Diagnosis and Management of Deep Gluteal Pain Syndrome (DGPS) | ||
| The Medical Journal of Cairo University | ||
| Volume 93, Issue 09, September 2025 PDF (71.74 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/mjcu.2025.464433 | ||
| Author | ||
| AHMED ELAKHRAS, M.D.*; MOHAMED A. ABBAS, M.D.*; MONA MOKHTAR, M.Sc.** and MOHAMED ISMAIL, M.D.*,*** | ||
| The Department of Neurosurgery* and Rheumatology & Rehabilitation**, Faculties of Medicine Kafr El Sheikh*, Girls Al-Azhar** and Cairo*** Universities | ||
| Abstract | ||
| Background: Deep Gluteal Pain Syndrome (DGPS) is a frequently misdiagnosed condition characterized by chronic buttock pain radiating to the posterior thigh, often mimicking lumbar radiculopathy. Sciatic nerve entrapment in the deep gluteal space is the primary etiology, making early diagnosis and appropriate management crucial. Aim of Study: This study evaluates the efficacy of different management strategies for DGPS, comparing conservative, in-terventional, and surgical approaches. Patients and Methods: A retrospective study was conduct-ed with 100 patients diagnosed with refractory DGPS. Partic-ipants were evaluated through clinical examinations, imaging (MRI, MR neurography), and ultrasound-guided diagnostic injections. Treatment strategies included physiotherapy, phar-macotherapy, corticosteroid/Botox injections, and endoscopic sciatic nerve decompression. Outcomes were assessed using the Visual Analog Scale (VAS) for pain and the Harris Hip Score (HHS) for function over 12 months. Results: Conservative management provided symptomatic relief in 65% of cases, while image-guided injections yielded =68.6% (24of 35 patient who had image guided injection af-ter failed conservative) short-term improvement, with =31.4% recurrence. Surgical decompression resulted in significant pain reduction (VAS score improved by 70%) and functional improvement (HHS increased by 50%), outperforming other treatment modalities. Conclusion: Endoscopic sciatic nerve decompression is the most effective intervention for refractory DGPS. While conservative management remains the first-line approach, sur-gical treatment is warranted in cases with persistent pain and confirmed entrapment. | ||
| Keywords | ||
| Deep Gluteal Pain Syndrome (DGPS) | ||
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