Medial Cluneal Nerve Block

Medial cluneal nerve blocks are used to treat persistent pain brought on by middle cluneal nerves.
This may be the best option for someone with chronic pain in the cluneal nerve region after failure conservative management

Relevant Anatomy

Arise from the posterior ramus of the sacral nerve roots S1-4

MCN Criteria

Lower back pain to the Buttocks
Symptoms exacerbated by lumbar puncture or posture
Trigger point 35 mm caudal to the PSIS and lateral to the edge of the iliac crest (corr. to nerve compression zone)
Numbness and radiating pain in the MCN area when trigger point compressed (tinel’s)
Relief with MCN Block
- Isu T, Kim K, Morimoto D, Iwamoto N. Superior and Middle Cluneal Nerve Entrapment as a Cause of Low Back Pain. Neurospine. 2018;15(1):25–32. doi:10.14245/ns.1836024.012

Posterior Longitudinal Sacroiliac Joint Ligament

Articles on Cluneal Nerve Blocks

"Superior and Middle Cluneal Nerve Entrapment as a Cause of Low Back Pain"
- Isu T, Kim K, Morimoto D, Iwamoto N. Superior and Middle Cluneal Nerve Entrapment as a Cause of Low Back Pain. Neurospine. 2018 Mar;15(1):25-32. doi: 10.14245/ns.1836024.012. Epub 2018 Mar 28. PMID: 29656623; PMCID: PMC5944640.
"The cluneal nerve syndrome; a distinct type of low back pain"
- STRONG EK, DAVILA JC. The cluneal nerve syndrome; a distinct type of low back pain. Ind Med Surg. 1957 Sep;26(9):417-29. PMID: 13462591.
"Middle cluneal nerve entrapment neuropathy attributable to lumbar disc herniation"
- Matsumoto J, Isu T, Kim K, Miki K, Isobe M. Middle cluneal nerve entrapment neuropathy attributable to lumbar disc herniation. Surg Neurol Int. 2021 Mar 30;12:132. doi: 10.25259/SNI_167_2021. PMID: 33880237; PMCID: PMC8053461.
"Anatomical study of middle cluneal nerve entrapment"
- Konno T, Aota Y, Saito T, Qu N, Hayashi S, Kawata S, Itoh M. Anatomical study of middle cluneal nerve entrapment. J Pain Res. 2017 Jun 13;10:1431-1435. doi: 10.2147/JPR.S135382. PMID: 28652809; PMCID: PMC5476578.
"Entrapment neuropathy of the medial superior cluneal nerve. Nineteen cases surgically treated, with a minimum of 2 years' follow-up"
- Maigne JY, Doursounian L. Entrapment neuropathy of the medial superior cluneal nerve. Nineteen cases surgically treated, with a minimum of 2 years' follow-up. Spine (Phila Pa 1976). 1997 May 15;22(10):1156-9. doi: 10.1097/00007632-199705150-00017. PMID: 9160476.

References

and Interesting Articles

Isu T, Kim K, Morimoto D, Iwamoto N. Superior and Middle Cluneal Nerve Entrapment as a Cause of Low Back Pain. Neurospine. 2018 Mar;15(1):25-32. doi: 10.14245/ns.1836024.012. Epub 2018 Mar 28. PMID: 29656623; PMCID: PMC5944640.
Maigne JY, Doursounian L. Entrapment neuropathy of the medial superior cluneal nerve. Nineteen cases surgically treated, with a minimum of 2 years' follow-up. Spine (Phila Pa 1976). 1997 May 15;22(10):1156-9. doi: 10.1097/00007632-199705150-00017. PMID: 9160476.
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 Rehabil. 2022 Jun 1;68(2):300-305. doi: 10.5606/tftrd.2022.6550. PMID: 35989956; PMCID: PMC9366497.
Anderson D, Szarvas D, Koontz C, Hebert J, Li N, Hasoon J, Viswanath O, Kaye AD, Urits I. A Comprehensive Review of Cluneal Neuralgia as a Cause of Lower Back Pain. Orthop Rev (Pavia). 2022 May 31;14(4):35505. doi: 10.52965/001c.35505. PMID: 35769655; PMCID: PMC9235435.

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