Deep Gluteal Syndrome

  • Hal D. Martin
  • Juan Gómez-Hoyos


The presence of non-discogenic, extra-pelvic sciatic nerve compression has been characterized as deep gluteal syndrome. This syndrome usually presents with symptoms of pain and dysesthesias in the buttock area, hip or posterior thigh, and/or as radicular pain.

The piriformis muscle and tendon is the most common source of extra-pelvic sciatic nerve entrapment. Nevertheless, several structures such as bone, fibrous scar bands, and other muscular structures can entrap the sciatic nerve in the deep gluteal space. The main differential diagnoses are intra-articular hip pathologies, spine issues, intra-pelvic abnormalities, ischiofemoral impingement, hamstring’s origin tendinopathy, and pudendal nerve entrapment. A comprehensive history and physical examination is key for the diagnosis of deep gluteal syndrome. Imaging-guided injections and magnetic resonance imaging are useful complementary diagnostic tools. The nonoperative treatment of deep gluteal syndrome is successful in most patients. Endoscopic sciatic nerve decompression may be indicated in cases of failure of the conservative treatment. Recent advances on new imaging protocols, innovative minimal invasive surgical techniques, and physical exam tests’ validation have been reported.


Deep gluteal syndrome Piriformis syndrome Posterior hip pain Gluteal pain Sciatic nerve entrapment Pudendal nerve entrapment Ischiofemoral impingement Hamstring avulsion 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Hal D. Martin
    • 1
  • Juan Gómez-Hoyos
    • 2
    • 3
    • 4
  1. 1.Medical and Research Director, Hip Preservation Center, Baylor University Medical CenterDallasUSA
  2. 2.International Consultant, Hip Preservation Center / Baylor Scott and White Research InstituteBaylor University Medical CenterDallasUSA
  3. 3.Department of Orthopaedic Surgery - Health ProviderClínica Las Américas / Clínica del CampestreMedellinColombia
  4. 4.Professor - School of Medicine - Sports Medicine ProgramUniversidad de AntioquiaMedellínColombia

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