Ischial bursitis

Ischial bursitis (also known as weaver's bottom) is inflammation of the synovial bursa located between gluteus maximus muscle and ischial tuberosity.

Ischial bursitis
SpecialtyOrthopaedics
SymptomsInflammation, Pain
CausesProlonged sitting on hard surfaces

Signs and symptoms

Ischial bursitis causes pain down the posterior aspect of the upper thigh.[1][2] There may be pain over the ischial tuberosity.[2] Chronic ischial bursitis may cause paraesthesia.[2] This pain may become immediately more severe when sitting down.[3]

Cause

Ischial bursitis is usually caused by prolonged sitting on a hard surface.[1] It may also be related to ischial apophysitis, which may be caused by exercise, particularly in young and athletic patients.[1]

Mechanism

The ischial bursa is a synovial bursa located between gluteus maximus muscle and ischial tuberosity.[4] When in a seated position, the ischial bursa is put under the highest amount of pressure, which is most significant against a hard surface.[3]

Friction from exercise can lead to inflammation of the ischial bursa, known as bursitis.[1]

Diagnosis

Ischial bursitis is usually diagnosed clinically based on symptoms. An x-ray (using injected contrast agent) may be used to identify the formation of calluses.[1]

Treatment

Ischial bursitis is usually treated conservatively. Lifestyle changes may be advised, avoiding certain exercises and sitting on hard surfaces.[1] Analgesics, such as nonsteroidal anti-inflammatory drugs, may be used to relieve pain.[1]

Ischial bursitis may be treated with medical and surgical interventions if it is persistent or particularly severe. Analgesics, anaesthetics, or triamcinolone may be injected to relive pain.[3]

Epidemiology

Ischial bursitis is a fairly rare illness. When a patient presents with symptoms, other conditions such as a spinal disc herniation may be considered.[3]

History

Ischial bursitis is also known as "weaver's bottom" and "tailor's bottom" after professions which involve prolonged sitting on a hard surface.[1]

References
  1. Olsen, Nicholas K.; Press, Joel M.; Young, Jeffrey L. (2011-01-01), Lennard, Ted A.; Walkowski, Stevan; Singla, Aneesh K.; Vivian, David G. (eds.), "11 - Bursae Injections", Pain Procedures in Clinical Practice (Third Edition), Saint Louis: Hanley & Belfus, pp. 77–81, doi:10.1016/b978-1-4160-3779-8.10011-9, ISBN 978-1-4160-3779-8, retrieved 2021-03-08
  2. Guanche, Carlos A. (2012-12-01). "Proximal Hamstring Syndrome: Repair and Ischial Bursectomy". Operative Techniques in Sports Medicine. Innovations in Hip Arthroscopy. 20 (4): 333–339. doi:10.1053/j.otsm.2012.09.007. ISSN 1060-1872.
  3. Ombregt, Ludwig (2013-01-01), Ombregt, Ludwig (ed.), "47 - Disorders of the inert structures", A System of Orthopaedic Medicine (Third Edition), Churchill Livingstone, pp. 629–649.e3, doi:10.1016/b978-0-7020-3145-8.00047-8, ISBN 978-0-7020-3145-8, retrieved 2021-03-08
  4. Fauci, Anthony (2010). Harrison's Rheumatology, Second Edition. McGraw-Hill Professional Publishing; Digital Edition. p. 271. ISBN 9780071741460.
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