For a long time my father was told that the shooting pain in his legs and buttocks were due to sciatica, but like so many others his condition didn't respond to sciatica treatment.
It was only after many months of misery that he finally visited a physical therapist, who correctly diagnosed the source of the pain as myofascial trigger points in his gluteus minimus rather than pressure on his sciatic nerve.
Sciatica is not the only condition that is commonly misdiagnosed in relation to myofascial triggers in the gluteus muscles.
A vast proportion of lower back pain cases are actually due to trigger points in the gluteus maximus, and these can easily be resolved by regular massage and stretching if caught early enough.
Trigger Points in the Gluteus Muscles The gluteus muscles are made up of the gluteus maximus, the gluteus medius, and the gluteus minimus, and triggers can occur in any of these with a variety of symptoms.
In large muscle groups such as the gluteus muscles it's quite common to have clusters of these points of muscle spasm.
The gluteus maximus is the largest of these muscles and contains the most common location for a gluteus trigger.
They are common at the top of the gluteus maximus muscle, where it joins the pelvis, and this point can be found just below those lower back dimples that we all have.
Trigger points in the gluteus maximus are usually felt as acute lower back pain, which is often worse at night, preventing sufferers getting a good night's sleep.
They may be caused by regular stair climbing or jumping, but are also common in people that sit incorrectly in a chair for most of the day, resulting in the gluteus maximus being continually stretched outside of its neutral position.
Gluteus medius and minimus triggers tend to be felt as pain that is concentrated in the buttocks, or that radiates down the back of the thighs, especially when the active points are pressed.
It is points of spasm located in these muscles that are commonly misdiagnosed as sciatica.
Trigger points in the gluteus medius or minimus are commonly caused by muscle imbalance or instability in the pelvis.
In athletes a prime cause of muscle spasms is sprinting from a start when the gluteus medius is not strong enough to support the pelvis in a stable position and therefore has to contract outside of its usual capacity.
Strengthening the core muscles can help to reduce triggers in the smaller gluteus muscles.
Combat Trigger Points by Stretching One of the best ways to avoid myofascial triggers in the gluteus muscles is to do regular stretching exercises; you'll be amazed at the impact a few simple stretches can have on back, buttock and leg pain.
The gluteus muscles are often neglected during warm up sessions, but they require stretching in the same was as leg and upper body muscles.
Here are three simple stretches that will help to prevent trigger points in the gluteus muscles:

1. The Lunge.
   Standing with feet shoulder width apart, step forward as far as possible with one foot and push your hips down towards the floor so your front leg is bent at a right angle and the back leg is stretched out behind.
   Hold for thirty seconds, return to standing and repeat on the other side.
   
2. The Pigeon.
   In a seated position, draw one foot into you so that the side of the calf rests crossways on the floor in front of you.
   Placing your hands on the floor for support, stretch the other leg out behind you so you are sitting on top of your hips.
   Lean forward to increase the stretch in the gluteus muscles.
   This is a very deep stretch.
   Hold for thirty seconds and repeat on the other side.
   
3. The Curl.
   Lying on your back with your knees bent, place one foot on the opposite knee so that the knee of the lifted leg points outwards.
   Place your hands around the shin of the lower leg and pull it gently towards your chest.
   Hold for thirty seconds and repeat on the other side.
   

If you do get myofascial triggers in the gluteus muscles, you can use your body weight to massage them out by rolling over a foam roller and maintaining pressure on any painful areas for around thirty seconds.
Many people also use golf or tennis balls to access deeper trigger points in the gluteus muscles with a more intense massage, but this should be done carefully as it can cause tissue damage.
As well as regular stretching there are plenty of other ways to prevent points of muscle spasm from developing in the gluteus muscles.

• Regular massage is essential for sore or tired muscles, so book a weekly appointment.
  
• Extremes of hot or cold can increase the risk of trigger points by affecting the blood flow to the muscles so make sure you warm up thoroughly and wear appropriate clothing.
  
• Deficiencies in vitamins and iron can make trigger points more likely so eat a balanced and healthy diet.
  
• Psychological factors such as stress and tiredness increase the risk of trigger points so try relaxation exercises and get plenty of sleep.
  
• Check your posture if you sit in a chair all day, and try to change position regularly.
  
• Make sure your equipment is adequate for your needs, for example check that your running shoes are supportive enough.
  
• Avoid sudden increases in the intensity of your exercise programme, and build up slowly to give your gluteus muscles time to adjust.
  

Because pain from gluteus trigger points usually manifests itself in the back or the legs, the root cause is often overlooked.
Regular stretching, combined with a good diet, regular massage and relaxation, and a sensible exercise regime will prevent the development of myofascial trigger points and the pain that they can cause.