Deep Gluteal syndrome

• Deep Gluteal syndrome:

  • Irritated sciatic nerve in the sub gluteal space
  • This causes buttock pain and sciatic type symptoms
• Deep Gluteal syndrome - Potential causes:

  • Gradual onset
  • Sedentary lifestyle
  • Repeated periods of hip flexion
  • Possible acute trauma
• Deep Gluteal syndrome - Who does it affect?

  • Footballers, dancers, cyclists
  • Plyometric sports
  • Manual workers with heavy lifting (lifting mechanics/manual handling)
• Deep Gluteal syndrome - Symptoms:

  • Hip and buttock pain
  • Gluteal tenderness
  • Often unilateral but sometimes bilateral
  • Unable to sit for more than 20 - 30 minutes
  • Disturbed or loss of sensation in an area of the affected limb
• Deep Gluteal syndrome - Objective findings

  • Neuroprovocation and neurointegrity tests e.g. Straight leg raise
  • Seated or lying piriformis stretch test
  • Pace’s sign - pts in sitting, resisted abduction and external rotation
• Deep Gluteal syndrome - Treatment:

  • Pain management, avoiding aggravators
  • Manual therapy, soft tissue release within pain limits
  • Sciatic nerve glide
  • Gluteal and lateral hip rotator stretches
  • Anaesthetic injection for pain relief
• Deep Gluteal syndrome - Investigations:

  • MRI
  • Nerve conduction tests