The pinched nerve in the buttocks usually means pinching the sciatic nerve (sciatic nerve).
The nerve arises from a plexus (nerve plexus) in the spinal cord. From there it runs along the thigh. The nerve is usually pinched in the spinal cord, for example through a herniated disc, or directly on the spine. The entrapment primarily causes pain in the buttocks, which radiate into the leg on the affected side.
The causes of pinching the sciatic nerve can be divided into different categories.
Structural causes are based on a disruption of the normal anatomy of the body (= body structure). For example, narrowing of the spinal canal (the canal in which the spinal cord lies) or other bony structures through which the nerve passes can irritate the sciatic nerve. A herniated disc in the lumbar spine area may also press on the spinal cord and thus trigger nerve pain.
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Inflammatory diseases such as borreliosis or infection with the herpes virus can inflame the nerve, damaging it and causing the same symptoms as an entrapment.
Pinching the nerve in the buttocks is more common in certain populations than others. The risk of entrapment increases with age, and obesity or pregnancy are also risk factors. Anyone who has already suffered an injury to the spine in the lumbar region can also suffer from entrapment more quickly. Very rare but serious causes of entrapment of the sciatic nerve can be a tumor in the spine.
also read: Piriformis Syndrome
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A pinched nerve in the buttocks causes various symptoms. In most cases, the symptoms are unilateral. The entrapment of the nerve itself leads to severe pain symptoms.
The characteristic of nerve pain is described as pulling or stabbing. The pain is in the buttocks and radiates into the leg, depending on the severity of the entrapment, only the thigh or even the entire leg up to the toes can be affected.
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These symptoms are aggravated by increases in pressure in the abdomen, caused for example by sneezing or coughing. The sciatic nerve, which is responsible for the symptoms, has two different functions: in one direction, it transmits movement information from the brain to the leg muscles. In the other direction, it transmits information about touch and pain from the leg to the brain. Depending on which part of the sciatic nerve is affected by the entrapment, this can lead to motor restrictions (e.g. weak foot dorsiflexion) or loss of sensation.
In severe cases, the supply of the bladder and intestinal muscles can be damaged, leading to urination disorders or incontinence.
also read: Pinched nerve
A pinched nerve in the buttocks is often associated with back pain.
The sciatic nerve, which is in the lumbar spine, is to blame for the symptoms. When the nerve is trapped, the back muscles become reflexively tensed, which causes back pain. This pain is particularly intense in the lumbar spine and sacrum area. In addition to the back pain, the pain usually also radiates into one side of the leg.
The risk of a pinched nerve in the buttocks is particularly high during pregnancy.
As the baby grows in size and weight, it puts more pressure on the pelvis and spine. This can lead to irritation in the area of the sciatic nerve and thus make the symptoms of entrapment. Exercise is the most important preventative measure; it can strengthen the gluteal muscles so that entrapment does not occur so quickly. Warmth also helps; a massage and light stretching exercises are also suitable. Pregnant women should only take medication after consulting their doctor.
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Therapy for a pinched nerve in the buttocks is initially aimed at relieving the pain. Rest and bed rest are recommended.
It often helps to elevate the affected leg. In addition, pain relievers such as paracetamol or ibuprofen can be taken. Ointments such as Voltaren or Doc ointment are also helpful.
Muscle-relaxing medication is occasionally injected when there is severe muscle tension in the back. If the acute pain symptoms are contained, physical therapy or physiotherapy should be carried out. Initially, this treatment aims to relax the muscles through massages and heat applications.
However, effective treatment for entrapment can only be achieved through exercise training. Therefore, exercises are carried out that strengthen the lower back muscles in particular.
If the nerve is pinched due to structural changes (e.g. herniated disc, narrowing of the spinal canal), an operation may be necessary. However, this is rarely the case. Surgery is also done when severe symptoms such as urination disorder occur or the pain cannot be adequately managed.
Cancer therapy must be carried out for causes such as malignant tumors on the spine. This usually consists of an operation, chemotherapy and radiation therapy.
The entrapment symptoms usually last for one to two months.
The duration is primarily based on the time the sciatic nerve needs to regenerate once the cause of the entrapment has been removed. Since the cause is often weak back muscles or poor posture, the duration of the symptoms depends largely on how regularly affected people carry out their exercise therapy.
A recurrence of the symptoms can only be prevented consistently by permanently strengthening the back muscles. Those who do not perform the exercises, on the other hand, have to reckon with a significantly longer course up to the chronification of the pain.
More on this: Duration of a pinched nerve
The diagnosis of a pinched nerve in the buttocks consists of various clinical tests.
In the so-called Laségue test and the Bragard test, the sciatic nerve is stretched in a targeted manner. If the nerve is pinched in one place, suddenly shooting pain occurs. Motor tests such as toe or heel gait can provide indications of motor failures. The reflexes of the patellar tendon (kneecap reflex) and the Achilles tendon (on the foot) are also tested. If the tests are positive, imaging such as MRI or CT can be performed.
