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Typically, ischial bursitis is caused by prolonged sitting on a hard surface and is most common in individuals who have a sedentary lifestyle(1), but it can also be caused by trauma to the area such as a fall, or from injury to the hamstring muscle or tendon from activities like running or biking

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Pain often returns because the underlying drivers—such as inflammation, tissue injury, nervous system sensitization, or metabolic dysfunction—were never corrected