If we divid the word Bursitis into two

Bursa – is a small fluid filled sac that reduces friction at certain points in the body (usually between tendon/muscle and bone).

Itis – inflammation

so put the two together and you have = inflammation of the bursa

Essentially this is an irritated bursa. The ‘Ischiogluteal’ bursa sits on the sitting bones! Pardon the pun. Running past it are the hamstrings tendons (again pardon the pun ?‍♂️) .

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People with this condition describe it as; sitting on a stone, burning deep in the bum, very focal point of tenderness, alternative sitting habits, difficulty sitting down. As this condition is usually worse upto sitting people are forced to stand up.

this bursa becomes irritated most commonly in those whom have sedentary lifestyles. Where they drive to work, are sat down at work, then drive home and sit on the sofa again. This is a lot of sitting. Even though our ancestors the homo-sapiens also sat for roughly 10 hours a day, a lot of it was interrupted! So this is essentially a lifestyle trade-off  condition. However there are circumstances where this condition arises from other causes.

Causes include:

– repetitive use of hamstrings – running / cycling (this usually lasts for a short time as these individuals are active – however ischiogluteal bursitis can last for a much longer time in those sedentary individuals).

-direct trauma (resultant bleeding)

-inflammation (arthritis, infection (rare), CPPD (crystal deposition)

 

in other bursa’s which become inflamed – they are usually secondary to another more concerning condition. However in the case of ischiogluteal bursitis it is mainly a mechanical issue. Hence it is really important to get your problems checked out.

 

Treatment

Once investigations for the primary cause of bursitis is investigated, then treatment can begin.

Musculoskeletal therapy consisting of manual therapy and exercise is the gold standard of  treatment for these issues. Majority of people will respond to this treatment and get fully better, some however may need further help with NSAID medications and last line of treatment is an invasive corticosteroid injection.

Manual therapy treatments may include:

– Cryotherapy (ice / heat)

-Therapeutic ultrasound (in clinics where available only)

-Dry Needling / Acupunture / Friction Massage

-Active +Passive Muscle Release Techniques

-Exercise – Nordic curls work on hamstrings / supplementary leg / glute ‘ Piriformis muscle work (all of these will depend on the individual)