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Treatment of Attachment Trigger Points in the Gluteal Muscles to Cure Chronic Gluteal Pain: A Case Report

Background The purpose of this case report is to demonstrate a patient of chronic myofascial pain syndrome in the gluteal region secondary to lumbar facet joint lesion. Findings Initially, he was treated conservatively with medication and physical therapy and had only temporary pain relief for few days. Later, he was treated with lumbar facet joint injection [with kenacort] and myofascial trigger point [TrP] injection [with one percent xylocaine] to bilateral L4-5 paraspinal muscle and gluteal muscles with a complete relief of low back pain but persistent pain in the gluteal region. Finally, he was found to have attachment TrP in the origin and insertion sites of gluteus medius and gluteus minimus muscles. He then further received a local injection with kenacort and one percent lidocaine to the attachment TrPs with immediate relief of gluteal pain. A follow-up confirmed that he had no pain recurrence up to six months. Conclusion Chronic myofascial pain syndrome in the gluteal region can be caused by both lumbar facet joint lesion and attachment TrPs of the involved muscles. It is necessary to eliminate the underlying etiological lesions appropriately in order to provide long-term relief of myofascial pain.