We’ve known of 3 common nerves since 1957 that help 80% of people with low back pain! They’re called your cluneal nerves. The problem is most doctors just don’t learn about them and don’t have any tools to treat them. In my clinic in Tampa, FL I treat cluneal nerves with perineural injections, dry needling and electro-acupuncture every single day.
In about 80% of people with low back pain, the pain is considered “non-specific”. That means it doesn’t come from herniated discs, irritated facet joints, or any other commonly seen structure on an MRI. This also means most doctors, including the orthopedic surgeon you probably saw, have NO CLUE how to treat it. So they end up passing you off to physical therapy, giving you steroid packs and muscle relaxers, shooting cortisone shots (check out this article on why that’s a bad idea) and ultimately not doing much for your pain.
What are the Cluneal Nerves?
The superior and the middle cluneal nerves (SCN and MCN) are cutaneous nerves that are purely sensory. They dominate sensation in the lumbar area and the butt, and get get irritated and entrapped around the area of your hip bone in your low back. This nerve irritation can cause your low back pain.
When these nerves get irritated, they can even radiate and produce leg symptoms in ~80% of low back pain patients. When these nerves are irritated, pain is exacerbated by lumbar movements, and the symptoms mimic radiculopathy.
The Superior Cluneal Nerve is a common cause of low back and glute pain
The Middle Cluneal Nerve is a common cause of pain around your SI joint area.
How Can Nerves Get Injured?
A nerve is made up of a few key components. One is the axons, which are like wires that send impulses in a nerve. Another is the covering of the nerve called the myelin sheath, which is like the insulating cover of a wire. A nerve also has a blood supply, which feeds the cells.
A nerve can be cut or compressed. When cut, growing back the connection of the axons can be tough. More commonly is a nerve injury due to compression. This means that something presses on the nerve. This reduces the blood supply, leads to inflammation, irritation and even scarring of the nerve. Think of kinking a hose – the water supply gets slowed down. Same thing happens if you kink a nerve, the blood supply and nutrient supply gets slowed down and the nerve gets sick. An unhealthy nerve doesn’t work so well. So numbness, tingling, and/or weakness may be the result. Other things can happen too, such as muscles that don’t move well against each other, due to nerve supplies being scarred.
How Can You Treat Irritated Cluneal Nerves?
To help this problem, we first carefully map out the course of the nerve using advanced knowledge of anatomy and very refined Palpation skill. I like to say my hands cost more money than most MRI machines because of the years of experience I have palpating over 30,000 treatments. Once we’ve mapped out the nerves and found the sites along them that are irritated we will use a number of advanced needling techniques to precisely treat each specific nerve and muscle affected. This may include an advanced electro-acupuncture and dry needling technique (I call it acupuncture 2.0), something that your average physical therapist dry needler has never even seen done. Or we may use a Perineural Injection of a 5% dextrose solution to bathe the irritated nerves in a solution that helps to calm them down and essentially feed them which in turns restores their proper function.
Cindi’s Cluneal Nerve Treatment Outcome
Cindi received three treatments with Dr. Hanson in Tampa, Fl using this precise and targeted treatment strategy which included a combination of Perineural Injections and Advanced Neurofunctional Acupuncture to treat her irritated cluneal nerves. She has had an excellent response and her pain levels dropped from a constant 9 out of 10 to a 1-2 after a lot of activity. All in all she essential has no pain most of the day and only a little nag after high intensity training. So a huge win!
The Next Step
The cluneal nerves are a common source of nagging pain in the low back and around the SI joint. Unfortunately most doctors have never heard of them and don’t have the right tools to treat them. The good news is that Dr. Hanson in Tampa, FL has treated literally 500+ cluneal nerves with Perineural Injections and Advanced Neurofunctional Acupuncture & Dry Needling. If you’re dealing with a nagging back pain or SI joint pain that isn’t responding well to the standard treatments of physical therapy, steroid packs, cortisone injections then it’s time to take a different approach.
