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 sciatic and back pain
sufferers. Gluteal pain that just won’t go away – a “toothache
in the butt” – is more renowned today as
its own concern often associated with irritation of
the sciatic nerve. Your La Grande chiropractor at Paulette Hugulet, DC, LLC is very
knowledgeable of 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 seen to allow external rotation
of the thigh. (1) A study of the sciatic nerve in both live volunteers and
cadavers 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 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 proposed that these
passive movements may well affect the sciatic nerve, producing retrotrochanteric pain in the gluteus. (3) Your La Grande chiropractor
sees how anatomy shapes how pain is felt
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 report of sciatic
nerve compression discussed 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 connected 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 contained the gemelli-obturator
internus muscle complex and related bursae. (5) Paulette Hugulet, DC, LLC 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 – reported that deep gluteal syndrome
has been more recounted in the medical literature lately
but named in a variety of ways: 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
may well beb conservatively treated. (6) Medical conservative and La Grande
chiropractic conservative each offer different options.
Paulette Hugulet, DC, LLC can help.
CONSERVATIVE TREATMENT OPTIONS
Conservative treatment is typically
first before any more invasive treatments. Medical approaches were listed
as rest, avoiding 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 La Grande
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 La Grande
chiropractic patients with this method.
CONTACT Paulette Hugulet, DC, LLC
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 La Grande chiropractic
appointment soon. The gluteal/butt/hip pain – regardless of
its name – may get relief at last!