What is the difference between cluneal nerve entrapment and piriformis syndrome?

woman with pain in her hip and buttockPiriformis syndrome and superior cluneal nerve entrapment can have similar symptoms, such as deep pain in the hip or buttock, but the two conditions also have major differences as well, including the type of treatment used to provide relief. Dr. Williams explains the similarities and differences between the two conditions and how he can treat either so you can get back to enjoying your regular activities without pain.

Similarities and Differences Between Superior Cluneal Nerve Entrapment and Piriformis Syndrome

Piriformis syndrome can mirror the symptoms of entrapment of the superior cluneal nerve since both conditions cause pain in the buttock or hip. The main difference between the two conditions is that with piriformis syndrome, sitting causes severe pain and discomfort, whereas with superior cluneal nerve entrapment, the pain subsides during periods of rest.

In addition to deep pain in the buttock, piriformis syndrome can cause spasms or cramps in the buttock and other symptoms such as:

  • Numbness in the foot, leg, or buttock
  • A sensation of pins and needles in the leg
  • Increase in pain when doing activities such as running, squatting, or climbing stairs

Superior cluneal nerve entrapment can cause pain in the buttocks and lower back and symptoms such as:

  • Burning sensation in the buttock
  • Pain that is to one side rather than concentrated in the middle
  • Pain that worsens with activity but reduces with rest

Diagnosis and Treatment Options

Since treatment options are different for piriformis syndrome and superior cluneal nerve entrapment, it is important to get an accurate diagnosis in order to find relief. Both conditions can be difficult to diagnose and are often misdiagnosed. To determine if the cause of your pain is due to superior cluneal nerve entrapment, a nerve block may be injected into the area. If the pain disappears, the diagnosis would likely be confirmed.

Diagnosing piriformis syndrome can be a challenge since there is not a single test to determine a diagnosis. Because other conditions such as superior cluneal nerve entrapment can cause similar symptoms, the two conditions can get misdiagnosed. To diagnose piriformis syndrome, a specialist will evaluate the pain and symptoms.

To treat piriformis syndrome, a doctor will recommend rest and physical therapy. In addition, steroids or muscle relaxants may be used to relieve pain. When conservative treatments do not provide relief, a nerve specialist can perform nerve release surgery to release the sciatic nerve from the piriformis muscle. To treat superior cluneal nerve entrapment, a specialist will likely recommend decompression surgery of the cluneal nerve. 

Since the treatment for piriformis syndrome and superior cluneal nerve entrapment are different, it is important to get the correct diagnosis and to see a peripheral nerve specialist such as Dr. Williams.

Contact Our Office

Dr. Williams has the expertise to treat both piriformis syndrome and superior cluneal nerve entrapment and can give the best advice to get you back to living pain-free. To schedule an appointment in the Baltimore office, contact us at (410) 709-3868 or fill out our contact form online.