaluate and compare changes in pain, tingling/numbness (paraesthesia), and daily life functioning using recognized clinical tools such as the Visual Analogue Scale (VAS), Neuropathic Pain Symptom Inventory (NPSI), and the Roland-Morris Disability Questionnaire (RMDQ). Data will be collected at the beginning, and then again after 2, 4, and 8 weeks.
This research will help determine which therapy-Dry Needling or Cyriax-is more effective in treating patients with this type of nerve-related back and thigh pain. The findings may guide physiotherapists and healthcare providers in choosing the most suitable treatment for managing meralgia paresthetica in chronic low back pain.
Read the detailed description
Chronic low back pain (CLBP) with radiating symptoms to the anterolateral thigh, often due to meralgia paresthetica (MP), represents a complex clinical presentation with both musculoskeletal and neuropathic components. MP results from entrapment or irritation of the lateral femoral cutaneous nerve (LFCN), leading to symptoms such as numbness, tingling, burning sensations, and pain in the outer thigh. These symptoms can significantly impair quality of life and physical functioning.
This randomized controlled trial aims to compare two physiotherapeutic interventions-Dry Needling (DN) and the Cyriax Technique-with respect to their impact on pain relief, reduction of paraesthesia, and improvement in functional disability among patients with MP secondary to CLBP.
Participants will be screened based on strict inclusion and exclusion criteria. Eligible participants will be adults aged 30-50 years, diagnosed with CLBP lasting more than three months and exhibiting characteristic symptoms of MP. Exclusion criteria include prior spinal surgery, coagulopathies, serious neurological disorders, or contraindications to dry needling.
After obtaining informed consent, participants will be randomly allocated to either the experimental group (DN) or control group (Cyriax) using computer-generated randomization. Both groups will receive 16 treatment sessions over 8 weeks (2 sessions per week), in addition to standard physiotherapy consisting of heat therapy, electrical muscle stimulation, and targeted exercises.
The dry needling group will receive intramuscular stimulation along the anatomical route of the LFCN, targeting muscles including piriformis, psoas major, iliacus, tensor fasciae latae, vastus lateralis, and sartorius. Aseptic technique using solid filiform needles will be followed, with each needle retained in situ for 15 minutes per session.
The Cyriax group will receive deep transverse friction massage along the LFCN pathway, focused around the anterior superior iliac spine (ASIS), with repeated mobilizations aimed at releasing nerve entrapment and relieving local tissue tension.
Blinding will be maintained at the assessor level to reduce bias. Outcomes will be evaluated using standardized tools:
Visual Analogue Scale (VAS) for pain intensity,
Neuropathic Pain Symptom Inventory (NPSI) for paraesthesia,
Roland-Morris Disability Questionnaire (RMDQ) for functional disability.
These assessments will be conducted at baseline, 2nd, 4th, and 8th weeks of the intervention period. The study is powered at 80% with a 95% confidence interval to detect statistically significant between-group differences. Statistical analysis will be performed using SPSS, with ANOVA applied for both intra- and inter-group comparisons.
This trial is expected to provide clinically meaningful insights into which physiotherapy technique yields better therapeutic outcomes in MP associated with chronic low back pain. It will also contribute to evidence-based practice by addressing a gap in the comparative literature for these two commonly used interventions in musculoskeletal and peripheral nerve-related pain management.
- Being tested
- Dry Needling Therapy, Cyriax Technique
- Keywords
- Chronic low back pain, Cyriax technique, Dry needling, Functional disability, Meralgia paresthetica, Neuropathic pain, Paraesthesia, Physiotherapy
- Medical subject headings
- Femoral Neuropathy, Neuralgia, Paresthesia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Dry Needling TherapyBehavioural
Dry needling will be applied along the lateral femoral cutaneous nerve (LFCN) pathway, targeting muscles such as piriformis, iliacus, tensor fascia latae, vastus lateralis, and sartorius. Sterile solid filiform needles (0.25x30mm and 0.30x50mm) will be inserted for 90 seconds to 2 minutes using a cone technique and retained in situ for 15 minutes. Sessions will occur twice weekly for 8 weeks, with standard physiotherapy (hot pack, EMS, and guided stretches) administered alongside.
Cyriax TechniqueBehavioural
The Cyriax technique involves deep friction massage and mobilization of the lateral femoral cutaneous nerve (LFCN) near the anterior superior iliac spine (ASIS). Using the "pinch and roll" and deep pressure technique, therapists will apply sustained pressure along the nerve path in 3-5 repetitions per session, holding each for 10-15 seconds. Sessions will occur twice weekly for 8 weeks, alongside standard physiotherapy modalities and exercises.
| Study group | Role | What they receive |
|---|---|---|
| Dry Needling Group | Experimental | Participants in this group will receive dry needling therapy targeting muscles along the route of the lateral femoral cutaneous nerve (LFCN), including the piriformis, iliacus, tensor fascia latae, vastus lateralis, and sartorius. Each session will involve needle insertion (90 sec-2 mins) with retention for 15 minutes. Sessions will be conducted twice a week for 8 weeks (total 16 sessions). Standard physiotherapy (hot pack, EMS, stretching) will be provided alongside. Receives: Behavioral: Dry Needling Therapy |
| Cyriax Technique Group | Active comparator | Participants in this group will receive the Cyriax technique (deep transverse friction massage and nerve mobilization) applied along the LFCN pathway near the anterior superior iliac spine (ASIS). Each session will involve 3-5 repetitions of mobilization, with 10-15 second holds. Sessions will be conducted twice a week for 8 weeks (total 16 sessions). Standard physiotherapy (hot pack, EMS, stretching) will be provided alongside. Receives: Behavioral: Cyriax Technique |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Pain Intensity Measured by Visual Analogue Scale (VAS)
Pain intensity will be assessed using the Visual Analogue Scale, a 10-cm line ranging from "no pain" to "worst possible pain." Participants will mark their pain level at each assessment point.
Measured: Baseline, 2nd week, 4th week, and 8th week
Change in Paraesthesia Measured by Neuropathic Pain Symptom Inventory (NPSI)
Paraesthesia symptoms including tingling, burning, and numbness will be assessed using the NPSI, a self-report tool evaluating intensity and frequency of neuropathic pain symptoms.
Measured: Baseline, 2nd week, 4th week, and 8th week
Change in Functional Disability Measured by Roland-Morris Disability Questionnaire (RMDQ)
Functional disability will be assessed using the RMDQ, a 24-item self-report questionnaire measuring the impact of low back pain on daily activities. Higher scores indicate greater disability.
Measured: Baseline, 2nd week, 4th week, and 8th week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Jul 2025
- Study start25 Nov 2024
- Primary completion11 Jun 2025
- Study completion19 Jul 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Meralgia ParestheticaStudies of the same condition, open and under way.
- More trials run by University of LahoreThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 80 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Lahore
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Faisal Javaid, University of Lahore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07089472
- Sponsor's protocol ID
- Rec-UOL-/504/08/24
- Status last verified
- Jul 2025
- First submitted
- 20 Jul 2025
- Last updated
- 28 Jul 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
de Ruiter GCW, Oosterhuis JWA, Vissers TFH, Kloet A. Unusual causes for meralgia paresthetica: systematic review of the literature and single center experience. Neurosurg Rev. 2023 May 6;46(1):107. doi: 10.1007/s10143-023-02023-2.
PubMed 37148363
Study at a glance
From the registry record, last updated by the sponsor on 28 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Dry Needling Versus Cyriax Technique on Pain, Paraesthesia and Functional Disability in Patients With Chronic Low Back Pain
- ClinicalTrials.gov ID
- NCT07089472
- Acronym / sponsor ID
- Rec-UOL-/504/08/24
- Keywords
- Chronic low back pain, Cyriax technique, Dry needling, Functional disability, Meralgia paresthetica, Neuropathic pain, Paraesthesia, Physiotherapy
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 80 participants (actual)
- Lead sponsor
- University of LahoreUniversity, hospital or other
- Study start
- 25 Nov 2024 (actual)
- Primary completion
- 11 Jun 2025 (actual)
- Study completion
- 19 Jul 2025 (actual)
- First posted
- 28 Jul 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study is designed to compare the effectiveness of two physiotherapy techniques-Dry Needling and the Cyriax Technique-in people suffering from chronic low back pain (CLBP) that radiates to the outer thigh, a condition commonly known as meralgia paresthetica.
Meralgia paresthetica occurs when a nerve called the lateral femoral cutaneous nerve (LFCN) gets compressed, leading to pain, numbness, tingling, or burning sensations in the front or side of the thigh. Many patients also experience difficulty in performing daily activities because of these symptoms.
Dry Needling is a modern treatment where fine, sterile needles are inserted into specific muscles to relieve tension and improve nerve function. It is believed to release natural pain-relieving chemicals and reduce inflammation.
On the other hand, the Cyriax Technique is a manual therapy approach involving deep friction massage and gentle mobilizations targeted at the affected nerve area to reduce pressure and pain.
In this study, 80 participants between the ages of 30 and 50 years, who have had low back pain for more than three months and symptoms of nerve entrapment in the thigh, will be randomly divided into two groups. One group will receive Dry Needling therapy, and the other will receive Cyriax treatment. Both groups will also receive standard physiotherapy, including heat therapy, muscle stimulation, and stretching exercises. Treatment will continue for 8 weeks (2 sessions per week).
The aim is to evaluate and compare changes in pain, tingling/numbness (paraesthesia), and daily life functioning using recognized clinical tools such as the Visual Analogue Scale (VAS), Neuropathic Pain Symptom Inventory (NPSI), and the Roland-Morris Disability Questionnaire (RMDQ). Data will be collected at the beginning, and then again after 2, 4, and 8 weeks.
This research will help determine which therapy-Dry Needling or Cyriax-is more effective in treating patients with this type of nerve-related back and thigh pain. The findings may guide physiotherapists and healthcare providers in choosing the most suitable treatment for managing meralgia paresthetica in chronic low back pain.
Detailed description
Chronic low back pain (CLBP) with radiating symptoms to the anterolateral thigh, often due to meralgia paresthetica (MP), represents a complex clinical presentation with both musculoskeletal and neuropathic components. MP results from entrapment or irritation of the lateral femoral cutaneous nerve (LFCN), leading to symptoms such as numbness, tingling, burning sensations, and pain in the outer thigh. These symptoms can significantly impair quality of life and physical functioning.
This randomized controlled trial aims to compare two physiotherapeutic interventions-Dry Needling (DN) and the Cyriax Technique-with respect to their impact on pain relief, reduction of paraesthesia, and improvement in functional disability among patients with MP secondary to CLBP.
Participants will be screened based on strict inclusion and exclusion criteria. Eligible participants will be adults aged 30-50 years, diagnosed with CLBP lasting more than three months and exhibiting characteristic symptoms of MP. Exclusion criteria include prior spinal surgery, coagulopathies, serious neurological disorders, or contraindications to dry needling.
After obtaining informed consent, participants will be randomly allocated to either the experimental group (DN) or control group (Cyriax) using computer-generated randomization. Both groups will receive 16 treatment sessions over 8 weeks (2 sessions per week), in addition to standard physiotherapy consisting of heat therapy, electrical muscle stimulation, and targeted exercises.
The dry needling group will receive intramuscular stimulation along the anatomical route of the LFCN, targeting muscles including piriformis, psoas major, iliacus, tensor fasciae latae, vastus lateralis, and sartorius. Aseptic technique using solid filiform needles will be followed, with each needle retained in situ for 15 minutes per session.
The Cyriax group will receive deep transverse friction massage along the LFCN pathway, focused around the anterior superior iliac spine (ASIS), with repeated mobilizations aimed at releasing nerve entrapment and relieving local tissue tension.
Blinding will be maintained at the assessor level to reduce bias. Outcomes will be evaluated using standardized tools:
Visual Analogue Scale (VAS) for pain intensity,
Neuropathic Pain Symptom Inventory (NPSI) for paraesthesia,
Roland-Morris Disability Questionnaire (RMDQ) for functional disability.
These assessments will be conducted at baseline, 2nd, 4th, and 8th weeks of the intervention period. The study is powered at 80% with a 95% confidence interval to detect statistically significant between-group differences. Statistical analysis will be performed using SPSS, with ANOVA applied for both intra- and inter-group comparisons.
This trial is expected to provide clinically meaningful insights into which physiotherapy technique yields better therapeutic outcomes in MP associated with chronic low back pain. It will also contribute to evidence-based practice by addressing a gap in the comparative literature for these two commonly used interventions in musculoskeletal and peripheral nerve-related pain management.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Dry Needling Group | Experimental | Behavioral: Dry Needling TherapyParticipants in this group will receive dry needling therapy targeting muscles along the route of the lateral femoral cutaneous nerve (LFCN), including the piriformis, iliacus, tensor fascia latae, vastus lateralis, and sartorius. Each session will involve needle insertion (90 sec-2 mins) with retention for 15 minutes. Sessions will be conducted twice a week for 8 weeks (total 16 sessions). Standard physiotherapy (hot pack, EMS, stretching) will be provided alongside. |
| Cyriax Technique Group | Active comparator | Behavioral: Cyriax TechniqueParticipants in this group will receive the Cyriax technique (deep transverse friction massage and nerve mobilization) applied along the LFCN pathway near the anterior superior iliac spine (ASIS). Each session will involve 3-5 repetitions of mobilization, with 10-15 second holds. Sessions will be conducted twice a week for 8 weeks (total 16 sessions). Standard physiotherapy (hot pack, EMS, stretching) will be provided alongside. |
Who may qualify
- Ages
- 30 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Diagnosed with chronic low back pain (time to onset ≥ 3 months) (Erbay, 2002).
- Roland Morris Disability Questionnaire score ≥ 4 (Lara-Palomo et al., 2022).
- CLBP radiating to Anterolateral thigh with symptoms of numbness tingling (de Ruiter et al., 2023).
Key exclusion criteria (3 listed)
- Patients with sensory and/or coagulation disorders (Lara-Palomo et al., 2022).
- A history of spinal surgery, heart complications, concurrent severe central or peripheral nervous system disease (de Ruiter et al., 2023).
- Epilepsy, needle phobia, serious pathologies that can be the main cause of chronic low back pain other than meralgia parasthetica (Lara-Palomo et al., 2022).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Dry Needling TherapyDry needling will be applied along the lateral femoral cutaneous nerve (LFCN) pathway, targeting muscles such as piriformis, iliacus, tensor fascia latae, vastus lateralis, and sartorius. Sterile solid filiform needles (0.25x30mm and 0.30x50mm) will be inserted for 90 seconds to 2 minutes using a cone technique and retained in situ for 15 minutes. Sessions will occur twice weekly for 8 weeks, with standard physiotherapy (hot pack, EMS, and guided stretches) administered alongside. | Behavioural | Dry Needling Group |
| Cyriax TechniqueThe Cyriax technique involves deep friction massage and mobilization of the lateral femoral cutaneous nerve (LFCN) near the anterior superior iliac spine (ASIS). Using the "pinch and roll" and deep pressure technique, therapists will apply sustained pressure along the nerve path in 3-5 repetitions per session, holding each for 10-15 seconds. Sessions will occur twice weekly for 8 weeks, alongside standard physiotherapy modalities and exercises. | Behavioural | Cyriax Technique Group |
Primary outcome
Change in Pain Intensity Measured by Visual Analogue Scale (VAS)
Time frame: Baseline, 2nd week, 4th week, and 8th week
Pain intensity will be assessed using the Visual Analogue Scale, a 10-cm line ranging from "no pain" to "worst possible pain." Participants will mark their pain level at each assessment point.
Change in Paraesthesia Measured by Neuropathic Pain Symptom Inventory (NPSI)
Time frame: Baseline, 2nd week, 4th week, and 8th week
Paraesthesia symptoms including tingling, burning, and numbness will be assessed using the NPSI, a self-report tool evaluating intensity and frequency of neuropathic pain symptoms.
Change in Functional Disability Measured by Roland-Morris Disability Questionnaire (RMDQ)
Time frame: Baseline, 2nd week, 4th week, and 8th week
Functional disability will be assessed using the RMDQ, a 24-item self-report questionnaire measuring the impact of low back pain on daily activities. Higher scores indicate greater disability.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Jul 2025.
- Background: PubMed 37148363de Ruiter GCW, Oosterhuis JWA, Vissers TFH, Kloet A. Unusual causes for meralgia paresthetica: systematic review of the literature and single center experience. Neurosurg Rev. 2023 May 6;46(1):107. doi: 10.1007/s10143-023-02023-2.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Dry Needling Therapy and Cyriax Technique in people with Meralgia Paresthetica and Chronic Low-back Pain (cLBP), run by University of Lahore at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 28 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Pain Intensity Measured by Visual Analogue Scale (VAS) (time frame: Baseline, 2nd week, 4th week, and 8th week). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07089472, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jul 2025.