Relevant Anatomy

Inferior Cluneal Nerve

  • The skin of the bottom region of the buttocks is innervated by the inferior cluneal nerves. 
  • The posterior cutaneous nerve of the thigh gives rise to them as branches

Inferior Cluneal Nerves

  • The sensory branches of S1-3 give rise to the posterior femoral cutaneous nerve of the thigh (PFCN), which in turn gives rise to the inferior cluneal nerves (ICN).
  • Along with the sciatic and pudendal nerves, the PFCN travels via the sciatic notch. 
  • It divides into the inferior cluneal and perineal branches in the subgluteal area. 
  • The nerves wind repeatedly around the gluteus maximus' inferior edge. 
  • The lateral anal region, lateral labia majora, and inferior region of the buttocks are all innervated by it.

Inferior Cluneal Nerve Block

  • Pain in the lower back, buttocks, and pelvic ring can be treated using x-ray or ultrasound guided injections known as cluneal nerve blocks. 
  • The nerves that lay on top of the pelvis and buttock are known as the cluneal nerves. 
  • These nerves may get entangled in muscle tissue and cause trigger points.

Indications

  • Chronic lower back pain
  • Cluneal nerve entrapment
  • Gluteal pain

Complications

Complications that could happen include bleeding, infections, paresthesias, and the potential for a nerve to be punctured during the needle insertion.

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References

and Interesting Articles

  • Darnis, B., Robert, R., Labat, J.J. et al. Perineal pain and inferior cluneal nerves: anatomy and surgery. Surg Radiol Anat 30, 177–183 (2008). https://doi.org/10.1007/s00276-008-0306-9
  • Jottard K, Bonnet P, Thill V, Ploteau S, de Wachter S. Diagnosis and treatment of pudendal and inferior cluneal nerve entrapment syndrome: a narrative review. Acta Chir Belg. 2022 Dec;122(6):379-389. doi: 10.1080/00015458.2022.2123138. Epub 2022 Sep 16. PMID: 36074049.
  • Yürük D, Akkaya ÖT, Polat ÖE, Alptekin HA, Köse Güven S. Easy to treat when the diagnosis is made: Three cases of clunealgia and the advantage of ultrasonography.

    Turk J Phys Med Rehab 2022;68(2):300-305.


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