Low back pain (LBP) is a common complaint that can be nonspecific. Superior cluneal nerve entrapment should be included in the differential for LBP because, without a precise diagnosis, treatment may be less effective. A 61-year-old female with a history of chronic LBP and sacroiliac (SI) pain requiring opioids for pain control presented with minimal relief following SI joint fusion. Physical exam showed tenderness over the iliac crest with burning, radicular pain into the buttock. The patient received a superior cluneal nerve injection of local anesthetic that provided 100% pain relief for 72 hours without the use of opioids and no complaints of burning or radicular pain. This confirmed the diagnosis of superior cluneal nerve entrapment syndrome causing superior cluneal neuralgia. Superior cluneal nerve entrapment syndrome should be considered when evaluating causes of LBP to avoid unnecessary procedures and reduce the use of opioids.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10462381 | PMC |
http://dx.doi.org/10.7759/cureus.44271 | DOI Listing |
Pain Physician
November 2024
Norman J. Dozier Pain Management, Abilene, Texas.
Background: Low back pain is a highly prevalent condition with substantial costs. Superior cluneal neuralgia is present in up to 14% of low back pain cases. This etiology of back pain is often overlooked because the symptoms of superior cluneal neuralgia manifest similarly to those of other conditions, such as radiculopathy and sacroiliac joint pain.
View Article and Find Full Text PDFCardiovasc Intervent Radiol
January 2025
David Grant USAF Medical Center, Travis AFB, Fairfield, CA, USA.
Interv Pain Med
December 2024
Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark.
Interv Pain Med
September 2024
Department of Anesthesiology, University of Miami, Miami, FL, USA.
Previous authors have described the anatomy of the superior cluneal nerves with medial, intermediate, and lateral branches as they pass over the iliac crest. Prior authors describe a technique for radiofrequency of the superior cluneal nerves with needle placement walking off of the superior border of the iliac crest with needle redirection by sensory testing and a monopolar radiofrequency lesion. This is a case report of a patient with sustained pain relief after performing a radiofrequency ablation of the superior cluneal nerves utilizing a bipolar palisade technique.
View Article and Find Full Text PDFInterv Pain Med
September 2024
Anesthesiology and Reanimation, Colombia.
Introduction: Chronic low back pain is a highly prevalent condition with multiple etiologies. Cluneal nerve neuropathy is an increasingly relevant condition in the management of this condition, and radiofrequency is an alternative management option.
Methods: A case series, which included four patients who underwent ultrasound-guided conventional radiofrequency intervention of the superior cluneal nerves, using a previously undescribed technique and direction of intervention.
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