The Superior ClunealNerve is a nerve that provides sensory innervation to the posterior iliac crest and the skin overlying the superior portion of the gluteus maximus.

•Patients with Superior Cluneal Neuralgia (SCN)can present with symptoms ranging from limitations in lumbar motion to radiating pain into the legs and antalgic gait, leading to misdiagnosis and the risk of unnecessary spine surgeries.

•The most common etiology of SCN is iatrogenic, such as autologous bone graft harvest from the iliac crest, spinal surgical procedures, debridement procedures, or muscle flap surgeries.

•The treatment options for SCN include local nerve blocks and neuroablative procedures such as phenol neurolysis or radiofrequency ablation. In refractory cases, surgical decompression can be utilized to decompress the distal superior cluneal nerve branches or the contributing lumbar radicular segments. PNS has been explored more recently as an option for patients with refractory SCN.

•This case report entails considering SCN in the differential for low back pain and the successful utilization of peripheral nerve stimulation (PNS) for treatment.