So you have pain in the butt, gluteus,
hip area? Everyone terms this pain with a variety of
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 renowned today as
its own issue often related to irritation of
the sciatic nerve. Your Richmond chiropractor at Johnson Chiropractic is very
experienced in sciatic
nerve irritation and its chiropractic care relief.
ANATOMY
There are multiple
overlapping structures in the region of this
gluteal/hip pain! The gemelli muscles lie in the posterior
hip area. Along with the obturator internus, piriformis, and quadratus femoris muscles,
the gemelli muscles were viewed as allowing external rotation
of the thigh. (1) A study of the sciatic nerve in both live volunteers and
cadavers during hip
rotation demonstrated that throughout
passive hip rotation, the sciatic nerve is very much related
to the gemelli-obturator internus complex, curving during
passive internal rotation and relaxing during external hip rotation. (2) In an
ultrasound study of the motions of gluteal
and subgluteal muscles, researchers recorded
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, producing retrotrochanteric pain in the gluteus. (3) Your Richmond chiropractor
sees how anatomy impacts how pain is felt
daily!
ANATOMY AND PAIN: The Sciatic Nerve
Right in the heart of|In the center of
all these gluteal muscles lies the sciatic nerve that runs
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 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 persistent
aching pain in the retrotrochanteric region 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) Johnson 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 – stated that deep gluteal syndrome
has been more conveyed in the medical literature lately
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 as a result of
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 Richmond
chiropractic conservative each offer different options.
Johnson 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, receiving
injections, or undergoing physiotherapy. Surgery may be done for patients with recurrent or persistent symptoms
after conservative care. (6) Chiropractors like your Richmond
chiropractor offer 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 Richmond
chiropractic patients with this approach.
CONTACT Johnson 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 Richmond chiropractic
appointment now. The gluteal/butt/hip pain – whatever
its name – may find its relief at last!