What is Ischial Bursitis?

Bursae are fluid-filled sacs present between the tendons and bones to help facilitate smooth movement. Ischial bursitis is a condition in which a bursa in the buttocks becomes swollen and painful.

The ischium is one of the pelvic bones, also referred to as the sit bone in the buttock as it prominently makes contact with the surface while we are seated. It gives attachment to the tendons of the hamstring muscles that run in the back of the thigh. The ischial bursa, located near this junction, can sometimes get irritated or inflamed.

Causes of Ischial Bursitis

Some causes of ischial bursitis include:

• Sitting for long periods on a hard surface
• Direct trauma to the area
• Injury to the hamstring muscle or tendon through repetitive activities such as running or bicycling

Symptoms of Ischial Bursitis

Common signs and symptoms of ischial bursitis include:

• Stiffness, and tenderness in the pelvis and buttock areas
• Swelling and redness in the region of the bursa
• Reduced range of movement
• Pain that is felt when sitting, walking, or running after sitting

Diagnosis of Ischial Bursitis

Your doctor will review your medical history and symptoms and based on this a physical examination of the joint will be performed. You will be asked to perform various movements to reproduce your symptoms or to rule out other conditions. Imaging tests may be recommended for further analysis. These include:

• X-ray
• MRI
• CT scan
• Ultrasound

Treatment for Ischial Bursitis

Ischial bursitis can usually be treated with conservative measures such as rest, ice, over-the-counter pain-relieving medication, and specialized pillows to relieve pressure on the area while sitting. if these measures fail, you may require:

• Prescription pain medications such as corticosteroid drugs to reduce inflammation and swelling
• Physical therapy to strengthen the muscles and maintain flexibility in your hip
• Injection of a steroid/anesthetic combination into the bursa

Massaging the area is not recommended as it can aggravate your symptoms.

In cases where the bursa becomes infected, treatment may include antibiotics, removal of fluid from the bursa with a fine needle, or surgical removal of the bursa.