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The 4 Most Common Causes of Pain in the Outside of the Hip. Superior Cluneal Nerve Entrapment.

4 most common cuases of lateral hip pain cupping dry needling hip pain lateral hip pain superior cluneal nerve entrapment May 09, 2023

Pain in the outside of the hip is quite literally a pain in the butt to figure out some times.  One of the most overlooked causes is an entrapment or irritation of the superior cluneal nerve.  


Here are the top 4 places that I see generating pain with our clients. This is not an extensive list, just the things we see most often.  Please make sure you see a direct primary care provider for pain lasting more than 2 weeks or involves nerve like sensation or weakness.

1. Increased sway or compression in the upper lumbar spine / thoracic lumber junction area where the superior nerve originates. 

2. Tightness in the QL or hip flexor muscles that can compress or irritate the superior cluneal nerves. 

3. Pain at L4-L5 that creates a sciatica effect and tightness in the deep hip rotators create irritation and circulation changes in that area.

4. Tendinopathy of the deep hip rotators. 

Any of these 4 areas can create irritation or inflammation along that superior counsel nerve pathway. A detailed assessment can help determine which of the four (or combination of the four) it might be.

A true entrapment of the superior cluneal nerves can also occur and be a source of low back pain.  This is discussed at a high level here by Trescott 2022 

No matter the origin, cupping is a nice start to treatment because it generates an immune healing response, it’s non invasive, relatively superficial, and let's us cover all of those areas quickly. The best part is that there are no medication side effects to the pain relief. Dry needling can be another, invasive option to treat deeper musculature and entrapment areas. 

Ultimately, we always have to assess for the cause of the inflammation to get the source of the problem and keep pain away. When pain is on board that can be really hard. So as we always say, assess first, get the pain down, and then address the root cause.

Cupping and treatment video by @bronze_age_chiro . Dr. Eric Perez at our Fairview Park location inside @ctownfitness_fairview_park.

Narration and Writing by @nicksanderspt. Dr. Nick Sanders PT, DPT, CSCS, CIDN. 

Learn a neuroinflammatory treatment model with Dr. Nick at Integrative Dry Needling.


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Written by Dr. Nicholas Sanders PT, DPT, CSCS, CIDN.  Dr. Sanders is the founder and owner of PHYT For Function where we provide a convenient and simple solution for people to continue to do the activities they love without muscle, joint, or nerve pain.  He is a national instructor for Integrative Dry Needling and Co-Creator of a Neuro-Inflammatory Manual Therapy course. 

Schedule a No Cost Phone Consult With Dr. Nick

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