Do you have pain in the rearend, gluteus,
hip area? Everyone terms this pain with different
terminology, even doctors and researchers! This pain is not all that
unusual for sciatic and back pain
sufferers. Gluteal pain that just will not go away – a “toothache
in the butt” – is more well recognized nowadays as
its own concern often associated with irritation of
the sciatic nerve. Your Manchester chiropractor at Manchester Chiropractic & Sports Injuries is quite
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 viewed as allowing 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 very much 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 suggested that these
passive movements may well affect the sciatic nerve, producing retrotrochanteric pain in the gluteus. (3) Your Manchester chiropractor
recognizes 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 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 correlated the clinical
presentation of deep gluteal, sciatica-like pain in back pain patients with persistent
aching pain in the retrotrochanteric area of the hip and upper
posterolateral thigh. The anatomist described how the
structures in this area involved the gemelli-obturator
internus muscle complex and related bursae. (5) Manchester Chiropractic & Sports Injuries 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 recounted in the medical literature recently
but named in a variety of ways: 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 caused by
nerve entrapment. If not pathological, the nerve entrapment of deep gluteal syndrome
may well beb conservatively treated. (6) Medical conservative and Manchester
chiropractic conservative each propose different options.
Manchester Chiropractic & Sports Injuries can help.
CONSERVATIVE TREATMENT OPTIONS
Conservative treatment is typically
first before any more invasive treatments. Medical approaches were enumberated
as rest, avoiding irritating movements, taking meds, receiving
injections, or undergoing physiotherapy. Patients with
persistent or recurrent symptoms after conservative treatment may undergo
surgery. (6) Chiropractors like your Manchester
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 Manchester
chiropractic patients with this method.
CONTACT Manchester Chiropractic & Sports Injuries
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.
Schedule your Manchester chiropractic
appointment soon. The gluteal/butt/hip pain – whatever
its name – may get relief at last!