Deep gluteal syndrome

Deep gluteal syndrome describes pain radiating down the leg from the lower back that results from irritation of the sciatic nerve within the deep gluteal space of the buttocks, a form of sciatica not caused by a problem in the spinal discs. It extends the older idea of piriformis syndrome, since irritation of the sciatic nerve in the buttocks is now understood to have many possible causes beyond just the piriformis muscle, with the two most common being piriformis syndrome itself and fibrovascular bands. People with the condition typically report pain or unusual sensations in the buttocks, hip, and back of the thigh, often worsened by sitting, with radiating leg pain in some cases; diagnosis relies on physical examination together with imaging such as MRI or magnetic resonance neurography and diagnostic nerve blocks, and surgical treatment involves endoscopically decompressing the sciatic nerve.