Musculoskeletal Condition · Glastonbury, CT

Buttock and Sciatic Nerve Entrapment (Deep Gluteal Syndrome)

Buttock pain or burning down the leg may be deep gluteal sciatic nerve entrapment. Learn about evaluation with Dr. Paul Tortland, DO in Glastonbury, CT.

Written and clinically reviewed by

Paul D. Tortland, DO, FAOASM, CAQSM, RMSK

Dr. Paul Tortland, DO is a non-surgical orthopedic & sports medicine physician specializing in regenerative orthopedics and surgical alternative treatment. He is dual board-certified in Sports Medicine & Osteopathic Manipulative Medicine (OMM) and Regenerative Medicine, Fellowship-trained in Sports Medicine. He became the first physician in the world to earn board certification in Regenerative Medicine in 2015. Diplomate, American Board of Regenerative Medicine (ABRM), 2015. Registered in Musculoskeletal Ultrasound (RMSK).

Condition

What is deep gluteal syndrome?

The sciatic nerve passes through the deep muscles of the buttock and can be compressed there by a tight piriformis or other muscles, scar tissue, or nearby structures. The result is dull ache, sharp or burning pain, or tingling in the buttock and down the back of the leg. It closely mimics sciatica from the spine, so the first task is working out which it is, and Dr. Tortland uses ultrasound to examine the nerve where it passes through the buttock.

Explore related conditions: Browse the Hip condition hub for related diagnoses and treatment options.

CARE OPTIONS

How is deep gluteal syndrome treated?

Dr. Tortland’s potential treatment options: Dr. Tortland first distinguishes deep-gluteal sciatic nerve entrapment from sciatica caused by a lumbar disc or spinal stenosis. For selected, confirmed peripheral nerve entrapment, he may consider ultrasound-guided nerve hydrodissection; benefit is not guaranteed and evidence remains limited for many deep-gluteal presentations.

Physical therapy and traditional care: Care commonly includes physical therapy focused on hip mobility, gluteal strength, movement mechanics, and gradual return to activity, along with avoiding positions that reliably aggravate symptoms. A tailored program is preferable to prolonged rest.

When other care may be needed: Back-origin nerve compression, progressive weakness, or another structural cause may need imaging or specialist care. New bowel/bladder dysfunction or numbness in the groin/saddle region is an emergency.

Common questions

Questions about deep gluteal syndrome

What is deep gluteal syndrome?

It is compression of the sciatic nerve in the deep buttock, often by the piriformis muscle or tight bands of tissue. It causes buttock pain that may travel down the back of the leg and is often confused with sciatica from a disc problem.

How is it different from sciatica that starts in the back?

Back-origin sciatica usually comes from a spinal nerve root, while deep gluteal syndrome compresses the nerve in the buttock. Pain with sitting and a tender deep buttock point suggest the second, but spine imaging and ultrasound of the nerve may both be needed.

Can hydrodissection or an injection help?

Ultrasound-guided hydrodissection has relieved symptoms in published case reports, but there are no controlled trials, so results vary and are not guaranteed. Exercise and addressing the cause of compression are part of any plan.

When is buttock or leg pain urgent?

Sudden leg weakness, loss of bladder or bowel control, numbness in the groin or saddle area, or pain with fever needs urgent medical assessment. These symptoms can signal a problem beyond routine muscle tightness or peripheral nerve irritation, so do not wait for a scheduled appointment if they occur.

Buttock and Sciatic Nerve Entrapment (Deep Gluteal Syndrome)

What is deep gluteal syndrome?

How is deep gluteal syndrome treated?

Questions about deep gluteal syndrome

What is deep gluteal syndrome?

How is it different from sciatica that starts in the back?

Can hydrodissection or an injection help?

When is buttock or leg pain urgent?

Not sure which treatment fits your condition?