Superior Cluneal Nerve Block

Most patients with symptoms of persistent pain in the back and buttocks can be managed with cluneal nerve blocks.

 Given that it can both alleviate pain and determine the true source of the back discomfort, it can also be utilized as a diagnostic technique.

Diagnosis of SCN

  • Low back pain involving the iliac crest and buttocks
  • Symptoms aggravated by lumbar movement or posture
  • Trigger point over the posterior iliac crest corresponding to the nerve compression zone
  • Patients report numbness and radiating pain in the SCN area (Tinel sign) when the trigger point is compressed.
  • Symptom relief by SCN block at the trigger point

SCN Diagnostic Criteria

  • LBP to the Iliac Crest and Buttocks
  • Symptoms exacerbated by lumbar puncture or posture
  • Trigger point over the PSIS  (corr. to nerve compression zone)
  • Numbness and radiating pain in the SCN area when trigger point compressed (tinel’s)
  • Relief with SCN 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

Superior Cluneal Nerve

Dismissed as a:

  • Gluteal Trigger Point
  • Sacroiliac Joint Pain
  • Gluteal Trigger Point
  • Facet Pain

Superior Cluneal Nerve Block

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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.
  • Herring A, Price D, Nagdev A, Simon B. Superior cluneal nerve block for treatment of buttock abcesses in the emergency department. 2009;39(1):83-85.
  • Talu G, Suleyman O, talu U. Supeior cluneal nerve entrapment. Regional Anesthesia and Pain Medicine. 2000;25(6):648-650.
  • Aota Y. Entrapment of middle cluneal nerves as an unknown cause of low back pain. World Journal of Orthopedics. 2016;7(3):167-170.


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