Home › Body Atlas › Nerves › Cluneal Nerves

Cluneal Nerves

nervi clunium

The cluneal nerves supply the skin of the buttock (Latin: clunes = buttocks) in three groups: superior cluneal nerves (posterior rami of L1-L3) crossing the iliac crest; middle cluneal nerves (posterior rami of S1-S3) emerging through the posterior sacral foramina; and inferior cluneal nerves (from the posterior femoral cutaneous nerve S1-S3) curving around the lower gluteal fold to supply the inferior buttock.

Region: Pelvis & Hip

Clinical Relevance

Clinical Notes

Superior cluneal nerve entrapment at the iliac crest is an under-recognised cause of low back and buttock pain in up to 14% of patients with chronic low back pain, producing a tender point at the iliac crest where the nerve crosses the posterior iliac crest approximately 7-8 cm lateral to the midline. Cluneal nerve injection provides diagnostic and therapeutic benefit. Superior cluneal nerves are at risk during posterior iliac crest bone graft harvest and during sacroiliac joint surgical approaches. Inferior cluneal neuralgia produces burning inferior buttock pain worsened by sitting.

Pathology

Common Injuries & Conditions

Superior Cluneal Nerve Entrapment at Iliac Crest

Superior cluneal nerves crossing the iliac crest through a fibro-osseous tunnel are entrapped by fascial thickening or trauma, producing a tender point 7-8 cm lateral to the midline on the posterior iliac crest with buttock pain radiation, managed by local nerve block and in refractory cases by fascial decompression at the tunnel.