Isolated upper buttock pain provoked by L5 nerve root compression - a case report.

UNLABELLED

Nerve root compression in lumbar spine may be associated with low back pain. However, isolated gluteal pain without any radicular symptoms in patient with lateral recess stenosis is rather unexpected and to our knowledge was not reported in the literature.

A CASE REPORT

We present a patient that suffered from isolated upper buttock pain without any radicular component. A series of selective injections under image guidance was performed in order to determine the source of patient's pain which turned out to be L5 nerve root compression. Following microsurgical decompression our patient remained pain free in a 1-year follow-up. Possible mechanisms underlying lumbar disc herniation-related low back pain and its management strategy are discussed.

CONCLUSIONS

Although very rare, L5 nerve root compression may manifest as exclusively axial pain without any radiculopathy. In such cases, L5/S1 transforaminal injection with Xylocaine should be performed in order to confirm the origin of pain. Surgeons should not be afraid to propose microsurgical decompression in such a case scenario.