A 45-year-old male who is a 5 handicap golfer has been unable to play for the past 3 months because of low back pain. He hurt his low back during a golf swing, in which he felt a pull in his right low back and glute muscle. He has mild pain at rest, but the pain is worse with sitting. He is unable to swing without significant pain. Pain does go down the right leg, but he does not have weakness. He had a low back MRI that showed a mild disc bulge at the left L5/S1 without nerve contact.
The physical exam localized pain in the right glute maximus muscle. An ultrasound of the right glute maximus muscle revealed an area of chronic fibrosis with inflammation. Under ultrasound guidance, he received a hydrodissection into the area of inflammation. He reported that the hydrodissection reproduced his pain. Following the hydrodissection, he was able to reproduce his swing without pain. Pain in the leg also resolved. He was able to sit without pain and return to full golf in 3 days.
Gluteal pain (pain in the buttocks) is often confused with low back pain and “sciatica”, especially if it moves into the leg. More often than not, the pain actually is from the gluteal muscle. In addition to a physical exam, an ultrasound evaluation can reveal the location of the injury. Once the injury is identified, an ultrasound-guided hydrodissection can rid the pain and begin the healing process. We also recommended percussion gun therapy to be used after practice and golf rounds. If you have a similar injury, you can make an appointment with The Fascia Institute and Treatment Center.