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June 20, 1986

Persistent Low Back Pain and Ischiogluteal Bursitis

Author Affiliations

Saint Vincent Hospital University of Massachusetts Medical School Worcester

JAMA. 1986;255(23):3251. doi:10.1001/jama.1986.03370230057028

To the Editor.—  In the QUESTIONS AND ANSWERS section of the Jan 24/31, 1986, issue of JAMA,1 regarding the patient with "persistent low back pain," we agree with Drs Taub and Crue that surgery is not indicated. Regarding the diagnosis in this 62-year-old woman, spinal stenosis is unlikely. In fact, the physical examination, roentgenograms, computed tomography, and electromyography revealed no evidence of neurologic dysfunction.Several diagnoses were suggested by Dr Taub; we would like to add ischiogluteal bursitis. The finding of tenderness in the distribution of the sciatic nerve was dismissed by Dr Crue as "merely subjective." However, this finding is compatible with ischiogluteal bursitis, since this bursa overlies the sciatic nerve.2 Other evidence for ischiogluteal bursitis in this woman is exacerbation of pain after sitting, the fact that low back pain is constant, and the fact that partial relief was achieved with nonsteroidal anti-inflammatory drugs.At this