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A Year in Review-30

It's day 8 today of this 12 hip days of Christmas miniblog series. You can return to read previous blogs from the main blogpage. Yesterday our paper was one of the first that started to really delineate what piriformis syndrome is and isn't, and outline other causes of nerve impingement in the deep gluteal space. Today, we visit a paper published many years after, to examine the progress in our understanding of buttock pain related to sciatic nerve impingement. This paper provides a wealth of information, including a new diagnosis - deep gluteal syndrome - and clinical guidelines for assessment and management of this condition.

PAPER 8: Deep gluteal syndrome – Mini-symposium

Seven years after Filler’s paper on Piriformis and Related Entrapment Syndromes (see last post), Hal Martin and colleagues published this paper that redefined sciatic nerve entrapment as Deep Gluteal Syndrome and described contemporary assessment and management of the condition. These authors suggested that because there are several locations where the sciatic nerve can be entrapped, the term ‘deep gluteal syndrome’ instead of ‘piriformis syndrome’ is now preferred. Deep gluteal syndrome is the presence of pain in the buttock caused from non-discogenic and extrapelvic entrapment of the sciatic nerve in the deep gluteal space, beneath the gluteus maximus muscle.

12 HIP days of Christmas 2021-23

Key learnings about deep gluteal syndrome:

  1. Deep gluteal syndrome is now preferred over piriformis syndrome, as an umbrella term for pain associated with non-discogenic and extrapelvic entrapment of the sciatic nerve anywhere in the deep gluteal space.
  2. The deep gluteal space is the potential space beneath the gluteus maximus muscle, with the following borders: Superiorly: greater sciatic notch; Inferiorly: distal ischium; Laterally: gluteal tuberosity of femur; Medially: sacrotuberous ligament.
  3. The combination of the seated piriformis stretch test with the piriformis active test has shown useful clinimetric properties for diagnosing sciatic nerve entrapment.
  4. Treatment recommendations include physical therapy, analgesic and anti-inflammatory drugs, and injections), and surgical decompression of the nerve (endoscopic preferably).

if you are interested in learning more about this condition, which can often present diagnostic dilemmas and predispose to persistent pain states, you might like to complete the course below, benefit from the extended resources in Hip Academy or sign up for a live workshop.

SPECIAL CHRISTMAS OFFER - Scroll to the bottom to find out more. (400 x 40 px) (650 x 40 px) (500 x 350 px) (900 x 350 px) (450 x 350 px)

Join Hip Academy Today

Join Hip Academy Today

By becoming a member today you can enjoy the benefits of a world class educational Hip Program, specifically designed by Dr Alison Grimaldi to help improve your knowledge surrounding the Hip and Pelvis, and become an expert in your field.

By becoming a member today you can enjoy the benefits of a world class educational Hip Program, specifically designed by Dr Alison Grimaldi to help improve your knowledge surrounding the Hip and Pelvis, and become an expert in your field.

Like to learn more about assessment and treatment of patients with deep gluteal syndrome?

In this course, you can find detailed information on pathoaetiology, assessment and management of deep gluteal syndrome and many other conditions.

I hope you enjoyed the infographic and key learnings from Day 8 of my 12 Top Hip Papers. There are 4 more papers to come, so stay tuned and return to the blog page each day to see what other top papers and infographics I have for you!

Click the image above to read Paper 7

Click the image above to read Paper 9

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