Superior Cluneal Neuralgia: What It Is and Why It Gets Missed
Short Answer
- Superior cluneal neuralgia is low back and upper-buttock pain that usually comes from small sensory nerves being compressed or irritated where they cross the iliac crest, rather than from a disc or a joint. These nerves originate in the upper lumbar spine, so a problem at that level can contribute as well.
- It is frequently mistaken for sciatica, a sacroiliac (SI) joint problem, or a disc issue, and an MRI or CT scan usually looks normal, because while MRI can show larger nerves reasonably well, these particular nerves are too small to be seen reliably.
- In our practice the diagnosis is confirmed with a comprehensive physical exam and diagnostic ultrasound, which shows these nerves clearly enough that we can palpate directly over them under guidance, and many patients improve with ultrasound-guided nerve hydrodissection without surgery.
Confirming the diagnosis and hydrodissecting the nerve directly, rather than continuing to treat other structures in the spine, is usually where true healing begins.
If your low back and upper-buttock pain has been blamed on your spine, you have probably already worked through physical therapy that helped a little and chiropractic adjustments that gave you short bursts of relief. You may also have tried a cortisone injection into the back and/or SI joint that barely touched it. Your MRI or CT scan most likely came back essentially normal, which is often the point where surgery gets raised, even though no one can tell you exactly what it would fix. When we test whether one of the small nerves crossing your iliac crest is compressed, the source of your pain frequently becomes clear for the first time.
Superior cluneal neuralgia treatment at Regenerative Performance starts with a thorough diagnostic workup, an in-depth history and a hands-on physical exam, followed by diagnostic ultrasound that lets us see the nerve directly and confirm it is the source of your pain. When your pain is coming from a compressed or irritated superior cluneal nerve, we offer ultrasound-guided nerve hydrodissection to decompress the nerve within the tunnel it travels through. This is a nerve problem rather than a spine problem, and imaging alone will not confirm it.
Schedule a comprehensive 2-hour evaluation for your low back and upper-buttock pain at our Gilbert, AZ clinic.
Key Facts About Superior Cluneal Neuralgia
Here is what you need to know about superior cluneal neuralgia.
- What it is: Superior cluneal neuralgia is pain caused by irritation or compression of the superior cluneal nerves, small sensory nerves that cross the iliac crest to supply feeling to the low back and upper buttock.
- Who it affects: People with chronic low back and upper-buttock pain that has been attributed to the spine or the SI joint, particularly when a normal MRI or CT scan has not explained the pain and spine-focused care has not helped.
- How it is diagnosed: A comprehensive hands-on physical exam combined with diagnostic ultrasound, which lets us see the nerve where it crosses the iliac crest and palpate directly over it under guidance. A diagnostic nerve block is reserved for more complex cases.
- Treatment options: Activity modification and nerve-informed physical therapy for some patients, and ultrasound-guided nerve hydrodissection to decompress the nerve when conservative care has not resolved it. Surgery is rarely necessary.
- Timeline: Many patients begin to notice changes within a few weeks of a nerve hydrodissection, with continued improvement over the following weeks to months.
- Where: Regenerative Performance, a regenerative and orthobiologic clinic in Gilbert, AZ.
- Next step: Call 480-508-4226 for a comprehensive 2-hour evaluation.
What Is Superior Cluneal Neuralgia?
Superior cluneal neuralgia is pain that comes from irritation of small sensory nerves, called the superior cluneal nerves, that cross the iliac crest to give feeling to the low back and upper buttock.
These nerves are remarkably small, measuring roughly 1 to 3 millimeters across in one anatomical study (Iwanaga et al., World Neurosurg, 2018), which is one reason a blind injection can miss the target entirely, and why ultrasound guidance matters so much for both diagnosis and treatment.
This is also a more common source of low back pain than most people expect, and in one study of patients with low back and leg symptoms, roughly one in seven turned out to have a superior cluneal nerve disorder (Kuniya et al., J Orthop Surg Res, 2014), a share broadly consistent with what later reviews of cluneal nerve entrapment have reported (Karri et al., Curr Pain Headache Rep, 2020).
Why Do the Superior Cluneal Nerves Get Compressed?
The superior cluneal nerves become compressed and irritated where they cross the iliac crest and pierce the thoracolumbar fascia, the tough sheet of connective tissue in the low back, on their way to the skin. At that crossing point many people have a narrow bony groove, or a true osteofibrous tunnel bordered by bone on one side and firm fascia on the other, and the nerve has to travel through that confined space every time you bend, twist, or stand up.
At this crossing point, anatomic studies have found a bony groove in just over half of the iliac crests examined (Iwanaga et al., World Neurosurg, 2019), and a true osteofibrous tunnel in just over half of the specimens studied (Dallas-Prunskis, book chapter, 2016), which is a large part of why compression and friction at this exact spot are so common. A newer anatomical mapping study found that these branches tend to cross the fascia at a fairly consistent, reproducible location, which is part of what makes a targeted ultrasound-guided approach practical (Ismailoglu et al., Reg Anesth Pain Med, 2026).
Every time you bend, twist, or sit for long stretches, friction and tension build on the nerve as it passes through that confined space, which is why this pain usually creeps up gradually rather than starting with a single injury. When a nerve is compressed, blood flow and oxygen delivery to the nerve itself are reduced, and that loss of circulation is a large part of what generates the pain you feel.
Nerve pain of this kind generally traces back to one of three situations, and it helps to understand which one is driving your symptoms. The first is compression, where a structure physically narrows the space the nerve travels through, which can be constant, as when a thickened ligament presses on a nerve, or intermittent, as when a nerve is squeezed only while a particular muscle is working. The second is friction and irritation, where the nerve is repeatedly rubbed as it crosses a bony landmark or passes through a tight tunnel, and this is precisely what happens to the superior cluneal nerve as it crosses the iliac crest. The third is chemical irritation, where inflammation from an injured or degenerating structure nearby irritates the nerve directly, even though nothing is mechanically pinching it.
What Does Superior Cluneal Nerve Pain Feel Like?
Superior cluneal nerve pain typically feels like an aching or burning pain over the iliac crest and upper outer buttock, usually on one side, roughly a hand's width to one side of the spine. It often gets worse with sitting for long periods, standing up from sitting, bending forward, rolling over in bed, or twisting at the waist.
The pain can spread down toward the buttock or upper thigh in a pattern that mimics sciatica, sometimes called pseudo-sciatica because it is sciatica-like pain that is not actually coming from the sciatic nerve or nerve roots. However, unlike true sciatica, this pain rarely travels below the knee. Many patients can point to a specific tender spot along the iliac crest that reproduces the pain when pressed.
Why Superior Cluneal Neuralgia Gets Missed (and Mistaken for Sciatica or the SI Joint)
Superior cluneal neuralgia gets missed because the problem is a peripheral nerve at the iliac crest rather than the spine or the SI joint, so an MRI or CT scan of the low back usually looks normal. Imaging of this kind is built to show discs, bone, and the spinal canal, and a nerve this small is simply not going to be seen reliably on it.
Because of that, the delays before someone gets the right diagnosis can be substantial. In one study, patients with superior cluneal nerve entrapment went an average of about 26 months before diagnosis, compared to about 16 months for spinal stenosis, and reported more disability than the stenosis group, and roughly one in four had already gone through spine surgery that did not resolve the pain (Miki et al., Asian Spine J, 2019). A published case report described a patient whose low back pain persisted after SI joint fusion surgery and was ultimately traced to a superior cluneal nerve, where a single diagnostic injection gave complete, if temporary, relief (Hostetter, Cureus, 2023). That case is illustrative, not proof that this happens to every patient, but it is a striking example of how easily this nerve can hide behind an SI joint diagnosis.
A neighboring nerve, the middle cluneal nerve, can also become compressed closer to the SI joint and produce a similar pattern of pain, and it has been found in roughly one in eight hospitalized low back pain patients in one series (Fujihara et al., Acta Neurochir, 2021; Aota, World J Orthop, 2016). Because these two nerves can look alike on history alone, your pain may be coming from the superior cluneal nerve, the middle cluneal nerve, the SI joint, or a combination of them, and a comprehensive physical exam and diagnostic ultrasound is what tells them apart.
How Is Superior Cluneal Neuralgia Diagnosed?
Superior cluneal neuralgia is diagnosed by starting with a thorough history and a comprehensive hands-on physical exam that reproduces your pain at the location where these nerves cross the iliac crest or pierce the thoracolumbar fascia, and then confirming that finding with diagnostic ultrasound.
We lead with the workup because low back pain can occur for several different reasons, and imaging on its own only shows what structures might be involved, not what is actually generating your pain. Diagnostic ultrasound is what makes this diagnosis practical, because it resolves small structures like these nerves far better than MRI or CT, letting us follow them where they cross the iliac crest and pierce the fascia, look at whether the nerve appears compressed at that point and whether there is swelling just upstream of it, and palpate directly over the nerve under guidance to see whether that reproduces the exact pain you came in with.
X-ray contributes very little here, since it does not show nerves at all. MRI shows soft tissue and larger nerves reasonably well, but these particular nerves are small enough that they are not visualized reliably. Diagnostic ultrasound performed by a registered musculoskeletal sonographer is far more useful for this problem, though every imaging finding still has to be read in the context of your history and physical exam rather than treated as an answer on its own. That principle matters more than any single test: imaging tells us what is there, and the exam tells us what is actually causing your symptoms.
In more complex cases, where several structures could plausibly be contributing, a targeted diagnostic nerve block can be a useful additional step, and substantial relief shortly afterward points strongly toward the nerve. In our practice that step is rarely necessary, because the exam and the ultrasound usually answer the question.
A normal MRI is an expected finding in isolated superior cluneal neuralgia rather than a reassuring one. In practice, though, we frequently see this nerve contributing alongside other findings, such as age-related disc degeneration or a disc herniation, so a scan that does show something is not evidence that the nerve is uninvolved. More often than not, the nerve is one part of the picture rather than the whole of it.
What Are the Treatment Options for Superior Cluneal Neuralgia?
Treatment for superior cluneal neuralgia usually starts with activity modification and physical therapy, and some patients do improve with conservative care alone once the aggravating positions are identified and changed.
Physical therapy for a nerve problem, however, is only as good as the therapist's understanding of nerve problems, and many therapists are not trained in this area. We prefer physical therapists trained in clinical neurodynamics, because they understand how an irritated nerve behaves and how to treat it. When therapy is aimed only at muscles and joints, it frequently aggravates a nerve condition rather than calming it, and for that reason many of our patients move directly to nerve hydrodissection.
For pain that persists, an ultrasound-guided nerve block can give both diagnostic information and short-term relief, and in one study patients who received a nerve block saw meaningful improvement in pain scores at one week, with the large majority reporting significant improvement (Kuniya et al., J Orthop Surg Res, 2014). A cortisone injection can quiet the irritation for a while, but it does nothing to decompress the nerve, and repeated corticosteroid exposure carries real downsides for the surrounding tissue. In our practice we almost never use cortisone for a nerve problem like this one, reserving it for the rare, genuinely indicated situation rather than using it as a routine series. When an injection procedure is warranted, we use non-steroid solutions such as platelet-rich plasma, protein concentrate (sometimes called A2M), or platelet lysate, which support the tissue instead of suppressing it.
Nerve Hydrodissection for Superior Cluneal Neuralgia
Nerve hydrodissection for superior cluneal neuralgia is an ultrasound-guided procedure in which we inject solution circumferentially around the compressed nerve, separating it from the surrounding fascia and bone and decompressing the nerve mechanically. This addresses the underlying problem directly, because when a nerve is compressed within a confined tunnel, creating space around that nerve is what relieves the compression and restores blood flow to it.
In one small clinical series specifically evaluating nerve hydrodissection for superior cluneal nerve entrapment, initial treatment success was reported in about three out of four patients treated (Wu et al., Insights Imaging, 2023). This is the most directly relevant outcome data available for this specific nerve, and it is why ultrasound-guided nerve hydrodissection is our primary approach once we have confirmed the superior cluneal nerve is the problem.
Precision matters enormously with a nerve this small, and this is where guidance separates a treatment from a guess. In a randomized study in healthy volunteers, ultrasound guidance reached this nerve in nearly every attempt, while injection without guidance reached it in none of them (Nielsen et al., Reg Anesth Pain Med, 2019). Ultrasound-guided nerve hydrodissection has also been studied across a range of other compressed nerves, including work using dextrose and using platelet-rich plasma, which supports the mechanism even though research specific to the superior cluneal nerve is still developing (Hailin, Pain Physician, 2024; Buntragulpoontawee et al., Front Pharmacol, 2021).
What We Inject During Nerve Hydrodissection
The solution used for a nerve hydrodissection matters, and we choose it for your situation rather than applying the same thing to everyone. Some clinics use saline, but we prefer dextrose, which has outperformed saline in hydrodissection research on other compressed nerves, so dextrose is our baseline.
Beyond dextrose, we frequently use an orthobiologic solution prepared from your own blood or tissue, including platelet-rich plasma, platelet lysate, protein concentrate (sometimes called A2M), and autologous stem cell therapy including bone marrow concentrate and microfragmented adipose tissue. These are not interchangeable, and they differ meaningfully in how they are prepared, their composition, and their biological activity, so the choice depends on your presentation, how long the nerve has been irritated, and what else is contributing to your pain. Published research on these solutions for the superior cluneal nerve specifically is limited, and our use of them reflects what we have found effective in clinical practice across many nerve conditions.
Schedule a comprehensive 2-hour evaluation for your low back and upper-buttock pain at our Gilbert, AZ clinic.
When Is Surgery Considered for Superior Cluneal Neuralgia?
Surgery for superior cluneal neuralgia is considered only when a well-supported diagnosis is paired with a genuine failure of appropriate non-surgical care, including nerve hydrodissection, and that combination is uncommon. Our goal is to resolve your pain without surgery, and in the overwhelming majority of cases that is exactly what happens, so surgery is not part of our usual pathway for this problem.
When surgery is pursued, surgical release of the compressed nerve has been reported successful in the large majority of cases in one series (Isu et al., Neurospine, 2018), and another study reported that most patients had relief following surgical release (Kim, Muscle Nerve, 2017). Surgery is the right call for a small number of patients, but it is a considerably bigger step with a longer recovery than a non-surgical procedure, and decompressing the nerve without an incision is enough for the great majority of the people we see.
What to Expect at Our Clinic for Superior Cluneal Neuralgia
Every patient with suspected superior cluneal neuralgia moves through the same four steps.
Comprehensive 2-Hour Evaluation
Every new patient starts with a detailed 2-hour evaluation that includes a thorough history, a comprehensive hands-on physical examination, and diagnostic ultrasound when indicated. We examine you thoroughly regardless of the diagnosis you arrive suspecting, because the working diagnosis may be incomplete or inaccurate, and the real source of the pain turns out to be something else entirely. We test the superior cluneal nerve and the surrounding structures directly to determine whether they are generating your pain, rather than relying on imaging alone.
The primary purpose of this evaluation is to identify the specific tissue causing your pain. This step matters because, in our experience, an accurate diagnosis is one of the most important factors in regenerative treatment success, and a missed or incomplete diagnosis is the most common reason we see regenerative treatment fall short.
Individualized Treatment Plan
Based on the evaluation, we determine whether you are a candidate for a diagnostic nerve block, nerve hydrodissection, or another regenerative approach. From there, we develop a plan specific to your case, including which nerve and surrounding tissue will be treated, the expected timeline, and your role in recovery.
In our experience, the first three months after treatment tend to be the window where most improvement occurs, so we typically recommend supplements and peptides during that period to help support your body's healing response.
Ultrasound-Guided Nerve Hydrodissection
On your treatment day we inject the solution circumferentially around the affected nerve under continuous ultrasound guidance, separating it from the surrounding tissue and decompressing it. The location we treat depends on where your nerve is actually being compressed or irritated, which we establish during your evaluation rather than assuming it sits in the same spot for everyone.
Our baseline solution is almost always an orthobiologic such as platelet-rich plasma, protein concentrate (A2M), or platelet lysate, each of which contains growth factors that support the nerve and the tissue around it. We treat the specific nerve and surrounding structures identified during your evaluation under direct ultrasound guidance, rather than injecting blindly into the general area.
Recovery and Follow-Up
After your procedure, we recommend resting for the remainder of that day so your body can begin to respond. Activity restrictions typically last 1 to 4 weeks, with a gradual return to full activity guided by your response.
In our clinic, many patients begin to notice changes within a few weeks, with continued improvement over the following weeks to months.
We schedule follow-up assessments to track your progress, giving both you and our team objective information on how your treatment is working.
Schedule a comprehensive 2-hour evaluation for your low back and upper-buttock pain at our Gilbert, AZ clinic.
Who Is a Good Candidate for Superior Cluneal Neuralgia Treatment?
A compressed superior cluneal nerve is worth exploring if any of the following describe your situation:
- Chronic low back or upper-buttock pain lasting 3 months or longer
- A normal or unremarkable MRI or CT scan despite ongoing pain
- You have been told the pain is coming from the SI joint, sciatica, or a disc, and treatment aimed at those has not helped
- You have tried physical therapy, chiropractic care, or cortisone injections without lasting relief
- You are looking for a non-surgical option before considering surgery
- You are willing to invest in your health, as these are cash-pay procedures
During your evaluation we determine whether nerve hydrodissection, a different regenerative approach, or an entirely different diagnosis and treatment plan is the right answer for you.
If you are unsure whether nerve hydrodissection is appropriate, or you are traveling from outside the Phoenix area, you can also call and ask about a brief 15 minute discovery call.
Frequently Asked Questions About Superior Cluneal Neuralgia
What are the symptoms of superior cluneal nerve pain?
Superior cluneal nerve pain typically feels like an aching or burning sensation over the iliac crest and upper outer buttock, usually on one side. It often worsens with sitting, standing up from a chair, bending forward, or twisting at the waist, and it can spread down toward the buttock or upper thigh, though it rarely travels below the knee.
Can superior cluneal neuralgia be mistaken for SI joint pain?
Yes, superior cluneal neuralgia is frequently mistaken for SI joint pain because both cause low back and upper-buttock pain in a similar location. A published case report (Hostetter, Cureus, 2023) described a patient whose pain persisted after SI joint fusion surgery and was ultimately traced to the superior cluneal nerve. A comprehensive physical exam and diagnostic ultrasound that specifically test the nerve, not just the joint, is what tells the two apart.
Why is my MRI normal if I still have superior cluneal nerve pain?
Your MRI can look normal because superior cluneal neuralgia is a problem with a peripheral nerve crossing the iliac crest, not with your spine, discs, or joints, which is what MRI is designed to evaluate. These nerves are also small enough that MRI does not visualize them reliably. A normal MRI does not rule out this condition, and it is a common and expected finding, which is one reason the diagnosis is so often missed.
What tests are used to diagnose superior cluneal neuralgia?
Superior cluneal neuralgia is diagnosed with a detailed history, a comprehensive hands-on physical exam that reproduces pain where the nerves cross the iliac crest or pierce the thoracolumbar fascia, and diagnostic ultrasound, which lets the nerve be examined directly for signs of compression. In more complex cases a targeted diagnostic nerve block can add useful information, though it is rarely necessary. MRI and CT are used to rule out other causes rather than to make this diagnosis.
Are nerve blocks effective for superior cluneal neuralgia?
Nerve blocks can be effective for superior cluneal neuralgia, both as a diagnostic tool and as short-term treatment. In one study (Kuniya et al., J Orthop Surg Res, 2014), patients who received a nerve block reported significant improvement in pain scores at one week. In our practice, however, the diagnosis is usually established by physical exam and diagnostic ultrasound, and a block is reserved for complex cases where several structures could be contributing, rather than used as a routine confirmation step.
Can nerve hydrodissection treat superior cluneal neuralgia?
Yes, superior cluneal neuralgia can be treated with nerve hydrodissection, an ultrasound-guided procedure in which solution is injected circumferentially around the compressed nerve to separate it from the surrounding fascia and bone and decompress it. In one small clinical series specifically evaluating this approach for superior cluneal nerve entrapment (Wu et al., Insights Imaging, 2023), initial treatment success was reported in about three out of four patients treated. Research on this specific nerve is still developing.
Does superior cluneal neuralgia require surgery?
Superior cluneal neuralgia does not usually require surgery, and surgery is not part of our usual pathway for this condition. Most patients improve with conservative care or nerve hydrodissection. Surgical release of the compressed nerve is reserved for the uncommon situation where the diagnosis is well supported and appropriate non-surgical care, including nerve hydrodissection, has genuinely failed, and it has been reported successful in the large majority of appropriately selected cases.
How long does recovery take after nerve hydrodissection for superior cluneal neuralgia?
After a nerve hydrodissection for superior cluneal neuralgia, activity restrictions typically last one to four weeks, and many patients begin to notice changes within a few weeks, with continued improvement over the following weeks to months. We track your progress at follow-up visits to guide next steps.
Still have questions? The best way to get answers is a conversation. Call 480-508-4226.
About Dr. Timmermans
Dr. Drew Timmermans, ND, RMSK
Dr. Drew Timmermans, ND, RMSK, is a naturopathic physician and registered musculoskeletal sonographer (RMSK) practicing at Regenerative Performance in Gilbert, AZ. He specializes in orthobiologic injections, including platelet-rich plasma, bone marrow concentrate, prolotherapy, perineural injection therapy, and nerve hydrodissection, using ultrasound and fluoroscopic guidance to treat the specific structures causing chronic pain rather than suppressing symptoms.
Dr. Timmermans has performed close to 10,000 orthobiologic injections, and tracks patient outcomes to refine diagnosis and treatment across thousands of cases.
References
- Kuniya H, Aota Y, Kawai T, et al. Prospective study of superior cluneal nerve disorder as a potential cause of low back pain and leg symptoms. J Orthop Surg Res. 2014;9:139. DOI: 10.1186/s13018-014-0139-7.
- Karri J, Lachman L, Hanania A, et al. Pain Syndromes Secondary to Cluneal Nerve Entrapment. Curr Pain Headache Rep. 2020;24(9):51. DOI: 10.1007/s11916-020-00891-7.
- Miki K, et al. Characteristics of Low Back Pain due to Superior Cluneal Nerve Entrapment Neuropathy. Asian Spine J. 2019;13(4):612-618. DOI: 10.31616/asj.2018.0324.
- Hostetter M. Superior Cluneal Nerve Entrapment as a Cause of Low Back Pain Refractory to Sacroiliac Joint Fusion: A Case Report. Cureus. 2023;15(8):e44271. DOI: 10.7759/cureus.44271.
- Iwanaga J, et al. Anatomic Study of the Superior Cluneal Nerve and Its Related Groove on the Iliac Crest. World Neurosurg. 2019;125:e1004-e1007. DOI: 10.1016/j.wneu.2019.01.210.
- Iwanaga J, Simonds E, Patel M, Oskouian RJ, Tubbs RS. Anatomic Study of Superior Cluneal Nerves: Application to Low Back Pain and Surgical Approaches to Lumbar Vertebrae. World Neurosurg. 2018;116:e1077-e1080. DOI: 10.1016/j.wneu.2018.05.087.
- Dallas-Prunskis T. Superior Cluneal Nerve Entrapment. In: Deer TR, et al, eds. Deer's Treatment of Pain. Springer; 2016. DOI: 10.1007/978-3-319-27482-9_51.
- Ismailoglu O, et al. Defining a bony landmark-based target zone for superior cluneal nerve blockade: a cadaveric mapping study. Reg Anesth Pain Med. 2026. DOI: 10.1136/rapm-2025-107510.
- Wu WT, et al. Enhancing diagnosis and treatment of superior cluneal nerve entrapment: cadaveric, clinical, and ultrasonographic insights. Insights Imaging. 2023;14:57. DOI: 10.1186/s13244-023-01463-0.
- Nielsen TD, et al. Randomized trial of ultrasound-guided superior cluneal nerve block. Reg Anesth Pain Med. 2019;44(2):199-204. DOI: 10.1136/rapm-2018-100174.
- Isu T, et al. Superior and Middle Cluneal Nerve Entrapment as a Cause of Low Back Pain. Neurospine. 2018;15(1):25-32. DOI: 10.14245/ns.1836024.012.
- Kim JT. Low back pain due to superior cluneal nerve entrapment: a clinicopathologic study. Muscle Nerve. 2017;56(4):647-651. DOI: 10.1002/mus.26007.
- Aota Y. Entrapment of middle cluneal nerves as an unknown cause of low back pain. World J Orthop. 2016;7(3):167-170. DOI: 10.5312/wjo.v7.i3.167.
- Fujihara F, et al. Clinical features of middle cluneal nerve entrapment neuropathy. Acta Neurochir (Wien). 2021;163(4):1069-1075. DOI: 10.1007/s00701-020-04676-0.
- Hailin H. A Randomized Double-blind Trial of 5% Dextrose Versus Corticosteroid Hydrodissection for Meralgia Paresthetica. Pain Physician. 2024;27(8):E835-E842. DOI: 10.36076/ppj.2024.7.e835.
- Buntragulpoontawee M, Chang KV, Vitoonpong T, Pornjaksawan S, Kitisak K, Saokaew S. The Effectiveness and Safety of Commonly Used Injectates for Ultrasound-Guided Hydrodissection Treatment of Peripheral Nerve Entrapment Syndromes: A Systematic Review. Front Pharmacol. 2021;11:621150. DOI: 10.3389/fphar.2020.621150.
NOTE: This article provides general information to help the reader better understand regenerative medicine, nerve and musculoskeletal conditions, naturopathic approaches to pain, and related subjects. All content provided in this article, website, or any linked materials, including text, graphics, images, research, and outcomes, are not intended, and should not be used, as a substitute for direct medical advice, diagnosis, or treatment. Please always consult with a professional and licensed healthcare provider to discuss if any treatment is right for you.
Please note: None of the injectates described here is an FDA-approved treatment for nerve conditions, and none is offered as a cure. Platelet-rich plasma, platelet lysate, and protein concentrate are autologous blood-derived preparations; in their minimally manipulated autologous form they are exempt from the FDA's 351 and 361 biologics pathways and are prepared using cleared devices, so FDA approval is not a pathway that applies to them. Bone marrow concentrate and microfragmented adipose tissue are autologous preparations regulated under the FDA's HCT/P framework, where minimally manipulated, homologous, same-procedure use does not require premarket approval; the FDA has approved only cord-blood-derived hematopoietic stem-cell products, for blood-forming disorders, not stem-cell products for nerve or orthopedic conditions. Dextrose solutions are approved for other uses and administered off-label for nerve hydrodissection.
Registry data from our single practice, powered by DataBiologics, is not a randomized clinical trial. Individual results may vary.