So you have pain in the butt, gluteus,
hip area? Everyone terms this pain with different
terminology, even doctors and researchers! This pain isn’t all that
uncommon for sciatic and back pain
sufferers. Gluteal pain that just will not go away – a “toothache
in the butt” – is more renowned nowadays as
its own issue often related to irritation of
the sciatic nerve. Your Montreal chiropractor at Dr. Hoang's Chiropractic 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 viewed as allowing external rotation
of the thigh. (1) A cadaver and live volunteer study of the sciatic nerve during hip
rotation documented that throughout
passive hip rotation, the sciatic nerve is very much linked
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 recorded
that passive movements of hip rotation and isometric contraction of muscles impacted
the sciatic nerve in the subgluteal space. They proposed that these
passive movements may well impact the sciatic nerve, triggering retrotrochanteric pain in the gluteus. (3) Your Montreal chiropractor
sees how anatomy shapes how pain is experienced
daily!
ANATOMY AND PAIN: The Sciatic Nerve
Right in the heart of|In the middle of
all these gluteal muscles is the sciatic nerve that runs
from the spine to the toes. Back in 2009, an early report of sciatic
nerve compression presented 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 continual
aching pain in the retrotrochanteric region of the hip and upper
posterolateral thigh. The anatomist described how the
structures in this area included the gemelli-obturator
internus muscle complex and related bursae. (5) Dr. Hoang's Chiropractic Clinic 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 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
can be conservatively treated. (6) Medical conservative and Montreal
chiropractic conservative each propose different options.
Dr. Hoang's Chiropractic Clinic 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, getting
injections, or undergoing physiotherapy. Surgery may be done for patients with recurrent or persistent symptoms
after conservative care. (6) Chiropractors like your Montreal
chiropractor deliver 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 irritation of the
sciatic nerve. (5) Relief is often forthcoming for Montreal
chiropractic patients with this approach.
CONTACT Dr. Hoang's Chiropractic 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 Montreal chiropractic
appointment soon. The gluteal/butt/hip pain – whatever
its name – may get relief at last!