By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)
Iliopsoas Syndrome, also known as psoas syndrome, is a very rare condition. It is often misdiagnosed due to its unspecific symptomatology. Iliopsoas Syndrome is an inflammatory response in the bursa located under the iliopsoas muscle. The bursa are small, fluid-filled sacs that lie between bones and soft tissues. They reduce friction and provide cushioning to allow tendons, muscles and other structures to glide. While the iliopsoas muscle are a group of two muscles located toward the front of the inner hip.
The iliopsoas is often misdiagnosed by most people and doctors, and it is difficult for most to describe the pain location other than the lower back.
- Sharp groin pain
- Tension and pain in the hips, buttocks, pelvis, groin and radiating into the knee, leg and lower back.
- Lower back spasm
- Painful when standing for a long period, especially in a fully upright posture
- Pain particularly when changing positions arising for sitting to standing
- Worse when twisting at the waist without moving the feet
Iliopsoas syndrome is most commonly caused by a overuse. It is considered as a source of pain in athletes. However it also affects office workers or anyone who spends much of their day sitting. The syndrome is thought to be prevalent in certain sports including soccer, dance, and hockey. These are at higher risk for the condition due to the nature of their activities.
Other risk factors include:
- Prior hip injury/ surgery
- Scoliosis, spinal arthritis
- Legs that are different lengths
- Bone spurs or calcium deposits
It can affect people of all ages, but it is common among women and the elderly.
- Medications. In most cases, it can be managed with anti-inflammatory medications to alleviate pain and reduce inflammation.
- Modifying activity, rest and exercise are shown to be beneficial for relieving the pain.
- Physical therapy. The exercise can improve hips strength and flexibility
- Corticosteroid injection. Doctors may suggest injection when patients fail for simple treatment. Studies suggest that pain relief of a corticosteroid injection lasts for up to 12 weeks.
- Surgical. In severe cases where pain persists despite taking these measures, the doctor may recommend surgical interventions. However, these instances are rare and avoided as much as possible due to the risk of complications such as nerve and muscle damage.
Iliopsoas syndrome is a rare condition, and the symptoms can mimic other more serious conditions. It is important to consult with us to get the right diagnosis and treatment.
Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.