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Submitted by Dr Wilkerson D.C.
The Regulatory World
By DenMat
Deep Gluteal Syndrome – What Is It?
T
he term deep gluteal syndrome (DGS) describes a condition that causes pain
in the buttock that may travel down the back of the leg when the sciatic nerve
is irritated. There are various structures that can result in sciatic nerve entrap-
ment within the gluteal space which include the following: the piriformis muscle;
fibrous bands containing blood vessels; the gluteal muscles; hamstring muscles, the
Gemelli-obturator internus (muscle) complex, vascular (blood vessels) abnormali-
ties; and space-occupying lesions.
Unique features within a patient’s history and physical examination can help to
differentiate and define the specific site of sciatic nerve entrapment. It is common for patients with sciatic
nerve entrapment to have a prior history of trauma, symptoms when sitting, and radiating pain from the low
back and/or hip with tingling into the affected leg. If the nerve becomes damaged, diminished reflexes and/or
muscle weakness can occur.
Because of the relationship between the lumbar spine
(lower back) and the hip, it’s important to examine both
regions in order to rule out a lumbar spine pathology as
either the cause or a contributing factor to a patient’s
symptoms. Failure to do this on a timely basis can lead
to chronic pain and reduce quality-of-life based on an
inaccurate diagnosis and treatment.
In one study, researchers found that a tight piriformis
muscle plays a role in the majority of cases of DGS. The
piriformis muscle can be stretched from a seated posi-
tion. First, cross the leg, grasp the knee of the crossed
leg, and pull toward the opposite shoulder (i.e., right
knee toward left shoulder and vice versa). Next, arch
the low back during this process and twist the trunk to
the crossed knee side. Lastly, move the crossed knee in
a circular manner to “work” the entire muscle. Do this
for 30-60 seconds per side, multiple times a day.
The key to successful management is a prompt, ac-
curate diagnosis followed by conservative care. While
conservative treatment approaches to stretch the piri-
formis muscle and to reduce any pressure on the sciatic
nerve are usually enough to reduce pain and improve function in patients with the condition, in some cases
more invasive treatments such as injections or surgery may be necessary.
This information should not be substituted for medical or chiropractic advice. Any and all health care concerns,
decisions, and actions must be done through the advice and counsel of a health care professional who is famil-
iar with your updated medical history.
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Dr.Marc F.Wilkerson
A
s a leading manufacturer
of quality dental products,
DenMat, located on West
Central Avenue, in Lompoc, must
be licensed with many regulatory
bodies. The company is licensed
and regulated by the Food and
Drug Administration (FDA), State of California, City of
Lompoc, Health Canada, National Board of Pharmacy, and
is ISO 13485 compliant for sales and distribution overseas.
And, nearly every state has their own requirements for sell-
ing certain regulated products to their licensed dentists.
This is an area of the business that is constantly changing
as new requirements are developed to meet the demands
of the global business world. DenMat’s regulatory team is
busy keeping up with the regulations and the audits that go
with them. Any discrepancies identified during audits must
be corrected in a timely fashion and procedures created to
maintain proof of compliance. Some audits are scheduled
while others are unscheduled, so the team must be prepared
and ready to respond at any time. Expert documentation
and record keeping are essential to keeping DenMat in
good standing with all the regulatory bodies.
DenMat has a staff of seven dedicated to the Regulatory
process. For a complete list of current job openings, see the
back page of the LOMPOC VISION or visit Career Oppor-
tunities at
www.denmat.com.