Thoraco lumbar junction syndrome: a case report.

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Maitland has described L1 buttock pain. I have seen many cases of UL or BL radiation of buttock pain from LPA or CPA of L1. this area is thoroughly associated with many symptomatic cases with buttock pain. While examining the L5 one must include L1 if the implications are strong.
Following is a case report by Deepak Sebastian, 2006 (the manual therapy book fame, JAYPEE)
This case report describes a 46-year-old female who experienced symptoms of low back pain with pain radiating into the right gluteal area. Initial intervention addressed mechanical dysfunction at the lumbosacral junction. Reduction in symptoms was observed following manual therapy procedures that addressed the lumbosacral junction; however, the right gluteal pain persisted with recurrence of back pain. Subsequent examination revealed non-neutral dysfunction at the thoracolumbar junction. Treatment was continued with manual therapy procedures that addressed facet restriction and soft tissue dysfunction in the thoracolumbar junction. A marked relief in symptoms was reported thereafter, with a decrease in right gluteal pain and improved functional ability.

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