Ischial bursitis (also known as weaver's bottom) is inflammation of the synovial bursa located between gluteus maximus muscle 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 posterior bony protuberance on the superior ramus of the ischium. It ...

Signs and symptoms

Ischial bursitis causes

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

down the posterior aspect of the upper

thigh In 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 tissu ...

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

paraesthesia Paresthesia is a sensation of the skin that may feel like numbness (''hypoesthesia''), tingling, pricking, chilling, or burning. It can be temporary or chronic and has many possible underlying causes. Paresthesia is usually painless and can oc ...

. 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 synovial bursa located between gluteus maximus muscle 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 (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...

(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, such as

nonsteroidal anti-inflammatory drugs A nonsteroidal compound is a drug that is not a steroid nor a steroid derivative. Nonsteroidal anti-inflammatory drugs (NSAIDs) are distinguished from corticosteroids as a class of anti-inflammatory agents. List of nonsteroidal steroid receptor mod ...

, may be used to relieve

. Ischial bursitis may be treated with medical and

surgical Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery ...

interventions if it is persistent or particularly severe. Analgesics, anaesthetics, or triamcinolone may be injected to relieve pain.

Epidemiology

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

spinal disc herniation A disc herniation or spinal disc herniation is an injury to the intervertebral disc between two 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, ...

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