Differentiating Buttock Pain and Sacroiliac Joint Disorders
Original Editors - Jessie Tourwe
Top Contributors - Mariam Hashem, Kim Jackson, Tarina van der Stockt, Lucinda hampton, Ewa Jaraczewska and Jess Bell
Where is the problem?
Gluteal or Buttock pain can be triggered by many causes such as[1]:
- Radicular pain from Lumbar spine origin
- Sciatic nerve entrapement
- Obturator internus/gemellus syndrome
- Piriformis Syndrome
- Quadratus femoris/ischiofemoral pathology
- Problems at the hamstrings
- Glutealmuscles disorders
The complicated anatomy of the SIJ, the Lumbar spine and the buttock area makes the differential diagnosis of pain and dysfunction a challenge. MRI findings are not consistent with LBP history and symptoms[2].
Considerations
The presence of chronic pain is not always caused by biopsychosocial causes. Missing the primary structural sources of the pain can lead to catastrophisation and development of fear avoidance and anxiety. Factors such as sleep, hormonal balance, smoking, the presence of comorbidities and activity level have an influence on their perception of the pain and the development of chronicity.The mangaemnt shouldn't focus only on the biosychosocial aspects without ignoring the structural causes.
Impingement of the sciatic nerve occurs mostly in the deep gluteal space and around the piriformis muscle than in the lumbar spine level.
Refernces[edit | edit source]
- ↑ Carro LP, Hernando MF, Cerezal L, Navarro IS, Fernandez AA, Castillo AO. Deep gluteal space problems: piriformis syndrome, ischiofemoral impingement and sciatic nerve release. Muscles, ligaments and tendons journal. 2016 Jul;6(3):384.
- ↑ Tonosu J, Oka H, Higashikawa A, Okazaki H, Tanaka S, Matsudaira K. The associations between magnetic resonance imaging findings and low back pain: A 10-year longitudinal analysis. PLoS One. 2017 Nov 15;12(11):e0188057.
