ischial tuberosity
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Ischial Tuberosity

Ischial tuberosity pain can be a very debilitating, severe pain along the large bones along the lower portion of the pelvic girdle, the ischium, commonly referred to as the sitz bones . It is known for literally causing “pain in the butt” especially noticeable when sitting, standing, or running.  This is a common area injured in sports as the hamstring and other tendons and ligaments attach at these large bones. But it can also be aggravated by too much sitting, since we sit on the ischial tuberosities, which can be the case with many people who have a desk job.

Traditional medicine recommendations generally include rest, physical therapy, or cortisone injections for pain relief. While rest and physical therapy have a place in treating ischial tuberosity pain, when there is weakness or damage at the attachments, these treatments do nothing to address the root cause of this problem. The problem with cortisone injections for this degenerative condition is it causes further long term degeneration, although is seen as helpful because of its short term pain relieving effects. For those seeking pain relief through restoring and strengthening the area, Prolotherapy is a more suitable option. Prolotherapy works like spot welding for triggering repair of the loose or damaged attachments.

Prolotherapy injections for ischial tuberosity pain

From a Prolotherapy physician’s perspective, pain at the origin of the hamstring muscle is typically tender upon palpation, indicating hamstring tendinosis or degeneration. Weakness at the sacrotuberous ligament attachment is also frequently noted upon exam for ischial tuberosity pain. Another less frequent, but possible, cause of pain in this area can be caused from a damaged acetabular labrum (hip labral tear). When the labral tissue is damaged, it causes instability of the hip, which can cause excessive contraction of the hamstring muscle for stability, resulting in pain along the ischial tuberosity. The physical exam is especially important when it comes to pain in this area to determine which areas demonstrate tenderness and crepitation (grinding/crunching sensation, or crackling/popping sounds).

Regenerative injections using a comprehensive Prolotherapy method has been shown to be helpful for pain in the ischial tuberosity. Again, the physical exam and physician experience is vital to getting a thorough treatment. In some instances, pain in the front part of the ischial tuberosity is coupled with pain in the pubic ramus and/or pubic symphysis instability. Likewise, pain generating from the back of the ischial tuberosity may require examining for weakness through the sacroiliac joints. Hence, ischial tuberosity pain often requires Prolotherapy treatment to both the ischial tuberosity attachments as well as other areas in the pelvis or low back. To ensure a good inflammatory healing reaction, a strong Prolotherapy solution should be used to treat all the weakened areas. Comprehensive Prolotherapy treatments are typically given one month apart, until a person is pain free, which takes an average of three to six visits.