Pain along the back rim of the pelvis
Pressing on one spot often reproduces your main pain, which feels sharp or burning rather than deep and achy.
The cluneal nerves are small sensory nerves that cross the back of the pelvis and the top of the buttock. When they’re irritated, pain sits along the back rim of the pelvis and can spread into the buttock and side of the hip. It often feels sharp or burning and gets worse with sitting, bending forward or a belt across the area.
The nerves can get irritated where they pass through tight fascia, the connective tissue that wraps muscle, near the pelvic rim. Tight glute and deep hip muscles add pressure. Because of this, it can look like SI joint pain or sciatica even when the spine isn’t the main source.
For cluneal pain I rely on dry needling, a form of acupuncture, and electroacupuncture. The superior cluneal nerves cross the iliac crest, the top of the pelvic bone. Tight low back muscles and upper glutes can pin them there, so I needle those muscles. An irritable cluneal nerve gets electroacupuncture instead, with fine needles near it and a mild current to help reset its signaling.
Most people have had anti-inflammatory medication, injections, an MRI and often core strengthening. Medication and injections can ease pain for a while without changing irritation where the nerve crosses the pelvis. An MRI shows discs and the spine well but usually can’t show a small irritated surface nerve. That can lead to a disc-focused plan when the pain behaves differently. Physical therapy may already be in your history. In New York it can’t include needling, because PTs and chiropractors aren’t licensed to dry needle.
I start with which positions flare the pain, such as sitting, bending or twisting, and what reliably calms it. Then the exam:
Orthopedics, spine and pain medicine, and physical therapy all have a role here, and I work with them. If my findings suggest one of them should take another look, I’ll tell you and send my notes.
Not necessarily. Sciatica usually describes pain down the leg from an irritated nerve root in the low back. Cluneal nerve pain comes from small surface nerves over the back of the pelvis and upper buttock. The two can overlap, which is why a hands-on exam and nerve testing matter.
Yes. MRI is very good for discs and the spinal canal. It usually doesn’t show a small surface nerve irritated where it crosses the pelvis. Reproducing your pain on exam tells me more for this pattern.
I check how movement changes your pain, test strength, reflexes and sensation, and press along the back of the pelvis and upper buttock. I’m looking for the spot that reproduces the pain you recognize. I also test how your hips and low back share load.
A common start is once or twice a week within a 4 to 6 week course. Sessions taper as the back of the pelvis becomes less reactive. I adjust the plan based on how you respond, not a preset package.
It can help ease pain and reduce the muscle guarding around the nerve. The approaches often work together here. Softening the muscles along the iliac crest lifts pressure off the cluneal branches, and current applied near them helps quiet their firing.
Get urgent care for worsening weakness, rapidly spreading numbness, numbness in the saddle area, or new bowel or bladder problems. Fever with severe back pain, major trauma, a history of cancer or unplanned weight loss also need a doctor first. These need medical evaluation before needling.
Adults with pelvic floor, nerve and orthopedic pain, along with neurological conditions. Most of my patients come to me after other care hasn't fully settled things. If you're looking for general wellness acupuncture, I'm not the right fit.
We review your history and what you've already tried. I assess the muscles and nerves involved, and you're treated the same day.
It depends on the condition. Pelvic and orthopedic plans usually run 4 to 6 weeks. Neurological plans are usually 2 visits a week for 6 weeks or 3 a week for 4. After that, visits space out so the changes hold. These are typical timelines, not promises.
Yes. I work alongside doctors, physical therapists and specialists. If something I find needs a closer look from one of them, I'll tell you.
I'm an out-of-network provider. You pay at the time of your visit, and my office submits the claim so any reimbursement comes to you. Free benefit checks are available before your first visit through the verification form, and HSA and FSA cards work. I don't take Medicare or Medicaid, though some Medicare Advantage plans reimburse out-of-network care. Full insurance details
Yes. I treat adults, teens and children, though I don't specialize in infants or toddlers.
Yes. Book a free discovery call to ask your questions and see whether we're a good fit.
Dry needling is a form of acupuncture. Fine needles go into tight bands of muscle and trigger points to lower muscle tension and change how the area is signaling.
You may feel a brief twitch or a deep ache as the needle reaches tight muscle. It passes quickly, and any soreness afterward usually fades within a day or two.
It's generally safe with a properly trained practitioner. Needles are sterile and single-use, and I check your health history first, including blood thinners. In New York, dry needling can only be performed by licensed acupuncturists, MDs and DOs. Physical therapists and chiropractors aren't permitted to perform it.
Eat something light beforehand and wear loose clothing that lets me reach the area being treated.
Usually not. Ultrasound helps in a few specific cases, but it hasn't been shown to improve results for common trigger points. A careful hands-on exam is what guides the needle. More on ultrasound-guided dry needling
Dry needling aimed at the pelvic floor and the hip and abdominal muscles around it, for pain, tension and urinary symptoms driven by those muscles and their nerves. More on pelvic floor dry needling
Sometimes, depending on the muscles involved, and you'll be draped throughout. Treatment always follows your consent and comfort. I don't do internal exams or internal treatment.
No, though it helps if you've already seen a doctor or pelvic floor physical therapist. Bring any notes or imaging you have.
Completely. I've heard it all, and there's no judgment here, just a straightforward conversation so we can treat what's going on.
Yes, I treat adults of every gender and identity. After gender-affirming surgery involving the pelvis, bring your surgical notes and we'll decide together what fits.
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Evidence-based acupuncture and dry needling on the Upper West Side. From chronic pain and headaches to pelvic floor dysfunction, Dr. Jordan Barber pairs the highest level of training with care that actually listens.
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