The Middle Cluneal Nerve Block procedure helps reduce chronic pain in the lower back and buttock, often due to nerve entrapment near the iliac crest. It alleviates pain, tingling, or burning, exacerbated by movement, sitting, or standing. The procedure involves injecting a local anesthetic, like lidocaine, with a steroid, such as cortisone, next to the nerve. It also serves as a diagnostic tool.

This nerve might be impacted by sacroiliac joint (SI) issues or past surgeries involving SI joint stabilization. Alternatives include physical therapy. Using fluoroscopic guidance, a real-time X-ray, ensures precise medication placement. It takes 15–30 minutes, and you can go home the same day.

During recovery, avoid driving and strenuous activities. Pain relief can be immediate; steroids reduce inflammation for six to twelve months. If pain returns, treatments like radiofrequency or cryoneuroablation may offer longer relief. Risks, though rare, include infection or nerve injury. Preparation may involve fasting, and managing blood thinners should follow your doctor’s advice.

If the nerve block gives temporary relief but pain persists, additional treatments like physical therapy or medications may be recommended. Surgery is rare. Extreme cases may consider peripheral nerve stimulation or spinal cord stimulation as long-term options. This procedure not only alleviates pain but also confirms whether the middle cluneal nerve causes your discomfort, guiding future treatments.