Ischial bursitis (also known as weaver's bottom) is inflammation of the

synovial bursa Synovial () may refer to: * Synovial fluid * Synovial joint * Synovial membrane * Synovial bursa Synovial () may refer to: * Synovial fluid * Synovial joint * Synovial membrane The synovial membrane (also known as the synovial stratum, synovi ...

located between

gluteus maximus muscle The gluteal muscles, often called glutes are a group of three muscles which make up the gluteal region commonly known as the buttocks: the gluteus maximus, gluteus medius and gluteus minimus. The three muscles originate from the ilium and sacr ...

and

ischial tuberosity The ischial tuberosity (or tuberosity of the ischium, tuber ischiadicum), also known colloquially as the sit bones or sitz bones, or as a pair the sitting bones, is a large swelling posteriorly on the superior ramus of the ischium. It marks th ...

Signs and symptoms

Ischial bursitis causes

pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...

down the posterior aspect of the upper

thigh In human anatomy, the thigh is the area between the hip (pelvis) and the knee. Anatomically, it is part of the lower limb. The single bone in the thigh is called the femur. This bone is very thick and strong (due to the high proportion of bone ...

. There may be pain over the ischial tuberosity. Chronic ischial bursitis may cause

paraesthesia Paresthesia is an abnormal sensation of the skin (tingling, pricking, chilling, burning, numbness) with no apparent physical cause. Paresthesia may be transient or chronic, and may have any of dozens of possible underlying causes. Paresthesias ar ...

. This pain may become immediately more severe when sitting down.

Cause

Ischial bursitis is usually caused by prolonged sitting on a hard surface. It may also be related to ischial

apophysitis In the skeleton of humans and other animals, a tubercle, tuberosity or apophysis is a Tubercle, protrusion or eminence that serves as an attachment for skeletal muscles. The muscles attach by tendons, where the enthesis is the connective tissue bet ...

, which may be caused by exercise, particularly in young and athletic patients.

Mechanism

The ischial bursa is a

located between

and

. When in a seated position, the ischial bursa is put under the highest amount of pressure, which is most significant against a hard surface. Friction from exercise can lead to inflammation of the ischial bursa, known as bursitis.

Diagnosis

Ischial bursitis is usually diagnosed clinically based on symptoms. An

x-ray An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nb ...

(using injected

contrast agent A contrast agent (or contrast medium) is a substance used to increase the contrast of structures or fluids within the body in medical imaging. Contrast agents absorb or alter external electromagnetism or ultrasound, which is different from radiop ...

) may be used to identify the formation of calluses.

Treatment

Ischial bursitis is usually treated conservatively. Lifestyle changes may be advised, avoiding certain exercises and sitting on hard surfaces.

Analgesics An analgesic drug, also called simply an analgesic (American English), analgaesic (British English), pain reliever, or painkiller, is any member of the group of drugs used to achieve relief from pain (that is, analgesia or pain management). It i ...

, such as

nonsteroidal anti-inflammatory drugs Non-steroidal anti-inflammatory drugs (NSAID) are members of a therapeutic drug class which reduces pain, decreases inflammation, decreases fever, and prevents blood clots. Side effects depend on the specific drug, its dose and duration of ...

, may be used to relieve

. Ischial bursitis may be treated with medical and

surgical Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...

interventions if it is persistent or particularly severe. Analgesics,

anaesthetics An anesthetic (American English) or anaesthetic (British English; see spelling differences) is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into two ...

, or

triamcinolone Triamcinolone is a glucocorticoid used to treat certain skin diseases, allergies, and rheumatic disorders among others. It is also used to prevent worsening of asthma and COPD. It can be taken in various ways including by mouth, injection i ...

may be injected to relive pain.

Epidemiology

Ischial bursitis is a fairly rare illness. When a patient presents with symptoms, other conditions such as a

spinal disc herniation Spinal disc herniation is an injury to the cushioning and connective tissue between vertebrae, usually caused by excessive strain or trauma to the spine. It may result in back pain, pain or sensation in different parts of the body, and physical ...

may be considered.

History

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

References

{{Soft tissue disorders Soft tissue disorders