Successful Treatment of Hamstring Tendinopathy in a Nonathlete with Ultrasound-Guided Injection to the Ischial Tuberosity: A Case Report

Background and Clinical Significance: Proximal hamstring tendinopathy can occur not only in athletes but also in nonathletes when daily activities impose repetitive tensile or compressive loading at the ischial tuberosity. Because symptoms often resemble piriformis syndrome or lumbar pathology, diagnosis may be delayed; Case Presentation: A woman in her twenties developed buttock pain during desk work. Lumbar MRI was normal, and piriformis blocks provided only temporary relief. Localized tenderness at the ischial tuberosity, pain provocation during sitting, and positive provocation tests suggested proximal hamstring tendinopathy. Ultrasound showed a mildly hypoechoic area at the tendon insertion without definite thickening or tear. Ultrasound-guided injection of levobupivacaine and dexamethasone produced immediate but temporary relief. She continued receiving injections every two weeks, combined with stretching, hip-lift strengthening, and reduced sitting. After 18 injections, her pain improved from a numerical rating scale score of 10 to 0–1; Conclusions: This case demonstrates that proximal hamstring tendinopathy can develop in nonathletes due to lifestyle-related mechanical loading. Characteristic clinical findings and ultrasound evaluation are essential for diagnosis, and ultrasound-guided injection combined with exercise and activity modification provided sustained symptom improvement.