Ischial bursitis is inflammation of the synovial bursa located between gluteus maximus muscle and ischial tuberosity.
Patients will present with gluteal pain and/or upper posterior thigh pain following prolonged sitting or exercise. The patient will most commonly complain of a low grade, pinpoint, and aching pain worsened by sitting down or stretching the gluteus maximus muscle.
Ischiogluteal bursitis, also referred to as Weaver's bottom, is mainly caused by synovitis and bursal effusion of the ischium, which usually affects adults and older populations.
Ischial bursitis is often caused by repetitive stress on an ischial bursa, causing it to become inflamed. This can happen when sitting for long periods of time or playing sports that require repetitive motion, like running or cycling.
Chronic pain: Untreated bursitis can lead to a permanent thickening or enlargement of the bursa, which can cause chronic inflammation and pain. Muscle atrophy: Long term reduced use of joint can lead to decreased physical activity and loss of surrounding muscle.
The condition is quite literally a pain in the butt. Symptoms include soreness, tenderness and swelling in the lower buttocks, and patients often notice that this pain worsens with movement. The area may also feel warm to the touch, as heat often accompanies inflammation. Ischial bursitis can affect anyone, at any age.
Causes of Ischial Bursitis
Ischiogluteal bursitis is caused by performing prolonged, repetitive activities that place stress on the ischiogluteal bursa. This is a common injury for athletes that participate in sports that require repetitive jumping, running and kicking.
Gently pull opposite knee toward chest until a stretch is felt in the buttocks. Perform 10 repetitions, holding for 5 seconds each side, 2-3 times a day. Cross involved leg over bent knee. Pull knee up and toward opposite shoulder until a stretch is felt in the hip or buttocks.
Exercise is often prescribed to improve joint pain, so walking could be a vital part of managing your bursitis symptoms.
Sleeping on your side is the most common recommendation for lots of pain patients, including those with osteoarthritis, bursitis, spinal stenosis as well as hip pain sufferers. Pregnant women should also sleep on their side for prevention of lower back and hip pain.
Activities or positions that put pressure on the hip bursa, such as lying down, sitting in one position for a long time, or walking distances can irritate the bursa and cause more pain.
The diagnosis of ischial bursitis is often missed due to its rarity and non-specific symptoms. The symptoms include pain in the buttock, posterior thigh, perineum, difficulty getting up and local swelling. The diagnosis is usually made clinically; however, ultrasound or MRI is advisable for confirmation.
Physiotherapy is an effective treatment to reduce symptoms of ischiogluteal bursitis.
Doctors may recommend over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to reduce inflammation in the bursa and tendon and relieve pain. These medications are typically recommended for a few weeks while the body heals.
It's also really important when suffering this type of pain, to avoid sitting with you legs crossed. At least until your symptoms settle down. It's also important that you sit with your hips a little bit higher than your knees to prevent compression of the hips tendons and bursa.
Physical therapy is often a part of the rehabilitation process for ischial tuberosity bursitis and often consists of exercises to strengthen and stretch muscles. Initial physical therapy treatments may include massage and the application of heat or ice to ease inflammation.
Conclusion: Ischiogluteal bursitis can be diagnosed with MRI by its characteristic location and cystic appearance.
The diagnosis of ischiogluteal bursitis is usually made clinically. However, imaging may be requested in doubtful cases. Ultrasound and MRI are excellent in depicting the lesions. Routine MRI sequences such as T1-weighted axial and T2-weighted axial images are sufficient to demonstrate the lesions.
Cases of malignant bursitis have been reported several times in the literature, though nearly all of the instances involved connective tissue or metastatic tumors. Tumor histologies include osteochondroma,8,9 malignant fibrous histiocytoma,10 synovial sarcoma,11 and metastatic breast cancer.
The key difference between arthritis and bursitis is the anatomical structures that they affect. Arthritis is a chronic condition that irreparably damages bone, cartilage, and joints, whereas bursitis is a temporary condition that involves the painful swelling of bursae for a time.