Psoas Syndrome

Excerpt

Psoas syndrome is characterized by pain and inflammation of the distal iliopsoas tendon, with less frequent involvement of the distal muscle. The condition often affects the psoas bursa and the tendon sheath. Psoas syndrome commonly occurs in athletes, particularly runners, dancers, and high jumpers, typically due to overuse or trauma. However, psoas pain may also result from infections (eg, tuberculosis) or malignancies. Psoas syndrome can also affect sedentary individuals of any age, "weekend warriors," or those with conditions that lead to flexion contractures, including spinal cord injury, multiple sclerosis, or cerebral palsy.

Groin pain is a frequent symptom, particularly in sports involving kicking or during adolescent growth spurts. Psoas syndrome may also develop following iliopsoas tendinitis after total hip arthroplasty (THA) and can coexist with iliopsoas bursitis or other musculoskeletal conditions. Terms such as psoas dysfunction, iliopsoas tendinitis, internal snapping hip, and iliopsoas impingement are often used interchangeably.

Most patients respond well to conservative treatment. In more persistent cases—especially among athletes reluctant to rest—management may include nonsteroidal anti-inflammatory drugs (NSAIDs), a short course of oral steroids, corticosteroid injections, or, in rare cases, surgery. Advanced imaging or electromyography may be warranted in select cases. Healthcare providers should include psoas syndrome in the differential diagnosis of anterior hip or groin pain.