Post-massage shooting pains and spasm?

Tonight I evaluated a 23 yo woman previously healthy who complained of shooting pain in her right gluteal region that started 3 weeks ago during a massage. She stated that the massage therapist really dug her elbow into the region, causing pain that lingered after the massage, and ever since she has been having episodic, very brief jolts of stabbing, electrical-type pain right in that spot with associated all-over body spasm (ie, when she has the pain her body jerks somewhat violently) and some radiation of the pain down her right thigh. She is pain free otherwise. The episodes occur about 4-5 time a day and can be provoked by lying on her left side. She reports a reduction of symptoms when driving if she puts her left leg up on the dashboard. She reported no red flags. She is a lifeguard and water polo coach who is quite active and has had to limit her activity due to the pain. NSAIDs have not helped very much.

Her exam was basically unremarkable except that the pain was reproducible with palpation of a deep spot in her right gluteal region, probably just lateral to her caudal sacrum which would correlate to a region dense with nerves, including the sciatic. Palpation did not cause the spasms though.

Quite an interesting case. Certainly the only one of its kind I've seen. My best thought is that it was indeed related to the massage and she may have had nervous or muscular injury due to the trauma, but I'm not sure why she would have these intermittent spontaneous jolts as opposed to just ongoing pain. I prescribed flexeril for evening use and suggested she give it another 1-2 weeks and if not improving to come back. If she does I'll probably have her see a neurologist.