Low Back Pain Not Coming from the Spine

Low back pain stemming from superior cluneal nerve entrapment is an underdiagnosed condition.

Dr. Tollestrup has developed a surgical approach to help alleviate low back that does not emanate from the spine. He has many patients who have had success with this procedure. Marty is one of them. He is sharing his story in hopes of reaching others still struggling with chronic low back pain.

Doctors like Dr. Tollestrup find a path to treatment

Marty’s First Nerve Surgery

Marty first came to see Dr. Tollestrup for groin pain after an inguinal hernia repair. Dr. Tollestrup eliminated the nerve pain by removing several damaged nerves in the right lower abdominal and groin area.

After nerve surgery, Marty continued to have some deep right groin pain due to severe arthritis in the right hip joint. After undergoing a right hip replacement, Marty’s right groin pain was finally completely gone.

New Low Back Pain

Unfortunately, during the time it took to resolve the orthopedic hip problem, Marty developed severe right-sided low back pain with radiation of the pain into the hip area. This pain became constant and debilitating. Lying on his back intensified the pain, making it impossible to sleep.

CT imaging of the spine did not show any reason for the low back pain and hip pain. With imaging clear, Marty tried pain management but was not able to get any relief.

Back to Dr. Tollestrup

Marty returned to see Dr. Tollestrup in hopes that he might be able to do something for his low back pain. After listening to Marty describe the location of the pain, Dr. Tollestrup suspected that Marty might be suffering from compression of the superior cluneal nerves.

The superior cluneal nerves are a cluster of nerves that branch off the main L1, L2, and L3 nerve roots and travel along the lumbar spine. These nerves pass through tight tunnels made up of fascia and bone and can become entrapped.

Entrapment of the superior cluneal nerves can cause severe low back pain which is usually off to the side slightly rather than in the middle, directly over the spine. There can also be a radiation of pain into the buttocks or hip. It is a common problem that is rarely diagnosed correctly. Many patients with this problem will undergo unnecessary spine surgery. Undergoing spine surgery when the low back pain is actually due to superior cluneal nerve entrapment will have no effect on the original pain at best, and at worst, can make the original low back pain become much worse.

Superior Cluneal Nerve Entrapment

Dr. Tollestrup sent Marty for a diagnostic block of the right superior cluneal nerves. Once the nerves were anesthetized Marty’s low back pain was instantly relieved. This let Dr. Tollestrup know that the real source of the low back pain was entrapment of the superior cluneal nerves and not some type of problem with the spine itself.

In this photo the green circle is around the superior cluneal nerves.

With this knowledge, Dr. Tollestrup was able to take Marty to the operating room and remove these small, unimportant sensory nerves to permanently relieve his low back pain.

Low Back Pain Gone

A week after surgery Marty is once again pain-free thanks to Dr. Tollestrup.

Superior cluneal nerve entrapment usually goes undiagnosed by orthopedic surgeons simply because they do not have comprehensive knowledge of the peripheral nervous system.

If you have unresolved low back pain, Dr. Tollestrup can help. Please fill out the form on the right or call the office at 702-666-0463.