Pain in the buttocks

Pain in the buttocks is an annoying problem that interferes with daily activities such as reading the newspaper while sitting, walking, playing sports, cycling, etc.

The ailment can be a:

  • dull and persistent,
  • sudden and stabbing pain.

Buttocks pain can interfere with the simplest activities, such as:

  • put on stockings,
  • tie shoes,
  • pick up some of the floor, etc.

Some people are in pain during the night and cannot sleep.
Others, on the other hand, feel the discomfort in the morning.
The main symptoms are pain and muscle stiffness, which make the affected area sensitive to touch.
There may be a torn muscle fiber under the gluteal muscle, but this is almost impossible within the gluteal muscles.

Contents

Causes of pain in the buttocks

The pain in the buttocks is a sign of many diseases: from muscle contracture to nerve compression. There may also be pain in the area of the lumbosacral spine.

Sciatica
The sciatic nerve is the longest nerve in the human body:

  • it begins in the spine,
  • runs over the buttocks halves,
  • moves to the lower extremities.

Sciatica is the term used to describe the pain caused by compression or irritation of this nerve structure.
The pain caused by sciatica persists and is felt as a strong burning sensation that can radiate:

  • into the buttocks,
  • outwards into the legs.

Along with the pain, one feels a tingling sensation or numbness of the legs and feet.
Prolonged sitting and certain movements aggravate the pain.

Herniated
disc A herniated disc is the prolapse of a small part of the nucleus pulposus of the intervertebral disc.

The inner layer of these discs is called the nucleus pulposus, while the outer layer is called the annulus fibrosus (fibrocartilage ring).
If an injury to the annulus occurs, a small part of the nucleus pulposus emerges from its natural seat and can compress and irritate the surrounding nerves, causing pain.
In rare cases, the disc hernia causes sciatica, i.e. the lumbar pain that radiates into the feet.
The symptoms are:

  1. back pain and pain in the legs up to the feet,
  2. loss of power,
  3. loss of sensitivity,
  4. Tingle
  5. loss of muscle tendon reflexes,
  6. Incontinence (rare).

This disease affects only one side, almost never both sides of the body are affected.
The pain is constant and worsens in the morning, because during the night the intervertebral discs absorb fluid (similar to a sponge), thereby increasing their volume.
The consequence of this is an increasing pressure on the nerve.
The pain becomes stronger when walking and decreases as the patient lies down.

Piriformis syndrome
The muscle in the deep gluteal area is called the piriformis muscle.
Its origin is at the sacrum (vertebral body S2/S3) and it attaches to the trochanter major of the femur.

The piriformis muscle can cause pain in two ways:

  1. In the case of an active trigger point (contracture at a certain muscle point), there is pain in the buttocks and along the back of the thigh to the knee (hollow of the knee);
  2. When the piriformis narrows the sciatic nerve and causes inflammation of the nerve, it can cause sciatica with pain, tingling, and numbness extending into the foot.

Piriformis syndrome is a condition in which the muscle compresses and irritates the sciatic nerve.
You feel pain:

  • in the lower back,
  • in the lumbar region,
  • in the hip,
  • in one half of the buttocks.

Piriformis syndrome arises due to:

  1. an anatomical change (the sciatic nerve runs between the fibers of the piriformis),
  2. an unequal incorrect load in the case of postural errors,
  3. of trauma.

The pain is felt especially when sitting and at night in bed, when you turn from one side to the other.

This syndrome almost always affects the left half of the buttocks, since the body is not symmetrical.

The consequence is that the sacrum (os sacrum) and pelvis make a rotation that exerts pull on the left piriformis muscle.
Patients with piriformis syndrome also often have pain in the groin.

Malfunction of the sacroiliac joint
The sacroiliac joints are located on the lower back on both sides of the spine.
Inflammation of the sacroiliac joint and nearby ligaments causes pain in the buttocks.
People with this condition feel intense pain:

  1. while running,
  2. when weight is shifted to only one leg,
  3. when walking.

This condition causes pain:

  • on the buttocks,
  • in the lumbar region,
  • in the groin.

The affected person may also suffer from stiffness and restriction of movement:

  • in the back,
  • in the hip,
  • in the pool.

Causes of malfunction of the sacroiliac joint Often there is no obvious cause for the malfunction of the sacroiliac joint.
In other cases, however, it can be caused by a postural error that overloads one side of the pelvis, for example:

  • lesions or trauma (e.g. due to a fall),
  • lower limbs of different lengths,
  • Scoliosis
  • after insertion of a hip prosthesis or vertebral fusion,
  • Activities that exert excessive pressure on the joint.

After the 5th month of pregnancy, pregnant women may feel pain in the lumbar region and pelvis due to the weight of the child and greater loosening of the ligaments.

Trigger points
Trigger points are point-shaped zones in which you feel a very painful lump at the touch of a finger. With pressure on this node, the pain is felt in another area of the body, for example, with pressure on a trigger point in the soleus muscle (calf muscle), the gluteal muscle could hurt.

Gluteal muscle
The three main gluteal muscles are the large, the middle and the small gluteal muscle. The gluteal muscle is the largest muscle in the body and some authors believe that it is also the strongest. All of these muscles can cause pain and tendon problems in the buttocks.
There are many trigger points within this muscle tissue that cause pain in the buttocks or throughout the buttocks.
There is:

  • 3 trigger points in the large,
  • 3 in the middle,
  • 7 in the small gluteal muscle.

Bursitis (bursa) A bursa (bursa synovialis)
is an anatomical structure filled with serous fluid. Its task is to reduce friction during movements between:

  • Brawn
  • Bone
  • Joints
  • Yearning.

The structures that “rub against each other” can become inflamed and cause pain. The two main bursae in the buttocks are:

  1. bursa trochanterica (lateral area),
  2. Bursa ischiadica (below).

Bursitis can affect the right, left, or both gluteal muscles.

Fracture of the pelvis and hip joint lip
As a rule, a pelvic fracture occurs in the anterior area and causes pain in the groin, which can extend into the buttocks.
The patient is in great pain, especially:

  • while standing,
  • while sitting,
  • when moving.

For diagnosis, it is necessary to perform an X-ray examination.

In the case of a displaced fracture, bed rest is indicated until the bone callus has formed. The patient is allowed to stand up as soon as the orthopedist allows the legs to be loaded.

The most effective therapeutic measures for fractures are:

  • Magnetotherapy to promote bone callus formation,
  • Exercise therapy (rehabilitation exercises), to regain strength, balance and range of motion.

Diseases that cause pain in the buttocks Buttocks pain is provoked by the following diseases:

  1. bone tumor in the pelvis (causes pain day and night);
  2. compartment syndrome: disease in which internal pressure increases in the muscular lodges and decreases blood flow to nerves, tendons and muscles;
  3. Fibromyalgia: is a chronic disease that causes pain, stiffness and weakness of the muscles, tendons and joints;
  4. pilonidal cyst: benign cyst that forms on the coccyx; can become infected and fill with pus (abscess);
  5. Herpes zoster: painful nerve disease caused by the varicella virus;
  6. spinal stenosis: the narrowing of the spinal canal causes pressure on the spinal cord or on the nerves;
  7. Pudendal neuralgia: causes burning pain along the nerve course and thus can affect testicles, vagina and areas of the buttocks near the anus.

What other symptoms occur with gluteal pain?

Buttock pain manifests itself with many other symptoms, such as:

  • restriction of movement of the back (in case of herniated disc),
  • restriction of movement of the hip (in arthritis),
  • difficult walking (limping),
  • Back pain
  • muscle weakness (with inflammation of sciatica),
  • numbness of the muscles,
  • pain in the right or left flank, legs or lumbar region,
  • swelling (edema) on the buttocks (due to trauma or fracture),
  • burning sensation (if the patient suffers from herpes zoster or sciatica).

Treatment of buttocks pain

The treatment is based on the disease that causes the symptoms.
In case of a past injury to the gluteal muscles, rest and the application of ice compresses should improve the pain within two days.
If this does not occur, a doctor should be consulted.
The doctor determines the cause based on the patient’s medical history with some tests and examinations, such as:

If the piriformis muscle is cramped, a heat pad on the buttocks can relax the muscles.
If this is not enough, a physiotherapist or osteopath can release the tension and deactivate the trigger points through manipulation or Rolfing (a rather painful muscle massage).

One cause of back pain is a malposition of the back.
Posture correction brings immediate relief to the gluteal muscles.
If the body is not properly aligned, a correction of the sacroiliac joint is made with the help of the physiotherapist.
As soon as the pain in the hip subsides, no stretching exercises of the muscles should be done.
The piriformis does not stretch and does not gain elasticity, but could start to hurt again.
This prolongs the time until an improvement.

In the case of a herniated disc or sciatica, jogging and some other training exercises such as squats and leg presses should be avoided.
Of course, other sports are also contraindicated, such as:

  • Tennis
  • Volleyball
  • Basketball.

Swimming is only recommended if there is no pain. However, it is well suited for prophylaxis.

Natural remedies for pain in the buttocks

Many doctors recommend muscle stretching exercises with trunk bends or stretching of the piriformis muscle. In fact, these exercises do not improve the situation, but can aggravate the pain in the short term.
Stretching exercises can relieve pain that comes from the iliolumbal ligament, but you should not overdo stretching this ligament.

Self-massage of the gluteal muscle can be performed by:

  1. sits on a tennis ball with a gluteal muscle,
  2. moves the pelvis back and forth.

This massage can relieve the pain in piriformis syndrome.

In the case of a herniated disc, the best recommended manual therapy is the McKenzie concept.

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