This is for our readers who treat pain patients.
Author: Jenna Fletcher
Medical News Today
Ischial bursitis is a condition in which fluid filled sacs in the pelvis become swollen and painful. Sitting for long periods on hard surfaces is a common cause of ischial bursitis.
Ischial bursitis can cause problems with walking, running, or sitting. Treatments are available to reduce inflammation and improve symptoms.
This article discusses what ischial bursitis is, how to treat it, and when to see a doctor.
Ischial bursitis occurs when the bursae in the joints of the lower pelvis become inflamed. Bursae are present all over the body near joints. They are fluid filled sacs that reduce friction resulting from muscles and tendons moving against skin and bones. They also facilitate movement but can become inflamed if there is too much pressure or friction in the area over an extended period.
The ischial bursae sit just below the buttocks, or gluteus maximus muscles. Their primary role is to prevent the gluteus maximus tendons from rubbing against the part of the pelvic bone that a person sits on.
Some people refer to ischial bursitis as “weaver’s bottom” because the first noted cases of the condition were in weavers, who traditionally sit on hard surfaces for long periods.
Ischial bursitis causes pain in the lower part of the buttocks that can travel down the leg. The pain might worsen when:
The pain is similar to that of sciatica. Sciatica occurs when a ruptured disk in the lower back places pressure on the sciatic nerve. Sciatica causes a sharp pain in the lower back that travels down the leg.
Treatment will usually involve lifestyle changes and home remedies. If the symptoms do not improve, a doctor may recommend medical treatments.
The following steps may help people manage ischial bursitis:
- resting from the activity causing the problem, such as sitting on a hard surface for long periods
- using ice packs to reduce swelling in the area
- taking nonsteroidal anti-inflammatory drugs, such as ibuprofen
- stretching the legs and lower back
If lifestyle changes and home treatments are not working, a doctor may recommend corticosteroid injections with lidocaine into the affected bursae. This treatment should provide immediate relief.
Doctors may also recommend increased exercise frequency and advise people with overweight to lose weight. These lifestyle changes may help prevent the problem from reoccurring.
It is important to discuss any exercises or stretches with a healthcare professional before incorporating them into a physical activity regimen. The healthcare professional can help the person avoid exercises that might worsen the problem or cause injuries.
A physical therapist can provide a range of exercises to treat pain and improve mobility in the buttocks, lower back, and legs.
Some examples of exercises and stretches include:
Lying buttocks stretch
People can perform a lying buttocks stretch as follows:
- Lie flat on the back with the head resting on a pillow and keep the legs straight.
- Slowly bend the right knee in toward the chest.
- Placing the hands around the thigh, just below the back of the knee, pull the knee closer to the chest.
- Hold the stretch for 5–10 seconds before returning to the starting position.
- Repeat 6 to 10 times on each leg.
Sitting rotation stretch
The sitting rotation stretch works both the buttocks and the oblique muscles in the core:
- Sit with a straight back and both feet straight out in front.
- Bend the right knee and place the foot flat on the floor.
- Move the right foot to the outside of the left knee.
- Gently twist to the right, pushing the left elbow against the right knee and looking over the right shoulder.
- Hold the stretch for 30 seconds, then return to the starting position.
- Repeat using the other leg.
Hip extensions can help strengthen the lower back and buttocks:
- Start on all fours with the knees under the hips and the hands under the shoulders, keeping the neck straight.
- Stretch the left arm out in front and the right leg out behind.
- Slowly raise the outstretched left arm and right leg until they align with the back.
- Hold the position for 2 seconds before switching to the other side.
- Repeat the exercise lifting the right arm and left leg.
- Repeat the above steps 5 times.
These exercises should not cause any additional pain. A person should stop the exercise immediately if they experience pain in the buttocks, lower back, or legs.
Some causes of pain in the buttocks will go away on their own without medical treatment. For example, vigorous exercise can cause muscle strains that produce temporary pain in the area.
However, it is important to see a doctor for persistent pain in the lower back, buttocks, or legs. This pain may be due to an underlying condition that requires treatment.
A doctor can make a diagnosis by evaluating the person’s symptoms and conducting a physical examination. After diagnosing the problem, they can provide advice on treatment and prevention.
Ischial bursitis causes pain in the buttocks and upper legs. It is the result of fluid filled sacs called bursae in the pelvis becoming inflamed. A common cause of ischial bursitis is sitting for long periods on a hard surface.
Treatment for ischial bursitis includes lifestyle changes and home treatments, such as performing regular exercises and stretches. A doctor may also recommend anti-inflammatory medication if other interventions are not working.