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Recent research suggests that the ‘piriformis syndrome’ diagnosis is incomplete and does not adequately address all of the pelvic issues that could create sciatica-like pain. So, this type of pain is now referred to as deep gluteal pain syndrome (DGPS), which describes situations where compression of either the sciatic or pudendal nerves in the pelvic region rather than the low back creates sciatica. Besides entrapment by the piriformis muscle, other issues including gemelli-obturator internus syndrome, ischiofemoral impingement syndrome and proximal hamstring syndrome can all create sciatica. Symptoms typically include pain in the buttock and/or hip regions that may also radiate into the distribution of the sciatic nerve (posterior thigh and lower leg/foot). Pain can result from a direct insult to the region including trauma or issues that would reduce blood flow (ischemia). Common insults include falls, hip-related surgery, pain-induced muscle guarding and prolonged mechanical compression, like sitting on a wallet. If you are experiencing pain in the buttock region that potentially radiates down the back of the leg, give the following exercises a try and let me know if you have any questions. 1. Lumbar Rotation Stretch 2. Posterior Hip Muscle Stretch 3. Sciatic Nerve Glide 4. Sidelying Hip Abduction Reference : Park JW, et al. Deep gluteal syndrome as a cause of posterior hip pain and sciatica-like pain. Bone Joint J. 2020.
