Definition
The ischium (medical term: Os ischium) and the associated ischial tuberosity (Tuber ischiadicum) are anatomical, bony structures of the human pelvis. Pain in the area of the ischium or ischial tuberosity can present itself in different ways. In many cases, involvement of the ligaments or muscles as well as adjacent nerves is likely. In order to find out the individual cause and to be able to initiate a suitable therapy, a specialist in orthopedics should be consulted.
Where is the pain? Left, right, or both sides?
Depending on the clinical picture underlying the pain, the pain can occur on the right or left side or on both sides. The mere fact that the pain is unilateral or bilateral does not allow us to conclude which clinical picture is present. For example, both tendon shortening and a systemic disease can lead to pain on both sides.
In general, however, if systemic diseases, such as certain rheumatic diseases, normally lead to pain on both sides. Muscular causes, on the other hand, also occur more frequently on one side and therefore tend to cause pain on the right or left side. If pain occurs unilaterally or centrally, the possibility of coccyx fistula (sinus pilonidalis) should also be considered.
Causes of ischialgia pain
The causes for the occurrence of pain in the ischium are manifold. Usually, it is not the bones themselves that are the cause of the pain. A fracture of the ischium can of course also cause pain in this region, but this bone usually only breaks after very strong violent impacts such as a traffic accident or a fall from a great height.
Inflammation of the coccyx The most pain in the ischium is caused by structures adjacent to the ischium bone. The ligaments and muscles must be considered first and foremost. It is not uncommon for the tendons of the pelvis to be shortened.
Since the ischium is the origin of many tendons, pain is relatively common in this region. This can particularly affect endurance runners, who put a very one-sided and heavy strain on the legs. But even untrained persons often suffer from shortened tendons on the ischium.
Reasons for this can be:. Irritation of the muscles themselves can also be caused by heavy training or incorrect loading. The pain then usually occurs acutely and a load is hardly possible.
Likewise, certain diseases can be the cause of the pain in the ischium. Above all, systemic joint diseases should be considered as a cause for chronic pain in the ischium area. Finally, local inflammation of the ischium must always be considered.
A common cause is the so-called ischial fistula (Sinus Pilonidalis) which leads to a chronic inflammation of the gluteal fold and also causes pain in the ischial region. Certain diseases can also be the cause of the pain in the ischium. First and foremost, systemic joint diseases should be considered as a cause for chronic pain in the ischium region.
Finally, local inflammation in the ischial region should always be considered. A common cause is the so-called ischial fistula (Sinus Pilonidalis) which leads to a chronic inflammation of the gluteal fold and also causes pain in the ischial region.
- Irregular training,
- An incorrect load
- And insufficient stretching
Broken bones in the pelvis and especially in the ischium usually lead to very strong pain in this area.
There are many reasons for a fracture of the ischium. Usually a high force is necessary to cause a fracture of the ischium. This force can be caused, for example, by a traffic accident or a fall from a great height as well as by direct violent impact on the pelvis.
If there are diseases that damage the skeleton of the pelvis, such as osteoporosis or a bone metastasis from a tumor, a fracture can sometimes occur even with less force. You can find more information about this under: Ischial fractureThe term rheumatism summarizes a number of different systemic diseases that can affect the human musculoskeletal system.Both older and younger people can suffer from a rheumatic disease. Pain in the ischium can also be an indication of a rheumatic disease.
This localization is particularly typical for the clinical picture of the so-called ankylosing spondylitis. This chronic inflammatory rheumatic disease initially affects the tendon insertions of the pelvis until the entire spine stiffens during the course of the disease. Also the so-called fibromyalgia, also a form of rheumatism, can lead to pain at this location.
Altogether it concerns however relatively rare disease pictures, why rheumatic disease pictures for pain at the ischium should not be considered first. A decubitus is a defect of the skin. Permanent pressure on one and the same spot damages the skin.
Anyone who puts pressure on the same area of the skin over the ischium for a long period of time can develop a pressure sore. Due to the pressure, the affected area is not sufficiently supplied with blood, the skin cells cannot regenerate and an open area develops. This typically affects people who are not particularly mobile, such as wheelchair users.
They sit all day long and often have difficulty shifting their weight from one side of their buttocks to the other. Nerve damage can also promote the development of a pressure ulcer. Because of the sensory disorder, affected persons do not notice that the skin is strained.
Typically, a pressure ulcer heals only very slowly due to the poor blood circulation; it can also become infected with bacteria, which can lead to a painful inflammation. The ischium (Os ischii) is a part of the pelvic bone. This is the part of the pelvis on which the weight rests when sitting, hence the name ischium.
The lower part of the ischium is protected by a fat pad. Reducing the fat pad can cause the ischium to become inflamed. This usually results in a painful inflammation of the periosteum.
The surrounding tissue can also be the origin of the inflammation. This can lead to a so-called aseptic inflammation, which is not caused by pathogens. If a small skin defect is present, germs can penetrate the skin and cause a superficial inflammation. This can spread into the depths and thus also cause the inflammation on the ischium.
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