The medial branch of the superior cluneal nerve passes over the iliac crest through a tunnel formed by the thoracolumbar fascia and the superior rim of the iliac crest. This branch of the superior cluneal nerve may become restricted in its osteofibrous tunnel against the iliac crest, just as osteofibrous tunnels affect other nerves, such as in carpal tunnel syndrome. The clinical symptoms include pain at low back which may radiate to the ipsilateral leg. The clinical signs include marked tenderness at iliac crest rim just above the dimple at the buttock and decreased touch sensation of the buttock just below the iliac crest. The treatment includes elimination of inappropriate use such as forward bending or acute twisting of the low back, NSAID therapy and local steroid injection. Surgical treatment by nerve decompression is used for cases of severe pain with failure of conservative treatment.