The superior cluneal nerves are small sensory nerves that start at the bottom of the spine (between T11 and L5) and pass over the iliac crest, toward the top of the buttocks. In some people, these nerves can become trapped as they pass through the muscle fascia, causing chronic pain in the lower back and buttocks. This type of pain does not follow the classic pathway of a sciatic or lumbar nerve, and is often not seen on radiological examinations.
What are the symptoms?
- Pain located above the iliac crest, often about 7–8 cm from the midline.
- Pain that worsens with movements such as standing, walking, or twisting the torso.
- Pain with “nervous” characteristics, such as burning or tingling.
How is the diagnosis made?
The diagnosis is based on a thorough examination and nerve point stimulation testing. A diagnostic block (anesthetic injection) of the cluneal nerves is often performed. If the pain improves after this injection, it is very likely that the cluneal nerves are the cause of the pain.
What is radiofrequency?
Radiofrequency is a minimally invasive technique that involves applying controlled heat through a special needle directly to the nerve causing the pain. The goal is to safely “deactivate” the nerve’s transmission of pain.
How is the treatment carried out?
- It is performed under ultrasound or X-ray guidance for maximum precision.
- Thin needles are used and strategically placed along the iliac crest.
- After confirming the position, heat (approximately 80°C) is applied for 90–120 seconds.
What are the results?
According to studies:
- Most patients experience a 50% to 90% improvement in pain.
- Benefits can last for months (up to a year or longer).
- No significant side effects have been observed.
- Patients also often report improved functionality in their daily lives.
Who is this therapy suitable for?
- People with chronic lower back/buttock pain that does not respond to medication or physical therapy.
- Patients who have had a good response to a diagnostic block of the cluneal nerves.
- Patients in whom other causes (discs, sacroiliac joints, etc.) have been ruled out.