Superior Cluneal Nerve Entrapment—Possible Pain Generator in Low Back Pain

Abstract

High number of patients coming to pain clinic complain of low back pain (LBP) and this puts the pain physician in lot of diagnostic predicament. Consideration of common reasons from myofascial pain generator to rarer like cluneal nerve entrapment requires updating of knowledge regarding various rare pain generators in the back region. The cutaneous branches of cluneal nerve, namely, superior and middle are purely sensory. They provide sensation in the lumbar region and the buttocks, and their impingement around the iliac crest can cause LBP radiating to lower limb. Diagnosing uncommon cause for LBP owing to superior cluneal nerve impingement becomes a challenging task due to the absence of any diagnostic criteria apart from the high-index suspicion based on clinical findings and ruling out other common causes of LBP. It is usually misdiagnosed as a lumbar spine disorder. Here we present a case of chronic low backache with vague symptoms, which was successfully treated with the cluneal nerve block and the diagnosis of cluneal nerve entrapment was confirmed.