Superior Cluneal Neuralgia (SCN)
The superior cluneal nerve maintains the fascia health in the upper and outer aspects of the buttock and provides sensation to the skin in the same region. Resulting from irritation or compression of the superior cluneal nerve, SCN can cause sharp, burning, or aching pain in the lower back or buttocks that often radiates to the hips or thighs. Although strictly a sensory nerve, many patients present with deconditioning atrophy and pain-induced weakness.
While the condition can be debilitating, the Orthohealing Center’s nonsurgical treatments are designed to help patients experience lasting relief.
What causes Superior Cluneal Neuralgia (SCN)?
Superior cluneal neuralgia is often caused by the compression or irritation of the superior cluneal nerve. This can occur due to a variety of factors, including:
- Nerve pressure resulting from tight muscle and rigid fascia in the lower back (iliac crest area)
Overstretched nerves due to poor posture or prolonged sitting - Injuries to the nerve due to blunt trauma or injuries to the lower back or hip, such as those brought on by:
- a prior bone marrow biopsy
- an iliac crest graft for lumbar fusion
- aggressive, repeated high-velocity chiropractic adjustments in the vicinity of the nerve
- a fall or car accident
- Nerve irritation resulting from an anatomical variation, such as a naturally compressed or narrow pathway for the superior cluneal nerve
The Orthohealing Center’s innovative therapies are designed to deliver effective and lasting relief from SCN.
Symptoms of Superior Cluneal Neuralgia (SCN)
Although the symptoms of SCN can vary, they typically include:
- Burning, sharp, or aching pain in the upper buttocks or lower back
- Pain that radiates down the outer side of the hip or thigh
- Numbness or tingling in the affected area
- Discomfort that worsens with certain movements, such as sitting for long periods or standing for extended times
- Sensitivity to touch or pressure in the buttock region
- Pain that worsens with attempted strengthening and stretching of the buttock and hip area
The pain can range from mild to severe, and it may interfere with daily activities. Early diagnosis and treatment are key to managing symptoms, preventing further complications, and restoring normal function.
Diagnosing Superior Cluneal Neuralgia (SCN)
Diagnosing typically begins with a thorough medical evaluation which includes the following steps:
- Taking a complete patient history to understand symptoms, lifestyle, and any previous injuries
- Conducting a thorough physical examination to assess likely lumbar or hip involvement, thorough neurological exam, and areas of discomfort
- Nerve conduction studies (NCS) and electromyography (EMG) to assess nerve and muscle activity to pinpoint the location and extent of nerve damage
- The potential use of advanced imaging techniques such as MRI to evaluate for lumbar or hip nerve compression, or structural issues that may be contributing to the condition
- The possibility of musculoskeletal ultrasound to help:
- detect fascial thickening in the fibrous tunnel in which the superior cluneal nerve travels (around the back of the hip, and as compared to the unaffected side)
- detect any evidence of changes in the thoracolumbar fascia, where inflammation and thickening can trap the nerves that contribute to the superior cluneal nerve downstream
- An ultrasound-guided nerve block to confirm the diagnosis
Determining the origins of any condition is a necessary part of the diagnostic processes, allowing our team to personalize preventive and therapeutic strategies to meet each individual’s needs.
Nonsurgical Treatment for Superior Cluneal Neuralgia (SCN)
The Orthohealing Center offers the following advanced nonsurgical treatments to address SCN:
- Platelet lysate or alpha 2 macroglobulin (A2M): these processes use the patient’s own growth factors and proteins to reduce inflammation and stimulate tissue repair
- MFAT: the stroma fibers and mesenchymal stem cells present in fat are used to support the health and reduce symptoms associated with damaged tissue and nerve
- Softwave therapy: this noninvasive technology is effective at reducing myofascial pain and muscle tension that could be compressing the nerve
- Class V laser therapy: this noninvasive technology promotes an anti-inflammatory environment, improves blood flow, and reduces pain mediators
- Nerve hydrodissection therapy: a minimally invasive technique that uses fluid to separate and relieve compressed nerves
- Fascia Hydrodissection therapy: this minimally invasive technique uses fluid to break-up fascia adhesions and restrictions
Customized, cutting-edge treatment plans are designed to restore function, alleviate pain, reduce inflammation, and enhance quality of life without the risks of surgery.
