Ischial Bursitis
About
Ischial bursitis is a painful irritation in the buttocks, specifically around the ischia, which are the bony parts you can feel in each buttock when you sit down. Usually, fluid-filled sacs called bursae protect the ischia, cushioning movements between the muscles and bones in the area. With excessive use, however, friction on the bursa can make it inflamed and irritated.
The condition is quite literally a pain in the butt. Symptoms include soreness, tenderness and swelling in the lower buttocks, and patients often notice that this pain worsens with movement. The area may also feel warm to the touch, as heat often accompanies inflammation.
Ischial bursitis can affect anyone, at any age. Patients with the condition aren't necessarily athletic or involved in physically demanding activities. Usually, they report sitting on hard surfaces for long periods of time, and some also report frequently riding horses. Injuries that involve trauma to the ischial bursae, like landing on the buttocks during a fall, can also cause the condition.
In physically active patients with ischial bursitis, the condition often develops after they perform activities that involve excessive contraction of the hamstrings (muscles at the back of the thighs), like running. These muscles can rub on the bursae, making them sore and irritated.
Regardless of the cause, however, proper care is effective for ischial bursitis. Your healthcare practitioner will select from a wide variety of healing modalities that will help decrease pain, decrease inflammation and improve movement.
Anatomy
Just like hinges need oil to move smoothly, our bodies need a lubricant to ensure smooth, comfortable movement between muscles, bones and tendons. This is where bursae come in. Much like greasy water balloons, these fluid-filled sacs provide padding and lubrication throughout the body, protecting muscles and tendons from rubbing against adjacent bones. Without them, the friction produced during movement would make even simple activities irritating.
With ischial bursitis, it's one of the bursae that cushions your ischia in the lower pelvis (around the lower buttocks) that becomes inflamed. Shaped like a V, the ischia are the two hard protrusions you can feel in the lower part of each buttock. Because they stick out this way, the surrounding soft tissue is prone to irritation. That's why the bursae are there. Each ischial bursa separates an ischium from the gluteus maximus muscle (buttock muscle).
While the ischial bursae do a good job dampening the friction of everyday tasks, they can't handle too much stress. Strenuous exercise, repetitive physical activity, direct trauma to the bursae or long periods of sitting on hard surfaces can all cause excessive friction between the ischial bursae and the surrounding muscles and bones. This makes the bursae inflamed, leading to painful irritation.
Several anatomical factors can predispose people to this problem. Differences in leg length, dysfunctions in the hip and chronic problems in the low back can all affect the position of the pelvis, and therefore affect the bursae. If the pelvis is positioned in such a way that it places more stress on the bursae, for example, it causes more friction and therefore increases the likelihood of irritation.
When you visit your chiropractor for management of ischial bursitis, he or she will perform a thorough assessment to determine what factors contributed to your condition. Once these are established, your chiropractic care can begin.
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