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Theme: Pain and Spine Medicine
Malathy Srinivasan, MD MBBS
Attending Physiatrist
Rothman Orthopedics Institute
Media, Pennsylvania
Disclosed no relevant financial relationships.
Ameet Nagpal, MD MS MEd
Division Chief, Physical Medicine & Rehabilitation; Professor, Department of Orthopaedics & Physical Medicine
Department of Anesthesiology
Medical University of South Carolina
Mt. Pleasant, South Carolina
Disclosed no relevant financial relationships.
Mehul Desai, MD MPH
Medical Director
International Spine, Pain and Performance Center
Washington, District of Columbia
Abbott (Consultant/Advisory Board)Avanos (Consultant/Advisory Board, Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received)Nalu Medical (Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received)Nevro (Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received)SPR Therapeutics (Consultant/Advisory Board, Stockholder/Ownership Interest (excluding diversified mutual funds))SynerFuse (Consultant/Advisory Board, Stockholder/Ownership Interest (excluding diversified mutual funds))Virdio (Consultant/Advisory Board, Stockholder/Ownership Interest (excluding diversified mutual funds))
Gluteal pain that is worse with sitting is a common complaint in a pain clinic. When MRI imaging fails to identify nerve root impingement in the lumbar spine, the condition remains un-diagnosed. Differential diagnosis of deep gluteal pain syndrome includes pelvic pain conditions such as piriformis syndrome causing non-discogenic sciatic nerve entrapment, Obturator internus syndrome, pudendal neuralgia, ischiofemoral impingement syndrome, superior and inferior clunealgia or posterior femoral cutaneous neuralgia and sacroiiac joint pain. Non-discogenic deep gluteal pain syndrome occurs in 6-17% of patients presenting with buttock pain. Diagnosis is based on careful history and specific provocative examination which is essential to direct appropriate physical therapy and injection interventions and also to provide a legitimizing diagnosis that is sometimes desperately needed for some patients.
This session will focus on history and specific physical examination tests and appropriate imaging to diagnose and treat these conditions that are unfamiliar to most physiatrists and review the limited evidence from the literature through case presentations and discussion of the topic.
Speaker: Malathy Srinivasan, MD MBBS – Rothman Orthopedics Institute
Speaker: Ameet S. Nagpal, MD MS MEd – Medical University of South Carolina
Speaker: Mehul J. Desai, MD MPH – International Spine, Pain and Performance Center