Cluneal neuropathy: Background, diagnosis, and treatment

Pain Pract. 2023 Apr;23(4):437-446. doi: 10.1111/papr.13199. Epub 2022 Dec 28.


Background and aims: Cluneal neuropathy is encompassed by three distinct clinical entities. Superior, middle, and inferior cluneal neuralgia make up the constellation of symptoms associated with cluneal neuropathy. Each has its own variable anatomy.

Materials and methods: We compiled a narrative review including a review of available literature. We conducted searches on PubMed/MEDLINE, Embase and Google Scholar on the topics of cluneal neuropathy and treatment therein.

Results: We collected source articles regarding original descriptions of the disease entities in addition to articles focused on treatment.

Discussion: Adjusted incidence rates of superior cluneal neuropathy are 1.6%-11.7%. Accurate diagnosis remains challenging due to the lack of standardized criteria and the aforementioned variability. Treatment may include therapeutic nerve blocks, ablative techniques, neuromodulation, and surgical decompression. Gaps including those related to true incidence and work up exist. Outcomes from interventional studies are limited and mixed due to significant population heterogeneity and non-standardized treatment approaches coupled with very small sample sizes.

Keywords: Cluneal; buttock pain; low back pain; neuropathy.

Publication types

  • Review

MeSH terms

  • Buttocks / innervation
  • Buttocks / surgery
  • Decompression, Surgical
  • Humans
  • Nerve Block* / methods
  • Nerve Compression Syndromes* / complications
  • Neuralgia* / surgery