A pain in the bottom!
Today I am going to tell you about a rare and under-diagnosed form of hip pain known as ischial bursitis or “weaver’s bottom”.
What is ischial bursitis?
Ischial bursitis occurs when there is inflammation or irritation of the ischial bursa which is located over the bony prominence of the ischium deep to the gluteal maximus muscle in the pelvic region. This bursa is a small synovial fluid filled sac which prevents the gluteals muscles from rubbing on the sitting bone in your bottom- your ischium. When this sac gets irritated and inflamed, more synovial fluid is produced by the body in response which causes the bursa to become slightly larger and become compressed by the gluteal muscles which as a result causes quite a bit of pain and discomfort. This condition can be quite limiting and can prevent many people from continuing sport and running activities and can affect their ability to sit at work without an onset of pain.
How does it occur?
Ischial bursitis can develop as a result of prolonged sitting postures and positions, especially on hard surfaces which can cause friction and aggravate the ischial bursa. Development may also occur from unaccustomed activity such as getting back into running or hiking.
Signs and symptoms:
The signs and symptoms of ischial bursitis are very similar to those of other more common conditions such as hip joint pain, lower back pain and sciatica.
- Pain in the lower third of the bottom that can range from being an ache to being quite sharp in nature. (Can sometimes also be present in the front of the hip).
- Weakness in the hip and leg on the affected side.
- Inability to lie on the affected side to sleep due to pain.
- Running and prolonged sitting postures can make symptoms worse.
- Exercises that stretch the gluteal muscles will make the symptoms worse.
- Reduced mobility and a possible limp.
- Pain that can refer down into the calf on the affected leg and can be present with pins and needles.
Treatment and management:
The good news is that with proper management and treatment the condition can settle down and you can recommence the activities you love.
Treatment from an experienced physiotherapist will involve looking at provocative postures and positions to identify any contributing muscle imbalances, joint stiffness or muscle length issues which will help relieve compression off the irritated ischial bursa. A comprehensive rehabilitation program will also be of use when suffering from this condition to allow you to gradually return to activity and prevent re-occurrence of the pain.
And if things don’t seem to be settling down with conservative management there are other forms of medical management which can ease the pain including the use of anti-inflammatory medication and injections.
The key to getting better if you are suffering from ischial bursitis is accurate diagnosis and management. So if you are troubled by hip or bottom pain that’s not getting better come in and get an accurate diagnosis from one of our friendly Physiotherapists at Bend + Mend in Sydney’s CBD!