Deep Gluteal Syndrome

Deep gluteal [GLOO-tee-uhl] syndrome is pain and numbness you feel in your buttocks (bottom) that can sometimes go down the back of your leg. This pain is caused by the muscles, skin, and blood vessels in your buttocks pressing on nerves. This pressure sends signals to the brain that can cause severe pain.

Small amounts of pain that go away after a few days or a week are normal, but deep gluteal syndrome causes pain that is usually more severe and doesn’t go away, even with rest and basic care at home.

Some other conditions are similar to deep gluteal syndrome, part of it, or have many of the same symptoms. These include:

• Piriformis [PIH-rih-FOR-mis] syndrome. Deep gluteal syndrome used to be called piriformis syndrome, because healthcare providers thought the pain always came from the piriformis, a muscle in your buttock, pressing on your sciatic nerve. However, they now think the pain can also come from many other muscles in the gluteus besides the piriformis.
• Sciatica [sy-AH-tik-uh]. Sciatica is a symptom of a problem with the sciatic nerve, which controls the muscles in your knee and lower leg. The sciatic nerve also lets you feel the back of your thigh, your lower leg, and the sole of your foot. When this nerve is under pressure or damaged, you can feel serious pain in all these areas that doesn’t go away.

The most common symptom of deep gluteal syndrome is sciatica, which is nerve pain in the back of your thigh, lower leg, and sole of your foot. Other symptoms can include:

• Tenderness or aching in the buttock.
• Tingling or numbness that extends down the back of your leg.
• Having a hard time sitting.
• Feeling pain that gets worse the longer you sit.
• Pain that gets worse with activity like walking or exercise.
• Severe pain in the lower body.

Usually, you’ll feel the symptoms on one side of your body, but depending on how the deep gluteal syndrome was caused, you might feel it on both sides.

Call your healthcare provider if:

• The pain in your buttock, thigh, lower leg, or the sole of your foot doesn’t go away after a few weeks or is getting worse
• Your pain started after an injury

Get medical attention right away if:

• The pain in your buttock, thigh, or lower leg is combined with numbness
• You have trouble controlling your foot
• You have trouble controlling your bladder or bowels

The symptoms of deep gluteal syndrome are usually caused by the muscles, bones, or other parts of your gluteus pushing on the nerves in that part of your body, including the sciatic nerve. This can happen because the gluteal muscles get irritated or injured, which can make them swell and spasm. Muscles can be hurt for many reasons, including:

• Sitting for long periods

• Exercising too much
• Repetitive activities like running, walking, or climbing a lot of stairs
• Playing sports, especially contact sports like football
• Lifting heavy objects

In addition to these everyday activities, you might also damage the muscles in your gluteus with trauma that can be caused by:

• A car accident
• A fall
• Twisting your hip too hard and too fast
• A deep wound, like from a knife

If your pain starts after a trauma or injury, be sure to get medical attention right away.

If your healthcare provider thinks you have deep gluteal syndrome, they will start by doing a physical exam and asking you questions about your symptoms and medical history. Some of these questions might include:

• When did the pain start?
• Does the pain get worse when you do certain activities?
• What other treatments have you tried so far?

During the physical exam, your healthcare provider will press on the parts of your body that are causing pain and look at them for any visible signs of this syndrome. Depending on the results of this exam, your healthcare provider might order an imaging test like an MRI or CT scan. These tests take pictures of the inside of your body and can help diagnose deep gluteal syndrome or similar problems like a slipped disc, arthritis, or spinal stenosis [steh-NO-sis].

In many cases, deep gluteal syndrome goes away on its own. You can help the healing process with some basic home care, like rest, ice, compression, and elevating your leg. Other basic treatments include:

• Exercising safely. You should always use proper form and equipment when doing sports, but making sure to exercise correctly while you have deep gluteal syndrome can help you heal faster.
• Taking medicine. Over-the-counter pain medicine like ibuprofen, naproxen, and acetaminophen can reduce swelling and pain in the affected areas.
• Applying ice and heat. Using an ice pack and/or heating pad can reduce the swelling that irritates the nerve and can help decrease the amount of pain you feel.
• Stretching. Your healthcare provider or a physical therapist might have stretches you can do to relax and strengthen the muscles in your gluteus.

If your symptoms are more serious, your healthcare provider might recommend other treatments to relieve pain and help you feel better:

• Muscle relaxants. These medicines relax the muscle in your gluteus, reducing pain and giving you a chance to stretch and exercise muscle.
• Electrotherapy [ee-LEK-troh-THER-uh-PEE]. Electrotherapy like TENS can help reduce severe pain and stop muscle spasms in your gluteus.
• Surgery. Surgery usually is not necessary. But if no other treatment works, your healthcare provider might recommend surgery to relieve pressure on the nerve that is causing you pain.

While you can’t prevent deep gluteal syndrome from happening all the time, you can take some basic steps to reduce your risk of having this condition:

• Exercise. Exercise makes your muscles strong and reduces your chance of getting injured.
• Warm up. You should always warm up and stretch before exercising. Gradually increase how hard you’re working out to give your muscles and body a chance to adjust.
• Don’t push through pain. If something you’re doing is causing pain, stop. Pushing through the pain can cause injuries.
• Avoid pressure on hips. Some ways of sitting or lying down can put extra pressure on your hips that can trigger deep gluteal syndrome.

Deep gluteal [GLOO-tee-uhl] syndrome is pain and numbness in your buttocks, thigh, and lower leg that is caused by the muscles in your gluteus pressing on nerves that send pain signals to the brain.