A potentially underrecognized and treatable cause of chronic back pain : Entrapment neuropathy of the cluneal nerves

We describe a case of longstanding low back pain related to entrapment neuropathy of the Ll-L2 dorsal ramus over the iliac crest. As 3 local anesthetic pain blocks (at the trigger point, 7 cm left of the L5 spine process and just above the iliac crest) were successful for 3 weeks each, a surgical procedure was performed. This corrected patient stricture of a voluminous dorsal ramus within a rigid osteofibrous orifice between the upper rim of the iliac crest and the thoracolumbar fascia. Pain decreased dramatically the same day and disappeared completely within less than a week.