Is it my Piriformis? Differentiating Buttock Pain in Clinical Practice
-- Benoy Mathew --
Chronic buttock pain is a common presentation in both sports medicine and primary care setting. Conditions like deep gluteal syndrome, ischio-femoral impingement and proximal hamstrings tendinopathy are being increasingly identified as cause of chronic gluteal pain in the physically active population. Multiple pathologies have been incorporated in this all-included ‘piriformis syndrome’.
The complex anatomy of the buttock and pelvis, variability of presentation and non-specific nature of signs and symptoms make the diagnostic process difficult. The aetiology of buttock pain is varied, it may be referred from the lower back, mimic other pathology and refer to the hip or the groin. The presentation of gluteal strains, hamstring tendinopathy/ tears or sacroiliac joint pathology is similar and for the clinician, eliciting the significant features in order to differentiate the diagnosis can be difficult. Whether it is the weekend warrior, yoga enthusiast or the competing triathlete, accurate diagnosis and management of chronic buttock pain can be challenging.
In this PowerTalk, we will be exploring deep gluteal syndrome (DGS) in detail. DGS is an under-diagnosed entity characterized by pain and or/dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the sub-gluteal space.
Chronic buttock pain is a common presentation in both sports medicine and primary care setting. Conditions like deep gluteal syndrome, ischio-femoral impingement and proximal hamstrings tendinopathy are being increasingly identified as cause of chronic gluteal pain in the physically active population. Multiple pathologies have been incorporated in this all-included ‘piriformis syndrome’.
The complex anatomy of the buttock and pelvis, variability of presentation and non-specific nature of signs and symptoms make the diagnostic process difficult. The aetiology of buttock pain is varied, it may be referred from the lower back, mimic other pathology and refer to the hip or the groin. The presentation of gluteal strains, hamstring tendinopathy/ tears or sacroiliac joint pathology is similar and for the clinician, eliciting the significant features in order to differentiate the diagnosis can be difficult. Whether it is the weekend warrior, yoga enthusiast or the competing triathlete, accurate diagnosis and management of chronic buttock pain can be challenging.
In this PowerTalk, we will be exploring deep gluteal syndrome (DGS) in detail. DGS is an under-diagnosed entity characterized by pain and or/dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the sub-gluteal space.
