Cluneal nerve entrapment: case report




Reid, Payton

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Angelo State University. Department of Physical Therapy.


Abstract Background and Purpose:  The superior cluneal nerve branches from the T11-L5 nerve roots and travels inferolaterally. It pierces through the thoracolumbar fascia just above the iliac crest where it becomes superficial to supply cutaneous sensation over the buttocks along the iliac crest. The superior cluneal nerve can become compressed at several locations, including the vertebral facets, the thoracolumbar fascia, and the gluteus medius muscle. Cluneal nerve entrapment is a lesser known cause of low back pain. This case report details the physical therapy treatment for a patient suffering from cluneal nerve entrapment. Case Description: The patient is a 69-year-old female who has suffered from low back and gluteal pain for years. The patient underwent right hemi-laminectomy. Her symptoms did minimally improve after surgery, but pain persisted. Patient reported to physical therapy 6 weeks after surgery with a goal of strengthening the core in order to reduce pain. Patient demonstrated decreased strength of abdominals and gluteals, increased tension of the hip musculature, and taut bands in the glute medius and piriformis. Patient was sensitive to palpation just inferior to iliac crest. Patient’s symptoms were consistent with cluneal nerve entrapment. Primary interventions included stretching and strengthening of the hip musculature. Outcomes: Overall, the patient demonstrated a positive response to treatment interventions after first week. The patient’s improvement in symptoms were consistent to findings in initial evaluation. Discussion: The patient presented with symptoms consisted with cluneal nerve entrapment, which is a diagnosis that is important to consider in order to better understand prognosis and clinical presentation. However, simply addressing and treating the impairments found in the evaluation might also have been sufficient to see patient improvement.



Superior cluneal nerve, cluneal nerve entrapment, low back pain, gluteal pain.