Ischeogluteal bursitis

[joshmeyer]

I have a patient with what i think is the above condition. She experiences sharp pain in the lower glut/upper hamstring during and after sport. Her pain after sport is made worse by sitting. Then usually 20 mins of sitting goes by and she experiences lateral thigh/leg pain of a referred nature. She has had an MRI of her lumbar spine which was normal and a bone scan which was also normal as i wanted to rule out a stress fracture of her pubic ramus. Can anybody suggest a theory to explain the relationship of the upper hamstirng sharp pain that can be easily reproduced with a hamstring contraction, to the lateral leg/thigh pain? Would there be some fibrous adhesions around the hammy tendon irritating the sciatic nerve? Is the bursa easily palpated? Moreover does anyone know of any good treatment regimes/techniques?

[Dave]

sound like you are on the mark re the ischiogluteal bursitis or otherwise hamstrings origin tendinitis but they are difficult to differentiate clinically. Your theory about the sciatic nerve could be correct - but i would look at a few other things also - namely the sij, piriformis syndrome? and neural tension - although it is strange these would reproduce her symptoms in sitting but prob worth a look