Pain distribution pattern in gluteal-related low back pain: A proposed patho-anatomical approach using gluteal triangle.

Abstract

Purpose: Different assessment strategies for radiating low back pain (LBP) abound across and within primary-contact disciplines yet physical diagnosis of the involved faulty anatomical structures remain difficult. This study investigated pattern of pain distribution in patients with gluteal-related low back pain. Methods: The study involved forty (40) participants with radiating low back pain who were referred for physiotherapy from two major referral clinical settings in Ghana. They were recruited into the cross-sectional survey through consecutive sampling technique. Using marker and transparent tracing sheet, gluteal triangle was outlined from the lumbar region, the involved gluteal region and the posterior part of the involved thigh. Pattern of pain distribution was noted and physically correlated with stereotype patterns of pressure points as gold standard. Data analysis involved mean, frequency distribution, percentage distributions and z-score. Alpha value was considered significant at p < 0.05. Results: The mean ages, year (SD) were 52.0 years (12.0) and 48 years (15) for male and female, respectively. Myofascial and piriformis syndromes were the most predominant presentations among the patients recording 13 (32.5%) and 10 (25%), respectively. Male group recorded 9 (22.5%) of pain originating from myofascial syndrome compared to 4 (10%) assessed in their female counterparts. There was no gender difference in the proportion of pattern of pain distribution among the participants. Conclusion: This study demonstrated different patterns of pain distribution and was found to be consistent with gold standard pressure point in the assessment of patients with radiating LBP, thus it can be included as complimentary diagnostic tool in clinical practice.