So you have pain in the butt, gluteus,
hip area? Everyone describes this pain with different
terminology, even doctors and researchers! This pain is not all that
uncommon for sciatic and back pain
sufferers. Gluteal pain that just won’t 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 McHenry chiropractor at OrthoIllinois Chiropractic is very
knowledgeable of the irritation of the sciatic nerve 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 cadaver and live volunteer study of the sciatic nerve during hip
rotation demonstrated that during
passive hip rotation, the sciatic nerve is very much linked
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 discovered
that passive movements of hip rotation and isometric contraction of muscles impacted
the sciatic nerve in the subgluteal space. They suggested that these
passive movements may well affect the sciatic nerve, producing retrotrochanteric pain in the gluteus. (3) Your McHenry 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 lies the sciatic nerve that extends
from the spine to the toes. Back in 2009, an early report of sciatic
nerve compression explained how endometriosis, abscess,
tumor, adjoining uterus, piriformis syndrome and newly presented
sciatic neuropathy as a result of compression of the sciatic
nerve by obturator internus tendon and muscle may well be causes
for sciatic pain. (4) Even earlier, in 2005, a chiropractic radiologist/clinician
and a chiropractic anatomist correlated 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) OrthoIllinois Chiropractic 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 – reported that deep gluteal syndrome
has been more talked about in the medical literature recently
but called all sorts of
different names: piriformis syndrome, gemelli-obturator internus syndrome,
ischiofemoral impingement syndrome, proximal hamstring syndrome. Reviewers characterized
this deep gluteal syndrome as posterior hip pain due to
nerve entrapment beyond the piriformis syndrome which can be caused by
nerve entrapment. If not pathological, the nerve entrapment of deep gluteal syndrome
can be conservatively treated. (6) Medical conservative and McHenry
chiropractic conservative each propose different options.
OrthoIllinois Chiropractic can help.
CONSERVATIVE TREATMENT OPTIONS
Before more invasive treatments are done, conservative
options are attempted. Medical approaches were enumberated
as rest, staying away from irritating movements, taking meds, getting
injections, or undergoing physiotherapy. Surgery may be done for patients with recurrent or persistent symptoms
after conservative care. (6) Chiropractors like your McHenry
chiropractor deliver conservative care effectively for most. The
clinician-author described conservative treatment as goading of
the bursa/sciatic nerve/muscle area – discussed as the GOIC (gemelli
obturator internus complex) area – along with Cox® Technic flexion distraction decompression
of the lumbar spine L5S1 area to relieve irritation of the
sciatic nerve. (5) Relief is often forthcoming for McHenry
chiropractic patients with this method.
CONTACT OrthoIllinois Chiropractic
Listen to this PODCAST
with Dr. Clint Dickason on The Back Doctors Podcast with
Dr. Michael Johnson as he describes the relief with The
Cox® Technic System of Spinal Pain Management.
Schedule your McHenry chiropractic
appointment soon. The gluteal/butt/hip pain – regardless of
its name – may get relief at last!