So you have pain in the butt, gluteus,
hip area? Everyone terms this pain with different
terminology, even doctors and researchers! This pain isn’t all that
unusual for back pain and leg pain
sufferers. Gluteal pain that just will not go away – a “toothache
in the butt” – is more well recognized nowadays as
its own issue often associated with irritation of
the sciatic nerve. Your Ashburn chiropractor at Poulin Chiropractic of Herndon and Ashburn is quite
knowledgeable of sciatic
nerve irritation and its chiropractic care relief.
ANATOMY
Many structures come together in the region of this
gluteal/hip pain! The gemelli muscles are positioned in the posterior
hip area. Along with the obturator internus, piriformis, and quadratus femoris muscles,
the gemelli muscles were seen to allow external rotation
of the thigh. (1) A study of the sciatic nerve in both live volunteers and
cadavers during hip
rotation showed that during
passive hip rotation, the sciatic nerve is closely related
to the gemelli-obturator internus complex, curving during
passive internal rotation and relaxing during external hip rotation. (2) In a study using ultrasound to see the motions of gluteal
and subgluteal muscles, researchers documented
that passive movements of hip rotation and isometric contraction of muscles affected
the sciatic nerve in the subgluteal space. They suggested that these
passive movements may well impact the sciatic nerve, triggering retrotrochanteric pain in the gluteus. (3) Your Ashburn chiropractor
recognizes how anatomy shapes how pain is experienced
every day!
ANATOMY AND PAIN: The Sciatic Nerve
Right in the heart of|In the middle of
all these gluteal muscles is the sciatic nerve that extends
from the spine to the toes. Back in 2009, an early description of sciatic
nerve compression presented how endometriosis, abscess,
tumor, adjoining uterus, piriformis syndrome and newly discussed
sciatic neuropathy as a result of compression of the sciatic
nerve by obturator internus tendon and muscle may well be reasons
for sciatic pain. (4) Even earlier, in 2005, a chiropractic radiologist/clinician
and a chiropractic anatomist connected the clinical
presentation of deep gluteal, sciatica-like pain in back pain patients with persistent
aching pain in the retrotrochanteric region of the hip and upper
posterolateral thigh. The anatomist illustrated how the
structures in this area involved the gemelli-obturator
internus muscle complex and related bursae. (5) Poulin Chiropractic of Herndon and Ashburn finds this to
be a small area for everything to fit!
TERMINOLOGY
A review of just what is published about deep gluteal
syndrome – pain in the gluteus – stated that deep gluteal syndrome
has been more talked about in the medical literature recently
but termed differently: piriformis syndrome, gemelli-obturator internus syndrome,
ischiofemoral impingement syndrome, proximal hamstring syndrome. Reviewers defined
this deep gluteal syndrome as posterior hip pain due to
nerve entrapment beyond the piriformis syndrome which can be due to
nerve entrapment. If not pathological, the nerve entrapment of deep gluteal syndrome
can be conservatively treated. (6) Medical conservative and Ashburn
chiropractic conservative each offer different options.
Poulin Chiropractic of Herndon and Ashburn can help.
CONSERVATIVE TREATMENT OPTIONS
Before more invasive treatments are done, conservative
options are tried. Medical approaches were enumberated
as rest, staying away from irritating movements, taking meds, receiving
injections, or doing physiotherapy. Surgery may be done for patients with recurrent or persistent symptoms
after conservative care. (6) Chiropractors like your Ashburn
chiropractor deliver conservative care effectively for most. The
clinician-author explained conservative treatment as goading of
the bursa/sciatic nerve/muscle area – referred to as the GOIC (gemelli
obturator internus complex) area – along with Cox® Technic flexion distraction decompression
of the lumbar spine L5S1 area to relieve pressure on the
sciatic nerve. (5) Relief is often forthcoming for Ashburn
chiropractic patients with this approach.
CONTACT Poulin Chiropractic of Herndon and Ashburn
Listen to this PODCAST
with Dr. Clint Dickason on The Back Doctors Podcast with
Dr. Michael Johnson as he illustrates the relief with The
Cox® Technic System of Spinal Pain Management.
Make your Ashburn chiropractic
appointment soon. The gluteal/butt/hip pain – whatever
its name – may find its relief at last!