Possible Cluneal Nerve Entrapment

by Matt Thorpe

Hi there,

I have been suffering for lower back pain deep in my left side and in my buttock for about 6-7 year. I have had scans and x-rays followed by an s1-l5 spinal fusion to try to fix the problem. Nothing has changed apart from my back is now less flexible and very stiff.

Anyhow, I can live with the stiff back because it's ok when warmed up but the nerve issue is really starting to get me down. I am very active but I am unable to jog/run because of the shock to the nerve which shoots from my lower back and down my buttock. I think I may have Cluneal Nerve entrapment but I am unsure. I have attached an images of where I am feeing the nerve pain.

I have tried all manner of stretches to fix the problems but none help. Sometimes it eases off if I stretch out my hamstrings but sitting for long periods becomes a real problem. I have tried chiropractors in the past, they have not solved the problem and proved to be very expensive.

Any help, diagnosis or assistance would be most appreciated.

Best regards


Hello Matt,
Alas, I don't think your problem is going to be solved, cured. Think of yourself rather like a diabetic would. Non curable but certainly needing to be maintained especially by your own way of life.

Like diabetes, a brisk walk would be a good place to start. Slow walking, window shopping, standing may be problematic if you have a short leg. If so, get someone to check the level of your hips. A small insert in your shoe can be of enormous benefit, and not expensive. Just how much and whether it should be under the heel, or the whole foot can be tricky.

If any of the xrays were taken standing that would give you a good idea of a short leg too.

Secondly, you must look to your chair, and you are the best one to do that. Some chairs will increase your pain, and probably some much better. Get into the habit of asking yourself everytime you sit in a different chair: good or bad?

When possible try lying rather than sitting, eg watching TV. Just sit less.

Make sure nothing in your back pocket when sitting.

Go to our lower back exercise page and start a disciplined set of exercises every single morning before getting out of bed. Every morning. They take less than two minutes.

To test for the cluneals is difficult. There are two groups, quite different. Often by exclusion, after everything else has been tested. They come from the upper lumbar spine. Any pain there?

Back care is expensive, no where more so than in London. Isn't everything high there? Hopefully including your salary! If one chiro doesn't help, try another. Do you homework, ask around for someone who is thorough. Always take your xrays, and refuse another set. The radiation not good. Find a good chiropractor may be your next step.

You are suffering from what is known as Failed Back Surgery. There are 100 different reasons, not least the wrong diagnosis with regard the level. It could be the sacroiliac joint that's giving trouble, or yes, a high lumbar. Or just a short leg.

I hope this contributes, sorry no easy, cheap answer. Well, the exercises come free, at a cost of two minutes in the morning before arising and last thing at night. Four minutes. Cheap.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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