Possible Cluneal Nerve Entrapment

by Matt Thorpe
(London)


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

Matt

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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