The condition known as cluneal nerve entrapment can often be difficult to diagnose. As a result, many people who suffer from lower back or upper buttocks pain have undergone a variety of treatments that fail to alleviate the pain. That’s why we are here to inform you of what the condition is and how you can seek more effective treatment.
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What is Cluneal Nerve Entrapment?
The cluneal nerves, also known as gluteal cutaneous nerves, are located in the lumbar spine: the lower back and pelvic region. The nerve is divided into three—Superior Cluneal Nerve (SCN), Middle Cluneal Nerve (MCN), and Inferior Cluneal Nerve (ICN).
Cluneal nerve entrapment is a condition where the cluneal nerves become entrapped or irritated within the buttocks area, causing lower back and/or leg pain. The entrapment of your cluneal nerve is similar to the entrapment of the median nerve that occurs in carpal tunnel syndrome. The pain you experience generally gets worse when you are active and may subside with rest.
Cluneal nerve entrapment is often underdiagnosed as the cause of lower back pain. Here are two ways to diagnose:
Physical Exam
If you are experiencing lower back and upper buttocks pain, your doctor may do a physical exam to
- Check for pain levels when sitting for extended periods of time
- Check for tenderness along certain trigger points around the lower back and buttocks
- Check for any history of lower back pain and upper buttocks pain
Imaging
- Ultrasound
- X-Ray and MRI (useful in ruling out other causes of low back/leg pain).
- CT SCAN
Cluneal Nerve Entrapment Treatment Options
One of the treatment options is non-invasive therapy, including non-scheduled medications, physical and chiropractic therapy, and acupuncture. Another treatment for cluneal nerve entrapment is injecting local anesthetic on top of the iliac crest. Injections can be performed using landmarks, ultrasound, or fluoroscopic guidance to help confirm proper needle placement. Cryoablations is another form of treatment that uses the aseptic technique to inject a small amount of local anesthetic using a needle; this option often uses the same guidance methods as the injection method. Finally, peripheral nerve stimulation can be used for treatment. This is a stimulator placed across the iliac crest to relieve pain.
Although cluneal nerve entrapment is a relatively rare cause of low back pain, it is still under-recognized and therefore not treated. If you want to learn more about cluneal nerve entrapment and treatments, contact us today!
