What is Deep Gluteal Syndrome & How is it Treated?

If you are feeling numbness and pain in your buttocks or bottoms that rushes down the back of your legs, then you may be suffering from deep gluteal pain or deep gluteal syndrome. This is a delicate condition and must be addressed medically. Let us understand deep gluteal syndrome, its symptoms, causes and treatment in detail.

Deep gluteal syndrome is a common condition and has many causes and conditions related to it. The main reason behind deep gluteal syndrome pain is the pressure caused by the muscles, skin and blood vessels on the nerves. The pressure forces the nerves to send pain signals to the brain. If there is a small amount of pain that goes away in a couple of days, it is normal and can happen to anyone. However, in the case of deep gluteal syndrome, it is usually severe and it stays for a long period of time and requires medical attention. Such pain does not go away just by resting.

In addition to the causes and symptoms of deep gluteal syndrome, it is important to note the medical conditions associated with deep gluteal syndrome. Some of these are:

Piriformis syndrome:^[2] Previously, the gluteal pain was called piriformis syndrome as doctors thought that it always comes from piriformis which is a muscle in your buttock. The sciatic nerve gets pressed because of the muscle that causes pain. However, there are many other muscles that can cause gluteal pain and result in deep gluteal syndrome.

Sciatica:^[3] Sciatica is a symptom of a condition, in which the sciatic nerve gets pressed. It controls the muscles of the knee and the lower leg. This nerve allows you to feel the back of your thigh, lower leg and the sole of the foot. In short, any problem with the nerve can cause severe pain in the whole lower body area, particularly on the affected side, which does not go away easily.

As these are associated conditions, they can either be present along with deep gluteal syndrome or need to be ruled out before confirming the diagnosis of deep gluteal syndrome.

The symptoms of deep gluteal syndrome appear mostly on one side of the body depending on the cause and underlying condition. In some cases, the pain in deep gluteal syndrome may be present on both sides which can be difficult to manage.

Some of the commonest symptoms of deep gluteal syndrome include

• Pain caused by pressing of the sciatic nerve
• Tender feeling and ache in the buttock
• Numbness in the buttock that can go down till the back of your leg
• Discomfort while sitting
• Worsening of pain when you try to sit
• Severe pain in the lower body

Though you should not ignore lower back pain, even if it is not acute, but in the cases mentioned below, immediate medical attention is necessary. Here are some of the most important concerns that could be the symptoms of deep gluteal syndrome and hence, must receive medical attention.

• If you feel the pain in your buttock, lower leg, thigh and the sole of your foot for a long period of time and it does not go away.
• If the pain gets worse with the time
• If you start feeling the pain after an injury
• If the pain leads to numbness in the buttock, thigh and lower leg
• If you find it hard to control your foot
• If you have difficulty in controlling your bladder and bowel moment

The causes of deep gluteal syndrome are mainly related to irritated muscles that put pressure on the sciatic nerve. Some circumstances that can lead to irritation of muscles and cause deep gluteal syndrome include the following.

• If you indulge in sitting job for a long period of time
• If you exercise a lot
• If you indulge in physical activities like running, walking or climbing a lot of stairs every day
• If you play sports especially football and basketball
• If your job includes lifting heavy objects
• If you have met with an accident or had a fall
• If you have twisted your hip too hard and too fast
• If there is a deep wound

Diagnosis of deep gluteal syndrome is based on history, physical examination and some investigations, if required. Some of the questions that help your doctor understand the severity of the condition include,

• When did you start feeling the pain?
• Does the pain shoot from your buttock to lower legs?
• Do you find it hard to sit down?
• Have you been in an accident?
• Do you exercise daily? If yes, what regimes you follow?
• Do you have a history of weak muscles in your family?

With the help of the answers that you provide, the doctor will determine if the scans like MRI^[4] or CT scan^[5] are appropriate. The imaging will help the doctor understand the damage caused to the nerve and will provide the information required to prescribe medication and therapy.

The treatment of deep gluteal syndrome includes proper medication as prescribed by the doctor and physiotherapy. Some of the important factors that help in the treatment of deep gluteal syndrome include

• Applying ice and warm compress, as appropriate
• Regular mild exercises and stretching,
• Proper rest and muscle relaxation
• Reducing some weight to release the load on lower back and hips

In some rare cases, the doctor may consider surgical treatment. It is only prescribed if the damage to the nerve is irreversible.

If you start feeling pain in your buttock, make sure to take rest. Do not push yourself with your exercises or daily activities. See a doctor as soon as possible. In many cases the pain goes away in a couple of days but if it worsens or if you feel numbness in the buttock and the lower body, it is time to check with the doctor to avoid any further damage to the nerves.

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