Comparing two ultrasound-guided ways to numb the superior cluneal nerve for low back and gluteal pain.

Proximal Versus Distal Superior Cluneal Nerve Block in Superior Cluneal Nerve Entrapment: A Prospective, Randomized, Single-Blind Trial

This study tests whether a proximal or distal ultrasound-guided superior cluneal nerve block works better to reduce chronic low back or gluteal pain in adults with cluneal syndrome.

Quick facts

• Study type: Observational
• Enrollment: 54 (estimated)
• Ages: 18 Years to 75 Years
• Sex: All
• Sponsor: Gaziosmanpasa Research and Education Hospital (other gov)
• Locations: 1 site (Istanbul)
• Trial ID: NCT07372430 on ClinicalTrials.gov

What this trial studies

This is a prospective, randomized, single-blind study comparing two ultrasound-guided injection techniques targeting the superior cluneal nerve. Participants with suspected SCN entrapment receive either a proximal or distal nerve block and are followed over time. Pain, function, neuropathic pain features, and quality of life are measured using VAS, ODI, LANSS, and SF-12 respectively, and radiographic/postural parameters are analyzed as secondary outcomes. The goal is to identify which injection approach provides superior clinical outcomes and whether posture or spinal alignment relates to treatment response.

Who should consider this trial

Good fit: Adults aged 18–75 with chronic (>3 months) unilateral low back or gluteal pain, localized tenderness over the posterior iliac crest, clinical suspicion of SCN entrapment, and prior failure of conservative treatment are ideal candidates.

Not a fit: Patients with prominent radicular neurological deficits, recent lumbar interventions, active infection, uncontrolled comorbidities, pregnancy, known allergy to the injectate, or cancer-related pain are unlikely to benefit from participation.

Why it matters

Potential benefit: If one approach proves superior, it could offer more reliable pain relief and improved function for patients with superior cluneal nerve entrapment.

How similar studies have performed: Nerve block of the superior cluneal nerve is an accepted diagnostic/therapeutic approach, but direct comparisons of proximal versus distal ultrasound-guided techniques are limited and lack consensus.

Eligibility criteria

Inclusion Criteria:

* Age between 18 and 75 years
* Chronic low back and/or gluteal pain lasting longer than 3 months
* Localized point tenderness and/or paresthesia on palpation over the unilateral posterior iliac crest
* Clinical suspicion of superior cluneal nerve entrapment based on physical examination
* Failure to respond to conservative treatment
* Ability and willingness to provide written informed consent

Exclusion Criteria:

* Active local or systemic infection
* Cognitive impairment or psychiatric disorders interfering with study participation
* History of malignancy or cancer-related pain
* Uncontrolled diabetes mellitus or severe comorbid conditions adversely affecting general health
* Pregnancy
* Known allergy to the medications used in the injection
* Prominent radicular pain associated with neurological deficit
* History of interventional procedures applied to the lumbar region within the last 6 months
* Initiation of another lumbar interventional or medical treatment during the follow-up period
* Suspected bilateral superior cluneal nerve entrapment
* Sphincter dysfunction related to neurological disease
* Bleeding diathesis or coagulation disorders

Where this trial is running

Istanbul

• Health Sciences University Gaziosmanpaşa Physical Medicine and Rehabilitation Training and Research Hospita — Istanbul, Turkey (Türkiye) (RECRUITING)

Study contacts

• Study coordinator: Tugce Yavuz Mollavelioglu, M.D

Conditions: Cluneal Syndrome, Neuralgia, Peripheral Nerve Entrapment, low back pain