Ultrasound-guided infiltration of the posterior femoral cutaneous nerve: a technical approach for neuropathic pain management

Purpose: To describe a reproducible ultrasound-guided technique for infiltrating the posterior femoral cutaneous nerve (PFCN) in patients with neuropathic pain involving the posterior thigh and gluteal region. Methods: High-resolution ultrasound was used to identify the PFCN along its superficial course over the long head of the biceps femoris muscle. Under sterile conditions, a perineural injection was performed using an in-plane approach. Hydrodissection with saline was employed to confirm needle placement. A local anaesthetic, with or without corticosteroids, was administered. Results: The PFCN was reliably visualised in all procedures, and the targeted infiltration was successfully performed in each case. Patients experienced immediate partial pain relief, and no adverse events were reported. The technique proved feasible, safe, and reproducible in clinical practice. Conclusion: Ultrasound-guided infiltration of the PFCN is a precise and minimally invasive approach for managing neuropathic pain in the posterior thigh. It enables accurate nerve targeting and provides both diagnostic confirmation and therapeutic benefit. This technique may reduce reliance on systemic medications and guide further management in complex pain syndromes. Additional studies are needed to evaluate long-term outcomes and confirm clinical efficacy.