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Cluneal nerves - an overlooked source of low back pain |
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An often overlooked source of pain are the superior clunueal nerves. These emerge from the spine at the dorso-lumbar and upper lumbar levels (just below where the ribs attach to the spine). They travel down the back and supply sensation to the buttocks. As they enter the back of the pelvis they pierce the thoraco-lumbar fascia, a sheet of connective tissue involved in bracing the spine.
The nerves can be compressed or irritated either where they emerge from the spine or in the osseo-fibrous tunnel formed as the pierce the thoraco-lumbar fascia. This causes pain in the buttock , but treatment needs to be focussed not on that area but at the site of nerve compression or irritation.Careful examination of the spine, using specific passive movements of thesuspected intervertebral joints, or tests for the area where the nerves pierce the fascia, can confirm cluneal nerve involvement. There are effective osteopathic techniques that can treat the problem at both sites. |
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