Deep Gluteal Syndrome: (Hip)

Deep gluteal syndrome is a condition where the sciatic nerve, the largest nerve in the body, becomes irritated or compressed by the muscles and tissues deep in the buttock. Unlike a “pinched nerve” in the lower back, this irritation happens outside the spine, usually within the deep gluteal space beneath the larger gluteal muscles.

The sciatic nerve runs from the lower back, through the buttock, and down the back of the leg. When it is squeezed by nearby muscles, such as the piriformis, obturator internus, or quadratus femoris, it can create pain and nerve symptoms. Patients often feel a deep aching or burning pain in the buttock, sometimes radiating into the hip, thigh, or leg. Numbness, tingling, or weakness may also occur if the nerve is significantly affected.

Symptoms are often worse with prolonged sitting, crossing the legs, or repetitive hip movements like running or climbing stairs. Some people describe discomfort when standing up after sitting for a long period, or when trying to sleep on the affected side. Unlike sciatica from a spinal disc problem, imaging of the lower back may appear normal, which can make diagnosis challenging.

Deep gluteal syndrome is one of several causes of sciatic nerve pain outside the spine, sometimes grouped under the term “extra-spinal sciatica.” Identifying the condition is important because it explains buttock and leg pain that does not come from the lower back. With proper evaluation, the underlying muscle irritation can be addressed to relieve nerve pressure and restore mobility.