Cluneal Nerve: Cutaneous Nerve Branch, Anatomy and it’s Dysfunction

The superior cluneal and middle cluneal nerves are some of the misdiagnosed entrapped nerves in the lumbar spine. The relationship between the cluneal nerve and LBP (low back pain) has been well established in several areas of research that identify common areas of entrapment causing typical nerve pathologic features such as ischemia (lack of blood flow) and pain when compressed or palpated.

The two main branches of cluneal nerves that identify the relationship between the cluneal nerve and LBP are the superior cluneal nerve, the middle cluneal nerves.

Cluneal Nerve: Cutaneous Nerve Branch, Anatomy and it’s Dysfunction

The Superior cluneal is located more superior (on top) along the iliac crest, and it a common area of entrapment and low back pain. Pain of these branches of the cluneal nerve are generally associated with standing and arching the back due to the L1-3 nerve roots origination.

The middle cutaneous branch are located over the sacrum and over the gluteus maximus. Entrapment of this nerve is often confused for SI joint pain. If you lightly rub the skin over the top of your sacrum and it’s painful then that’s most likely cluneal nerve pain rather that the SI joint.

Cluneal Nerve Entrapment Symptoms

  • Low pain associated with iliac crest tenderness.
  • Upper buttocks pain during lumbar extension related activities (bending backwards) and standing
  • Skin of low back and gluteal region hypersensitive to skin rolling or compression
  • Common source of low back pain in pregnant women due to the overly extended lumbar spine caused by the enlarged abdomen.

Treatment

  • Skin rolling along the nerves path
  • Cluneal nerve stretches
  • Core exercises that limit lumbar extension

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