So you have pain in the rearend, gluteus,
hip area? Everyone terms this pain with a variety of
terminology, even doctors and researchers! This pain isn’t all that
uncommon for back pain and leg pain
sufferers. Gluteal pain that just will not go away – a “toothache
in the butt” – is more well recognized today as
its own issue often associated with irritation of
the sciatic nerve. Your Burlington and Hamilton chiropractor at Spinal Care Clinic is very
knowledgeable of sciatic
nerve irritation and its chiropractic care relief.
ANATOMY
Many structures come together in the area 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 documented that during
passive hip rotation, the sciatic nerve is closely related
to the gemelli-obturator internus complex, curving throughout
passive internal rotation and relaxing during external hip rotation. (2) In an
ultrasound study of the motions of gluteal
and subgluteal muscles, researchers found
that passive movements of hip rotation and isometric contraction of muscles affected
the sciatic nerve in the subgluteal space. They proposed that these
passive movements may well affect the sciatic nerve, triggering retrotrochanteric pain in the gluteus. (3) Your Burlington and Hamilton chiropractor
recognizes how anatomy shapes how pain is senses
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 discussed how endometriosis, abscess,
tumor, adjoining uterus, piriformis syndrome and newly discussed
sciatic neuropathy due to 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 continual
aching pain in the retrotrochanteric area of the hip and upper
posterolateral thigh. The anatomist described how the
structures in this area contained the gemelli-obturator
internus muscle complex and related bursae. (5) Spinal Care Clinic notes how tight an area it is 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 recounted 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 as a result of
nerve entrapment beyond the piriformis syndrome which can be caused by
nerve entrapment. If not pathological, the nerve entrapment of deep gluteal syndrome
may well beb conservatively treated. (6) Medical conservative and Burlington and Hamilton
chiropractic conservative each propose different options.
Spinal Care Clinic 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 performing physiotherapy. Surgery may be done for patients with recurrent or persistent symptoms
after conservative care. (6) Chiropractors like your Burlington and Hamilton
chiropractor deliver conservative care effectively for most. The
clinician-author explained 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 Burlington and Hamilton
chiropractic patients with this approach.
CONTACT Spinal Care Clinic
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.
Make your Burlington and Hamilton chiropractic
appointment soon. The gluteal/butt/hip pain – regardless of
its name – may find its relief at last!