Skip to main content
. 2022 Oct 31;27(1):5–14. doi: 10.1007/s10029-022-02693-9

Table 2.

Evidence table of non-surgical management options of CPIP

Intervention type Author Year N =  Study design Conclusion Comment
Pharmacological topical therapy
 Lidocaine patch (5%) Bischoff [21] 2013 21 Randomized, double-blind, placebo-controlled, crossover trial: lidocaine patch (5%) versus placebo patch No difference in summed pain intensity differences between lidocaine and placebo patch treatments in all patients Small-volume study
 Capsaicin patch Bischoff [22] 2014 46 Randomized, double-blind, placebo-controlled, crossover trial: capsaicin 8% patch versus placebo patch No statistically significant benefit of the capsaicin patch, although there was a trend toward less pain in the capsaicin group at one month Small-volume study. Only one month follow-up
Pharmacological systemic therapy
 Paracetamol, NSAID and gabapentinoid No evidence
Interventions
Nerve blocks and trigger point infiltrations
  Ultrasound-guided nerve block Voorbrood [23] 2015 28 Prospective study Permanent pain reduction was achieved in 18 of 28 (62%) patients with neuropathic pain
  Ultrasound-guided nerve block Bischoff [24] 2012 12 Randomized, double-blind, placebo-controlled, crossover trial: lidocaine versus placebo 1 lidocaine responder, 6 non-responders, and 5 placebo responders. Ultrasound-guided ilioinguinal nerve and iliohypogastric nerve blocks did not produce pain relief It is not clear from the study what percentage of patients had improperly-placed nerve blocks despite ultrasound guidance
  Ultrasound-guided or nerve stimulator-guided nerve block Thomassen [25] 2013 43 Retrospective study Thirty-two percent of the patients were relieved of moderate-to-severe pain and nerve blocks 21 patients (55.3%) no longer reported neuropathic pain Ilioinguinal/iliohypogastric nerve blocks can be effective to treat chronic inguinal pain following surgery of the groin Nerve stimulator-guided blocks were performed prior to January 2009, and thereafter, ultrasound-guided blocks
  Ultrasound-guided or landmark-based nerve block Trainor [26] 2015 36 Retrospective study 14 patients (70%) in the landmark-based and 11 patients (79%) in the ultrasound-guided groups experienced at least a 50% reduction in VAS scores (p = 1.0) Small-volume study. No information on follow-up
  Ultrasound-guided tender point blockade Wijaya-Singhe [29] 2016 14 Randomized, double-blind, placebo-controlled, crossover trial: bupivacaine 0.25% versus placebo Median pain reduction of 63% (44.1 to 73.6%) after bupivacaine compared with 36% (11.6 to 49.7%; p = 0.003) after placebo Small-volume study. Short follow-up of 14 days. No difference in movement related pain, summed pain intensity scores, or sleep quality scores
  Tender point infiltration (TPI) Verhagen [10] 2018 54 Randomized controlled trial: tender point infiltration versus neurectomy TPI was successful in 6 patients (22%), a neurectomy was successful in 17 patients (71%). After unsuccessful TPI, 19 patients crossed over to neurectomy and their median VAS score dropped from 60 to 14 (p = 0.001). A step-up treatment strategy starting with tender point infiltration followed by a tailored neurectomy is advised Although neurectomy seems superior in this trial, minimally invasive techniques are preferred in a step-based approach
  CT-guided nerve block Parris [27] 2010 1 Case-report CT-guided transpsoas genitofemoral nerve block is a viable option for safely and selectively blocking the genitofemoral nerve for diagnostic or therapeutic purposes Case-report
  CT-guided peri-neural injections Poh [28] 2019 58 Retrospective study Improvement was seen in 84% of the cases Non-controlled, non-randomized study design and unclear duration of effect
Neuroablative techniques and stimulation techniques
 Cryoablation Fanelli [30] 2003 10 Case series 77.5% mean overall pain reduction, average follow-up period of eight months Small-volume study. Short follow-up
 Peripheral nerve stimulation Shaw [31] 2016 6 Retrospective study Average improvement of 62% in the immediate post-operative follow-up. Eighty-five percent patients were completely satisfied with an average follow-up of 22 months Small-volume study. Non-controlled, non-randomized study design
 US-guided microwave ablation Lee [32] 2019 10 Retrospective study Immediate pain reduction in 92% of the subjects, and 69% pain reduction at 12 months follow-up. The average duration of clinically significant pain reduction was 10.5 months Small-volume study. Non-controlled, non-randomized study design
 Dorsal Root Gang-lion Stimulation Schu [33] 2014 12 Case series Mean VAS reduction of 76.8% ± 8.2%, pain relief in 10 (83%) patients, follow-up period of 17.4 ± 5.7 weeks Small-volume study with various etiologies of groin pain. Short follow-up
 Spinal Cord Stimulation Yakovlev [34] 2010 15 Case series Pain relief of > 75% and reduced pain medication intake, follow-up period of 12 months Small-volume study
Other therapies
 Physical therapy, psychotherapy, hypnosis, behavioural therapy, biofeedback, acupuncture, mind–body therapy No evidence