Treatment of Low Back Pain Elicited by Middle Cluneal Neuralgia: Case Report and Literature Review of Interventional Treatments

Authors

• Colton Reeh
• Royce Copeland
• Loc Lam
• Christian Vangeison
• Andrea M Trescot
• Emanuel Narcis Husu

Language

English

Publication Date

9-1-2023

Journal

Pain Medicine Case Reports

PMID

40929583

Abstract

Background: Cluneal neuralgia is increasingly becoming recognized as an etiology of low back pain. The majority of the literature on cluneal nerve interventions describes modalities targeting the superior cluneal nerves with little emphasis on the middle cluneal nerves.

Case report: A 21-year-old woman with a medical history of congenital myelomeningocele with tethered cord at L5-S1, status post 3 decompressive releases, presented to the clinic with chronic low back pain and associated sacroiliac paresthesia. Over 11 months, she underwent 7 ultrasound-guided bilateral middle cluneal nerve blocks, without corticosteroid, resulting in significant, immediate pain relief sustained for 4 to 6 weeks.

Conclusions: A nerve block with local anesthetic has proven to be therapeutic for middle cluneal neuralgia, but with varying long-term efficacy. The use of radiofrequency ablation, peripheral nerve stimulation, regenerative medicine, and alcohol neurolysis have shown promise as long-term therapeutic options and as a substitute for invasive surgical release.

Keywords

Alcohol neurolysis, cluneal nerve block, middle cluneal neuralgia, peripheral nerve stimulation, prolotherapy, radiofrequency ablation, tethered cord

Published Open-Access

yes

Recommended Citation

Reeh, Colton; Copeland, Royce; Lam, Loc; et al., "Treatment of Low Back Pain Elicited by Middle Cluneal Neuralgia: Case Report and Literature Review of Interventional Treatments" (2023). Faculty, Staff and Students Publications. 7782.
https://digitalcommons.library.tmc.edu/baylor_docs/7782