Clinical term
Cluneal neuralgia
Cluneal neuralgia is pain linked to irritation of the cluneal nerves, small sensory nerves of the skin of the buttock. Depending on the branch involved, it is felt in the upper buttock and lower back, or in the lower buttock, sometimes markedly when sitting.
Scientific basis
Three groups of cluneal nerves are distinguished: superior, arising from the lumbar roots, which cross the iliac crest; middle, arising from the sacral roots, which pass near the posterior sacroiliac ligaments; inferior, branches of the posterior femoral cutaneous nerve, which supply the lower buttock.
Compression of the superior cluneal nerves at the iliac crest is a recognized but often overlooked cause of low back and buttock pain. Involvement of the inferior cluneal nerves can produce lower buttock pain that worsens when sitting, which must be distinguished from pudendal neuralgia. Diagnosis relies on clinical examination and, often, on a diagnostic anesthetic nerve block.
Blue Portance / SBNFA™ reading
As with other nerves, the SBNFA™ distinguishes the neurological mechanism of pain from the mechanical environment of the nerve: support pressure, pelvic orientation, how long positions are held and the possibilities for variation.
The SBNFA™ framework puts forward the hypothesis that certain pelvic profiles, when restricted in sitting, could increase stress on the posterior region of the pelvis.
Contribution to the analysis of sitting
When buttock pain increases when sitting, observing where the support points are, how long positions are held and whether the person can shift support provides functional information, without replacing medical diagnosis.
Not to be confused with
Pudendal neuralgia, which affects the perineum; sciatica, pain that travels down the leg along the path of a nerve root; sacroiliac joint pain; piriformis syndrome.
Related terms
Sources and scope
- Isu et al. (2018): superior and middle cluneal nerve entrapment as a cause of low back pain (Neurospine)
- Review (2022): cluneal neuralgia as a cause of low back pain (Orthopedic Reviews)
- Systematic review (2025): cluneal nerve decompression, 236 surgical cases (European Spine Journal)
Anatomy and clinical data are established but come mainly from surgical case series and reviews. The link between pelvic profile and cluneal neuralgia belongs to the SBNFA™ reading.
