Ischial bursitis

Last updated
Ischial bursitis
Specialty Orthopaedics
Symptoms Inflammation, Pain
CausesProlonged sitting on hard surfaces

Ischial bursitis (also known as weaver's bottom) is inflammation of the synovial bursa located between gluteus maximus muscle and ischial tuberosity.

Contents

Signs and symptoms

Ischial bursitis causes pain down the posterior aspect of the upper thigh. [1] [2] There may be pain over the ischial tuberosity. [2] Chronic ischial bursitis may cause paraesthesia. [2] This pain may become immediately more severe when sitting down. [3]

Cause

Ischial bursitis is usually caused by prolonged sitting on a hard surface. [1] It may also be related to ischial apophysitis, which may be caused by exercise, particularly in young and athletic patients. [1]

Mechanism

The ischial bursa is a synovial bursa located between gluteus maximus muscle and ischial tuberosity. [4] When in a seated position, the ischial bursa is put under the highest amount of pressure, which is most significant against a hard surface. [3]

Friction from exercise can lead to inflammation of the ischial bursa, known as bursitis. [1]

Diagnosis

Ischial bursitis is usually diagnosed clinically based on symptoms. An x-ray (using injected contrast agent) may be used to identify the formation of calluses. [1]

Treatment

Ischial bursitis is usually treated conservatively. Lifestyle changes may be advised, avoiding certain exercises and sitting on hard surfaces. [1] Analgesics, such as nonsteroidal anti-inflammatory drugs, may be used relieve pain. [1]

Ischial bursitis may be treated with medical and surgical interventions if it is persistent or particularly severe. Analgesics, anaesthetics, or triamcinolone may be injected to relive pain. [3]

Epidemiology

Ischial bursitis is a fairly rare illness. When a patient presents with symptoms, other conditions such as a spinal disc herniation may be considered. [3]

History

Ischial bursitis is also known as "weaver's bottom" and "tailor's bottom" after professions which involve prolonged sitting on a hard surface. [1]

Related Research Articles

Gluteus maximus Largest and most superficial of the three gluteal muscles

The gluteus maximus is the main extensor muscle of the hip. It is the largest and outermost of the three gluteal muscles and makes up a large part of the shape and appearance of each side of the hips. Its thick fleshy mass, in a quadrilateral shape, forms the prominence of the buttocks. The other gluteal muscles are the medius and minimus, and sometimes informally these are collectively referred to as the "glutes".

Bursitis Human disease

Bursitis is the inflammation of one or more bursae of synovial fluid in the body. They are lined with a synovial membrane that secretes a lubricating synovial fluid. There are more than 150 bursae in the human body. The bursae rest at the points where internal functionaries, such as muscles and tendons, slide across bone. Healthy bursae create a smooth, almost frictionless functional gliding surface making normal movement painless. When bursitis occurs, however, movement relying on the inflamed bursa becomes difficult and painful. Moreover, movement of tendons and muscles over the inflamed bursa aggravates its inflammation, perpetuating the problem. Muscle can also be stiffened.

Quadratus femoris muscle

The quadratus femoris is a flat, quadrilateral skeletal muscle. Located on the posterior side of the hip joint, it is a strong external rotator and adductor of the thigh, but also acts to stabilize the femoral head in the acetabulum. Quadratus femoris use in the Meyer's muscle pedicle grafting to prevent avascular necrosis of femur head.

Gluteal muscles Group of three muscles which make up the buttocks

The gluteal muscles are a group of three muscles which make up the buttocks: the gluteus maximus, gluteus medius and gluteus minimus. The three muscles originate from the ilium and sacrum and insert on the femur. The functions of the muscles include extension, abduction, external rotation, and internal rotation of the hip joint.

Muscles of the hip Causes movement in the hip.

In human anatomy, the muscles of the hip joint are those muscles that cause movement in the hip. Most modern anatomists define 17 of these muscles, although some additional muscles may sometimes be considered. These are often divided into four groups according to their orientation around the hip joint: the gluteal group; the lateral rotator group; the adductor group; and the iliopsoas group.

The gluteal tuberosity is the lateral ridge above the linea aspera of the femur. It is the site of insertion of the gluteus maximus muscle.

Snapping hip syndrome

Snapping hip syndrome, also referred to as dancer's hip, is a medical condition characterized by a snapping sensation felt when the hip is flexed and extended. This may be accompanied by a snapping or popping noise and pain or discomfort. Pain often decreases with rest and diminished activity. Snapping hip syndrome is commonly classified by the location of the snapping as either extra- articular or intra-articular.

Inferior gluteal nerve

The inferior gluteal nerve is the main motor neuron that innervates the gluteus maximus muscle. It is responsible for the movement of the gluteus maximus in activities requiring the hip to extend the thigh, such as climbing stairs. Injury to this nerve is rare but often occurs as a complication of posterior approach to the hip during hip replacement. When damaged, one would develop gluteus maximus lurch, which is a gait abnormality which causes the individual to 'lurch' backwards to compensate lack in hip extension.

Ischium

The ischium forms the lower and back part of the hip bone.

Sacrotuberous ligament

The sacrotuberous ligament is situated at the lower and back part of the pelvis. It is flat, and triangular in form; narrower in the middle than at the ends.

Ischial tuberosity Bones used to sit

The ischial tuberosity, also known colloquially as the sit bones or sitz bones, or as a pair the sitting bones is a large swelling posteriorly on the superior ramus of the ischium. It marks the lateral boundary of the pelvic outlet.

The body of femur, is the almost cylindrical, long part of the femur. It is a little broader above than in the center, broadest and somewhat flattened from before backward below. It is slightly arched, so as to be convex in front, and concave behind, where it is strengthened by a prominent longitudinal ridge, the linea aspera.

Prepatellar bursitis Inflammation of the prepatellar bursa at the front of the knee

Prepatellar bursitis is an inflammation of the prepatellar bursa at the front of the knee. It is marked by swelling at the knee, which can be tender to the touch and which generally does not restrict the knee's range of motion. It can be extremely painful and disabling as long as the underlying condition persists.

Ulnar styloid process

The styloid process of the ulna is a bony prominence found at distal end of the ulna in the forearm.

Knee effusion

Knee effusion occurs when excess synovial fluid accumulates in or around the knee joint. It has many common causes, including arthritis, injury to the ligaments or meniscus, or fluid collecting in the bursa, a condition known as prepatellar bursitis.

Greater trochanteric pain syndrome (GTPS), is inflammation of the trochanteric bursa, a part of the hip.

Olecranon bursitis

Olecranon bursitis is a condition characterized by swelling, redness, and pain at the tip of the elbow. If the underlying cause is due to an infection, fever may be present. The condition is relatively common and is one of the most frequent types of bursitis.

Subacromial bursitis

Subacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon from the overlying coraco-acromial ligament, acromion, and coracoid and from the deep surface of the deltoid muscle. The subacromial bursa helps the motion of the supraspinatus tendon of the rotator cuff in activities such as overhead work.

Hip bone

The hip bone is a large irregular bone, constricted in the center and expanded above and below. In some vertebrates it is composed of three parts: the ilium, ischium, and the pubis.

The bicipitoradial bursa is a bursa located between the distal tendon of the biceps brachii muscle and the anterior part of the tuberosity of the radius. It partially or completely wraps around the biceps tendon. It ensures frictionless motion between the biceps tendon and the proximal radius during pronation and supination of the forearm. With pronation, the tuberosity of the radius rotates posteriorly, causing compression of the bursa between the biceps tendon and the radial tuberosity.

References

  1. 1 2 3 4 5 6 7 8 Olsen, Nicholas K.; Press, Joel M.; Young, Jeffrey L. (2011-01-01), Lennard, Ted A.; Walkowski, Stevan; Singla, Aneesh K.; Vivian, David G. (eds.), "11 - Bursae Injections", Pain Procedures in Clinical Practice (Third Edition), Saint Louis: Hanley & Belfus, pp. 77–81, doi:10.1016/b978-1-4160-3779-8.10011-9, ISBN   978-1-4160-3779-8 , retrieved 2021-03-08
  2. 1 2 3 Guanche, Carlos A. (2012-12-01). "Proximal Hamstring Syndrome: Repair and Ischial Bursectomy". Operative Techniques in Sports Medicine. Innovations in Hip Arthroscopy. 20 (4): 333–339. doi:10.1053/j.otsm.2012.09.007. ISSN   1060-1872.
  3. 1 2 3 4 Ombregt, Ludwig (2013-01-01), Ombregt, Ludwig (ed.), "47 - Disorders of the inert structures", A System of Orthopaedic Medicine (Third Edition), Churchill Livingstone, pp. 629–649.e3, doi:10.1016/b978-0-7020-3145-8.00047-8, ISBN   978-0-7020-3145-8 , retrieved 2021-03-08
  4. Fauci, Anthony (2010). Harrison's Rheumatology, Second Edition. McGraw-Hill Professional Publishing; Digital Edition. p. 271. ISBN   9780071741460.