Neuromodulation Treatment for the Superior Cluneal Nerve by Peripheral Nerve Stimulation: A Case Report

Case Diagnosis: Superior cluneal nerve neuralgia that was treated by Peripheral Nerve Stimulation.

Case Description or Program Description: An 82-year-old male patient presented to his pain management doctor with a chief complaint of chronic low back pain for 20 years. The patient had undergone different types of injections, nerve blocks, physical therapy, and chiropractor adjustments but had minimal relief. After reviewing the patient's medical history, it was eventually identified that the superior cluneal nerve was the cause of his pain. The patient underwent two successful diagnostic nerve blocks before being given a peripheral nerve stimulation trial. The trial succeeded, and the patient was given a permanent peripheral nerve stimulator.

Setting: Innovative Physiatry Spine Clinic, which is an outpatient clinic.

Assessment/Results: Successful neuromodulation was obtained through the peripheral nerve stimulator, which has allowed for excellent pain relief in the patient.

Discussion (relevance): Superior cluneal neuralgia is an often misdiagnosed condition that is mistaken for sciatica, SI joint dysfunction, or lumbar facet syndrome. Patients suffer pain in their lower back, which can sometimes radiate down their legs due to the overlapping nerve routes between these conditions. peripheral nerve stimulation is a technique that uses neuromodulation to disrupt the pain pathways and lead to pain relief. This case reports presents a case that highlights a patient who suffered from chronic low back pain for 20 years, which was eventually identified to be caused by the superior cluneal nerve and was relieved with peripheral nerve stimulation.

Conclusions: This case report highlights a misdiagnosed condition that can cause patients much pain. This project is designed to bring awareness to cluneal neuralgia as well as education about peripheral nerve stimulation treatment. This awareness can educate healthcare professionals on the signs of cluneal neuralgia and provide education on treating some neuralgia conditions with peripheral nerve stimulation.