Pain in the buttocks

Generally

Pain in the area of ​​the buttocks is mistaken by most sufferers as lower back pain.

This can mainly be explained by the fact that pain in the buttocks usually radiates to other parts of the body.

In this way, the original focus is often localized very late and treated the underlying disease in a correspondingly advanced stage.

Pain in the buttocks can vary greatly in intensity as well as in quality ( piercing, dull, pulling, burning ).

In most cases, the complaints are perceived by the affected patients, especially during running, bumping or standing.

In addition, the majority of the causative diseases cause pain, which initially occurs only during exercise.
Patients are completely symptom free at rest during the early stages of the disease.
Only with the progression of the underlying change do painful rest arise.
Many patients who suffer from buttock pain compare the intensity of the discomfort with the typical sciatic pain.

This fact can be explained by the fact that the sciatic nerve is in many cases indirectly involved in the development of pain in the buttocks.
Inflammation of the pomaceous muscles ( gluteal muscles ) often leads to an enlargement of the muscle belly.
In this way, a direct irritation of the sciatic nerve can arise and typical symptoms arise.

Pain on the buttocks occur in principle at any age.
The gender distribution between the affected patients is also approximately the same.
Nevertheless, especially in older people it can often lead to pain in the buttocks.
The reason for this is the fact that it often comes during aging to a significant decrease in the gluteal muscles.
In this way, the nerve running under the musculature is strongly irritated, especially during long periods of sitting.

In addition, it can be observed that especially people who work in the office or have a malposition of the physiological axis of the body are particularly likely to suffer from pain in the buttocks.

However, pain on the buttocks does not always have to be treated.
In many cases, even without medical intervention, a complete reduction of the symptoms will occur after a short time.
People who suffer from chronic and / or frequent pain on the buttocks should urgently consult a doctor and clarify the cause of the symptoms.

symptoms

Most of the affected patients experience especially when walking, sitting and / or bending a strong pain in the area of ​​the buttocks.

The quality of the pain perceived by those affected ranges from piercing to burning or burning.
Pain on the buttocks can occur both centered on a single point, as well as over the entire buttocks.

In addition, diseases tend to trigger the pain on the buttocks in most cases also cause discomfort in the back and thighs.

Depending on the cause, the pain experienced by the patient may either occur at rest or after a prolonged stress period.

In addition, some of the sufferers describe the feeling of a significant fatigue of the buttocks and thigh muscles.

The occurrence of general symptoms ( fever, for example ) is also possible in some of the underlying diseases.

Causes of pain in the buttocks

Buttock pain can have a variety of causes.
In most cases, there is no actual disease.
Accordingly, the symptoms perceived by the affected patient are caused by external triggers ( for example, a new bicycle saddle ) and disappear within a very short time without medical intervention.

The classic " muscle soreness " is one of the typical causes of pain in the buttocks.
However, the most common reasons for discomfort of the buttocks are dysfunctions of the body's musculoskeletal system ( tendons, ligaments and muscles ).

In this connection, different forms of functional disorders can be distinguished. Many of the affected patients have so-called " myofascial pain ".
These are tensions of the muscles and / or tendons, which are mainly caused by postural errors and monotonous movements.

Typically, these patients undergo significant hardening during the physical examination.

Other common causes of pain on the buttocks are:

Piriformis syndrome

Piriformis syndrome is one of the so-called functional causes of buttock pain.
This disease is caused by a permanent irritation of the sciatic nerve. Typically, the affected patients experience buttock pain, which can occur from the hip to the thighs.

The symptoms are similar in most cases to those of a classic lumbar disc herniation.
Distinguishing a piriformis syndrome from a lumbar disc herniation is also difficult for the experienced physician.
The name of this syndrome goes back to the piriformis muscle, which can exert both internal and external pressure on the sciatic nerve.
The onset of piriformis syndrome usually goes back to prolonged, monotonous strains.
For this reason, especially athletes ( such as endurance runners ) are affected.
However, pains in the area of ​​the buttocks that are provoked by an irritation of the sciatic nerve can also be caused by accidents or falls on the buttocks.
In addition, forward bending, bending down, or lifting heavy objects from a straddle position often results in such painful symptoms.

Another cause of pain in the buttocks may also be a hamstring in the buttocks. The torn muscle often occurs when the muscles are still unharnessed and the muscles are stretched and stressed beyond the physiological level. Noticeable is a strong, stabbing pain, which can also pull in the direction of the back or thigh. Depending on the severity of the injury, there may be a bruise or swelling at the affected area. If you suspect a torn muscle, you should stop immediately with the load and cool the affected area and protect.

Disorders of the sacroiliac joint

Furthermore, diseases of the iliac crural joint can lead to pain in the area of ​​the buttocks.
In this context, a blockage of the joint can be detected in the affected patients particularly often. Due to the blockade, there is a disruption of the interaction of the individual ligaments, tendons and muscles in the joints between the cross and the pelvis ( so-called sacroiliac joint, short: ISG ).

The result of this functional disorder is tension in the muscles and recurrent blockages that lead to severe pain in the buttocks.
The reason for the dysfunction in the affected patients is in most cases mechanical factors.

Above all, postural errors and sports overload often play a role in the disease development. In addition, unilateral leg shortening, increased curvature of the lumbar spine forward, and degenerative joint changes (such as hip osteoarthritis ) may be the cause.

real sciatica

Although functional changes are much more likely to cause pain in the buttocks, direct damage to the sciatic nerve may also be responsible for the development of the symptoms.
Direct damage to the nerve is usually caused by irritation directly in the area of ​​the nerve root.
In these cases, the affected patients feel a sharp pain that pulls the leg down from the buttocks in a defined area of ​​the skin. The direction of progression of the symptoms perceived by the patient corresponds approximately to the course of a lateral trouser seam.
In this area, there is also the development of tingling and / or a feeling of numbness.

Due to the nerve damage induced throttling of the nervous innervation of the leg muscles, muscle atrophy can also be observed.

The irritation of the root of the sciatic nerve is usually caused by a herniated disc. Furthermore, bony spurs and bone structure disorders ( such as osteoporosis ) can damage the nerve root.

diagnosis

An X-ray image can lead to a diagnosis.

Patients suffering from long-lasting or regular pain in the buttocks should urgently consult a doctor and clarify the causative disorder.

The most important step in the diagnosis of pain on the buttocks is the detailed doctor-patient interview ( keyword: anamnesis ).

During this conversation, both the intensity and the quality of the pain felt should be revealed.
Also the temporal connection between physical activities and the occurrence of the complaints can provide a first indication of the underlying problem.

Following the doctor-patient interview usually follows a comprehensive physical examination in the attention to pain triggers and possible malpositions of the body axis is respected.

As a rule, the imaging of pain in the buttocks is done by taking MRI from the pelvis - or, more rarely, a CT scan.
With these methods, a more targeted diagnosis is possible in comparison to the classic X-ray.

therapy

The treatment of buttock pain depends on the underlying condition.
For this reason, extensive diagnostics are essential for optimal therapy.
The affected patients can help themselves with painkillers ( analgesics ) at the first onset of pain in the buttocks.
Above all, medicines with the active ingredients ibuprofen and paracetamol can be taken for the time being without hesitation.

If minor injuries to the gluteal muscle are responsible for the discomfort, observing a resting phase and prudently cooling the painful area can be enough to alleviate the pain.

Pain in the area of ​​the buttocks that are triggered by functional causes usually needs to be treated physiotherapeutically.
During each treatment session, stretching exercises and complementary physical therapy applications ( eg, electric or ultrasound applications ) are performed.

The aim of the physiotherapeutic treatment of pain in the buttocks is to release the strong muscle tension.
Even with functional causes painkillers can be taken if necessary.

Patients suffering from very severe symptoms may be prescribed a weak opium preparation in addition to ibuprofen and paracetamol.
Pain in the buttocks caused by sciatica usually requires more extensive therapy.

At present, various treatment strategies are used, which are used depending on the particular symptoms of the individual patient.
Among the most commonly used methods is the so-called " step storage ".
This method can relieve the lower back and relax the sciatic nerve.

In addition, general physiotherapy and the use of electrical impulses are among the most common treatments for patients suffering from buttock pain.

The drug therapy of the affected patients includes drugs for the inhibition of inflammatory reactions and pain.
In most cases, non-steroidal anti-inflammatory drugs ( NSAIDs such as aspirin ) and cortisone preparations are used.

Another effective treatment for pain in the buttocks caused by nerve damage, the so-called " periradicular therapy " ( short: PRT ).
This method is a special syringe therapy in which a drug for anesthetizing the nerve is applied locally.

Buttock pain, which is caused by an abscess of the pelvis or by an injury or foreign body-induced abscess, must in most cases be treated surgically.
In the affected patients, the abscess cavity is opened through a skin incision and the pus therein is removed. In addition, after the opening of the abscess antibiotic therapy must be initiated.

prophylaxis

Pain in the buttocks in the majority of cases is due to congenital misalignments of the body axis or acquired posture damage.

For this reason, most of the causes that lead to the development of such a pain symptom can be prevented by an adapted lifestyle.

Above all, weight loss and a sufficient degree of physical activity play a decisive role in the prevention of pain in the buttocks.

location of pain

Pain in the buttocks and thigh pain

Pains that originate in the buttocks or lower back sometimes drag down to the legs.

If a pain radiates from the lower back to the legs, in many cases a certain nerve can be named as the cause. Nerves, which are responsible for muscles and skin areas in the leg, arise in deep areas of the spine between the last lumbar vertebrae and the beginning of the sacral vertebrae, in the area of ​​the sacrum.

A well-known syndrome that causes pain that begins in the buttocks and radiates into the leg is the so-called "piriformis syndrome". The pain is described as pulling and stabbing on the back of the thigh. In severe cases, tingling and numbness can come to your toes. The cause of this nerve pain is the "piriformis muscle", which runs in the immediate vicinity of the large sciatic nerve.
With a strong irritation it comes thus to pain from the lower back to the toes. A lower back herniation may also trigger similar symptoms. A close examination by the orthopedist is important in order not to falsely diagnose "herniated disc".

Letting the patient lift their legs while lying on their backs with their knees stretched out, no pain should be felt with the Piriformis syndrome. If it still hurts, one can rather start from an origin in the spinal column or the sacrum. If it hurts the patient when he pulls the bent legs against the upper body and at the same time internally rotates, this can be an indication of a Piriformis syndrome. However, as these examinations do not allow a complete diagnosis, an orthopedist should always be consulted for buttocks pain radiating to the legs.

The treatment of piriformis syndrome is mainly due to physiotherapy. Targeted exercises according to the instructions of orthopedists or physiotherapists must train the piriformis muscle and relieve the sciatic nerve. The pain should be pre-breastfed by analgesic drugs from the group of "NSAIDs". These include, for example, ibuprofen, diclofenac or aspirin.

Pain in the buttocks and hips

In addition to the Piriformis syndrome, which can also cause pain in the hip, nerve, muscle and bony causes come into question. Degenerative damage to the joints can cause unpleasant pain in the long term. Often the symptoms start in the form of pain after physical work, after getting up in the morning or after exercising, and develop into permanent symptoms after months to years.

A common consequence of permanent malfunctioning or overloading is the so-called "ISG blockade". The trigger can be muscle tension in the pelvis, irritation of the sensitive nerves on the sacrum, or hip arthrosis.

The cause of pain can also be in the area of ​​the outer hip and pull into the buttocks. If the external rotating muscles of the legs are irritated or inflamed on the outside of the hip, a pulling, stabbing pain can reach all the way into the paw.

The pain itself can be treated with medication. Since the causes of the pain can be extremely diverse, one should imagine with permanent complaints to a doctor.

Right and left pain in the buttocks

In most cases, pain in the buttocks occurs unilaterally. Only rarely is the pain exactly in the middle or equally pronounced on both sides. Many pain causes are easy to fix and are temporary. These include, above all, muscle tension and slight nerve irritation due to bad stress or overloading during physical work or sport.

If the posture or load is inclined to a particular side, the weight also shifts to this side and there is quickly a one-sided pain.

If a permanent one-sided load, the body gets used to it. The muscles on one side shorten, the tendons as well and in bad cases can lead to degenerative changes of the bones, especially the vertebral body. The pain persists and can worsen over time.
Bad postures and stress levels in everyday life or in sports must always be prevented and counteracted. Once a slight pain occurs due to the maladjustment, the body automatically assumes posture which promotes poor posture and worsens it permanently.

Pain can be prevented with pain and anti-inflammatory drugs. To correct serious maladjustments, a professionally guided physiotherapy is often necessary.

Pain in the buttocks when sitting

Pain is often described especially when sitting in the buttocks.
The causes are obvious:
a large proportion of all occupations take place seated and represent a permanent and extraordinary burden on the pelvis and lower spine.
In order to maintain the whole body and the cross while sitting, a permanent load on the muscles and ligaments is necessary. In order to relieve the strain on the hip and back, one sometimes takes in postures that are particularly bad for the lower back. Anyone who sits many hours a day finds it difficult to be optimally ergodynamically optimally seated.
If the pain comes from sitting so much, only a few things are recommended:
a backrest shaped desk chair can do wonders. Similarly, despite long hours, one should try to minimize sitting and, if possible, do some work while standing. Read more about: ergonomic workplace
The biggest guide to chronic low back pain is strengthening your muscles by balancing sports at leisure. Targeted physical activity helps to prevent or remedy most of the back problems.

Chiropractic Treatments : Relief for Sciatic Nerve Pain in the Buttocks Area (December 2019).


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