Q: I am a 71-year-old woman who was recently diagnosed with ischial tuberosity bursitis. It is very painful to set and I also have pain when lying down or climbing stairs. My legs also hurt a great deal. Please discuss the best treatment for my condition and how long it will take to recover. I’ve gone from being a very active senior citizen to one that’s just trying to make it through each day.
A: Bursitis occurs then the bursa (small, fluid-filled sacs that cushion muscles, tendons and bones near a joint) become inflamed. The most common areas of the body to be affected are the hip, shoulder and elbow. In bursitis of the hip, the condition presents with pain and possible stiffness, numbness and tingling in the buttock and/or hip areas. Most commonly, the cause for bursitis is repetitive use of the joint, such as throwing a baseball, lifting over your head during employment, extensive kneeling as with gardening, or sitting on hard surfaces for extended periods of time as might be the case with factory workers sitting on a hard stool or bench for hours at a time. Bursitis may also result from a joint injury or trauma such as a direct blow or fall, rheumatoid and other forms of arthritis, infection, and gout.
The ischium is the dorsal and posterior of the three principal bones that comprise either half of the pelvis. The bursa is similar to a smooth cushion that allows a tendon to glide over a bone as it contracts and relaxes. Ischial bursitis, therefore, is inflammation of the bursa that covers the area known as the ischial tuberosity – the protrusion of bone in the pelvis upon which a person sits. When the ischial bursa fail to function properly due to inflammation, friction and pain in the buttocks, (particularly when a person sits down), results.
The numbness and tingling nay radiate down one leg and produce symptoms that resemble sciatica, because the sciatic nerve travels from the spinal canal down the buttocks and continues down the back of each leg. Further, any one of the three hamstring muscles at the back of the thigh may be involved.
Generally speaking, ischial bursitis is not serious in most instances, nor will it cause additional complications but physical therapy might be helpful with specific stretches. Ask your physician for a referral to your local hospital or clinic that can provide such a service. On the home front, resting the buttock area by walking around periodically and avoiding extended periods of sitting are advised. Consider mild exercises, ice packs and over-the-counter pain relievers to help alleviate swelling and other symptoms. Good posture (at all times but particularly when sitting), cushioning the chair with a pillow you plan to sit on, and taking brief breaks and moving about during those breaks can help prevent the situation from occurring or worsening.
Treatment for other forms of bursitis will likely depend on the cause for the bursitis. In the case of an infection, for instance, an antibiotic might be appropriate. If an injury is to blame, physical therapy to strengthen the muscles in the affected area might be beneficial. When conservative treatment for symptoms fails to subside after about a month, a physician may choose to inject the patient with a corticosteroid. Not all types of bursitis can be prevented but many can. Speak with your primary care physician or orthopedic specialist about the best way to handle your case.
