Ischial Bursitis: The Misdiagnosed Pain in the Buttock Many people suffer from nagging pain in the buttock region that gets worse while sitting on hard surfaces, climbing stairs, or bending forward. Often, this pain is mistaken for sciatica, hamstring injury, or even lumbar spine problems. One condition that is commonly overlooked is Ischial Bursitis. What is Ischial Bursitis? The ischial bursa is a small fluid-filled sac located between the ischial tuberosity (the 'sitting bone') and the hamstring muscles. Its role is to reduce friction when we sit or move. When this bursa becomes irritated or inflamed due to overuse, prolonged sitting, or injury, the condition is called Ischial Bursitis. Why is it Misdiagnosed? Ischial bursitis shares symptoms with several other conditions: • Sciatica – Both cause buttock pain radiating down the leg. • Hamstring injury – Pain while running or bending forward mimics tendon problems. • Lower back issues – Pain after sitting often gets blamed on slipped disc or arthritis. Because the symptoms overlap, patients often undergo unnecessary spine treatments or physiotherapy without relief. Symptoms of Ischial Bursitis • Pain in the lower buttock, especially while sitting on hard chairs. • Pain that worsens with stair climbing, running, or stretching the hamstrings. • Tenderness over the sitting bone (ischial tuberosity). • Sometimes, radiation of pain down the thigh but without true nerve involvement. Treatment Options 1. Bursa Injection Ultrasound-guided bursa injection with local anesthetic and anti-inflammatory medicine provides targeted relief by reducing inflammation in the bursa. This is a safe and effective option when pain is persistent. 2. Dry Needling of Gluteal Muscles and Hamstrings Often, patients with ischial bursitis also have tightness and trigger points in the gluteal muscles and hamstrings. These knots perpetuate pain and can mimic nerve pain. Dry needling, performed under ultrasound guidance, relaxes these muscles, improves blood flow, and accelerates recovery. 3. Lifestyle Modifications • Avoid prolonged sitting on hard surfaces. • Use cushioned seats or donut cushions. • Stretching and strengthening exercises as advised by a pain specialist. Why Choose Dr Priya Rathi, Pain Specialist? A pain specialist can differentiate ischial bursitis from other causes of buttock pain with the help of clinical evaluation and ultrasound guidance. With precise diagnosis, unnecessary treatments can be avoided, and targeted interventions like bursa injection and dry needling can give lasting relief. 👉 If you are struggling with persistent buttock pain that hasn’t improved with routine treatments, it may not be sciatica—it could be ischial bursitis. Book a consultation with best pain specialist in Pune to get the right diagnosis and treatment.