Entrapment of the Medial Branch of the Superior Cluneal Nerve – a Previously Unrecognized Cause of Lower Back Pain in Cricket Fast Bowlers

Abstract

Cricket fast bowlers have a high incidence of injury and are prone to back problems that can become debilitating and foreshorten their careers. We present a case of superior cluneal nerve (SCN) entrapment neuropathy as a previously unrecognized etiology of lower back pain in a professional cricket fast bowler, often misdiagnosed as a lumbar spine disorder. We believe that the SCN may be susceptible to compression related to repetitive contraction of the back musculature, in particular the Thoraco-lumbar erector spinae (TLES) and Latissimus dorsi which contribute to a fibro-osseous tunnel through which the SCN runs. The problem can be readily treated with surgical decompression and patients can expect a return to near full function. Clinicians should be aware of this diagnosis when investigating athletes for chronic lower back pain.