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April 20, 2023

Sciatica is a catch-all term that many people use to describe the pain that runs through your lower back and buttocks. Nerve-related pain, also called neuralgia, in the buttock region is commonly incorrectly referred to as sciatica. However, it is important to note that there are actually many different reasons why this area could be hurting. One particularly challenging affliction, which is commonly misdiagnosed as sciatica, is called “superior cluneal nerve entrapment” and “Maigne Syndrome”.

Sciatica Fast Facts 

Sciatica is the compression of the sciatic nerve, which runs down your low back, hips, and even into your legs. The condition is often caused by a bone spur or herniated disc in the low back that exerts pressure on the nerve, leading to irritation and pain. Patients suffering from this disease often respond well to appropriate rest, chiropractic treatment, and physical therapy. But when low back, buttock, and leg pain is persistent regardless of the best care, then your low back pain might have a different origin.

What Is Cluneal Nerve Entrapment Syndrome and Maigne Syndrome?

It so happens that some “sciatica” patients might have been misdiagnosed. It’s worth noting that the pelvic and low back region is complex, with many structures interacting and numerous neural bodies relaying messages to and from your brain. Keeping this in mind, and considering that the symptoms are almost identical, it shouldn’t surprise you that cluneal nerve entrapment (CNE) or Maigne Syndrome is frequently misdiagnosed as sciatica.

Most patients with low back pain endure tightness close to the top of the buttocks, right at the junction where their lumbar and thoracic vertebrae meet. Dorsal ramus are sensory nerves that pass through or underneath this area, which become cluneal nerves as they emerge into the buttocks at the iliac crest. These nerves can get entrapped close to the posterior iliac crest, leading to similar pain symptoms as sciatica. Sciatica generally involves pain in the lower part of the buttock radiating down the back of the leg. Superior cluneal nerve entrapment involves irritation near the buttock where Maigne Syndrome involves nerve irritation near the thoraco-lumbar junction.  Therefore, these symptoms typically include pain in the lower back through the buttock—but not into the leg.

Because of this small difference the cluneal entrapment or Maigne Syndrome is frequently overlooked or misdiagnosed as sciatica. This is why it’s very important that when seeking treatment, you are very honest with your doctor about everything so they can offer a proper diagnosis. It’s important as well to ensure you follow any treatment plan they have created for you. The doctors here at BC + PT always have your best interest and wellness as their priority.

CNE/Maige Syndrome & Physical Therapy 

Conservative or non-invasive treatment options for cluneal nerve entrapment, or CNE, include  physical and chiropractic therapy. If you suspect you have CNE and feel pain in your lumbar and pelvic regions, it’s best to see a medical expert. You may be referred from there for imaging tests to identify the origin and severity of the injury or to dismiss a differential diagnosis. Undergoing physical therapy can be effective in minimizing the nerve pain and inflammation that CNE or Maige Syndrome patients experience.

Your physical therapist will work with you on  an individualized treatment plan. Each and every injury is unique, so therapy at BC + PT could include a lot of different modalities and techniques not available to you just at home. To learn about any of these techniques, check out our Passive Therapy Treatments page! Your physical therapist may recommend ice/ heat application, rest, and will be there to answer any questions you may have. 

 Sciatica & Chiropractic Care 

In diagnosing sciatica versus CNE or Maige Syndrome, a chiropractor will need to understand the condition’s underlying cause. This understanding allows them to target their treatment at the actual cause, allowing for long-term recovery and potential injury prevention instead of simply masking the symptoms. As such, the treatment you may experience for your specific condition will differ from another person’s.  

Cluneal Nerve vs. Sciatica: Differences & Treatment Options

Since BC + PT  chiropractors are professionally trained to evaluate and treat conditions associated with the musculoskeletal system, they can help you through this process.

It’s worth noting that chiropractic care doesn’t describe a specific treatment but entails the whole care package. Sciatica patients can receive a combination of joint manipulation, massage and soft tissue release, as well as corrective exercises. Besides reducing pain in the short term, this may also help to eliminate the problem for good. Having your spine adjusted is just one part in keeping the pain away!


The BC + PT team is lucky enough to have the ability to help with these different types of back and leg pain, with both chiropractors and physical therapists under the same roof.  This access to care makes it easier to get the treatment that you need.  If you are ready to stop hurting and start healing today, give us a call!  Wellness is a journey, and we’d love to be there for you.

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