Gluteal Pain Syndrome
Gluteal pain syndrome, formally known as piriformis syndrome, is a common condition treated by our osteopaths at Recovery +, and is characterised by a combination of symptoms including posterior hip or buttock pain, alongside numbness and/or paraesthesia in the sciatic nerve distribution. Gluteal pain syndrome is most commonly diagnosed in middle aged population and is more likely to affect women than men.
Etiology
Gluteal pain syndrome is most often caused by macro-trauma to the buttocks, leading to inflammation of soft tissue & gluteal muscle spasms, and subsequent nerve compression. Direct trauma to the posterior hip, hip surgery and lumbar & sacroiliac pathologies can all lead to muscular spasms, resulting in gluteal pain syndrome.
Micro-trauma of the piriformis muscle, and other gluteal muscles can also cause gluteal pain syndrome. This micro-trauma often occurs from overuse, such as in runners, or by repetitive direct compression caused by sitting on hard surfaces for long periods of time.
The lower limb biomechanics are another area worth looking at to identify a potential cause for one’s gluteal pain. Altered biomechanics of the lower limb, lower back and pelvic region can result in dysfunction of the piriformis muscle, leading to compression or irritation of the sciatic nerve.
Common Symptoms
Persistent posterior hip pain (buttocks)
Radiating low back pain
Numbness &/or paraesthesia in sciatic nerve distribution
Difficulty with walking, sitting, squatting, standing
In more severe cases, difficulty with bowel movements and dyspareunia (painful intercourse) in women.
Investigations
There are limited tests that can diagnose gluteal pain syndrome. Imaging investigations are often used to rule out other possible causes of the symptoms the patient may be experiencing i.e. pathologies of the lumbar spine, sacroiliac joint or hip joint.
In persistent and more severe cases electromyography, electrophysiological testing and nerve blocks may be used to aid the diagnosis of suspected gluteal pain syndrome.
Physical Therapy Management
Osteopathic treatment including soft tissue mobilisation, stretching, dry needling and at home exercises can be utilised to aid in the improvement of gluteal pain syndrome symptoms.
Simple lifestyle modifications can also be implemented to avoid aggravation of symptoms associated with gluteal pain syndrome. Some of these include:
Avoid sitting for long periods of time. Get up and walk around every 20 minutes.
Make frequent stops when driving
Prevent direct trauma to the gluteal region
Daily stretching and a basic hip strengthening program is recommended
An example of a piriformis stretch that one can do at home is explained in the link below.
https://www.youtube.com/watch?v=mT-3b4rgRzg
Often a tailored hip strengthening program can greatly improve one’s pain associated with gluteal pain syndrome. This may be targeted at improving the lower limb biomechanics or addressing any weaker areas than could be contributing to the gluteal dysfunction.
At Recovery + we provide both hands on osteopathic treatment and tailored strength and conditioning coaching, so you can receive conservative management for gluteal pain syndrome all at one location.
If you think you may be experiencing gluteal pain syndrome or you are experiencing hip pain, book an appointment today!
