Back pain is familiar to many people, but often there is actually pain in the buttocks behind it. Since the pain can radiate, the original focal point is often recognized late and then treated accordingly.
What is buttock pain?
Pain in the buttocks can be centered in just one spot, or it can radiate over large areas of the lower back. Buttock pain can vary in intensity. Many people are familiar with the stabbing pain of walking, bending, or sitting that can radiate from the buttocks into the thigh. In the beginning, the pain often occurs only during exertion, but later severe attacks of pain occur even at rest and especially in the early morning. The intensity of the pain is reminiscent of sciatic pain, and sometimes the pain in the buttocks is even indirectly triggered by the sciatic nerve. A large gluteal muscle runs directly above the sciatic nerve. If this is enlarged due to inflammatory processes, direct irritation of the sciatic nerve can occur and lead to the severe pain. In the period of office work and incorrect posture, discomfort in the musculature is very common. The gluteal muscle is heavily used in many activities, whether running, sitting, walking, standing, without the piriformis muscle, the usual daily movements would not be possible. Irritation, inflammation or overuse are not uncommon due to the daily stress, so buttock pain has become a common disease along with back pain.
Causes
Pain in the buttocks can be centered at just one point or it can radiate over large areas of the lower back. Symptoms are often misinterpreted, and it is not uncommon for buttock pain to be interpreted as sciatica and treated accordingly. In fact, there is a muscle deep in the buttocks, the so-called piriformis muscle, which can be seen as the cause of the complaints. This muscle runs over the sacrum to the thigh bone, which often explains the transmission of the pain into the leg. Immediately below the piriformis muscle is the sciatic nerve, one reason why pain in the buttocks is so often diagnosed as sciatica. The gluteal muscle is stressed during almost any form of exercise, as well as when sitting. If there is an overuse or injury to this muscle, it swells, which in turn leads to pressure on the sciatic nerve. A burning pain in the buttocks with radiation into the lower back and often into the leg is the result. Another cause of pain in the buttocks can be the hip joint, known by name as the sacroiliac joint. Often this type of discomfort occurs after injuries to the coccyx or hip. Pain in the buttocks can also be caused by overloading the hip bone during exercise.
Diseases with this symptom
- Decubitus (bedsores)
- Sciatica
- ISG syndrome
Diagnosis and course
Before going to the doctor, many people try to treat the pain in the buttocks themselves with painkillers. This can relieve the symptoms in the short term, but the cause remains. At first, the pain occurs only sporadically during movement and exertion, and the condition quickly improves at rest. As the disease progresses, the pain becomes more severe and can no longer be completely suppressed with painkillers. At this point, at the latest, most sufferers consult a doctor. He or she will first inquire about the course of the symptoms and then obtain an impression by means of imaging procedures. As a rule, MRI or CT are preferred to X-ray examination, since a better diagnosis is possible. If left untreated, the pain in the buttocks would worsen and limit those affected in their daily lives. However, once the diagnosis is made, appropriate therapy is quickly initiated so that patients have a good chance of recovery.
Complications
Pain in the buttocks may be associated with muscle soreness, postural deformity, sciatic pain, and herniated discs. Buttock pain may also be accompanied by inflammatory pain associated with ankylosing spondylitis – a rheumatic disease. The chronic disease can lead to stiffening of the spine. Pain in the buttocks may also be associated with an abscess. The abscess develops from a bacterial infection in the spine or intestinal area.An injection into the gluteal muscle can also cause an abscess. In addition to this purulent inflammatory process, the patient may suffer from fever. Pain in the buttocks may also indicate a coccygeal fistula – especially if the pain is severe. A coccygeal fistula is a granuloma that can form around an ingrown hair. Patients with a coccygeal fistula may not be able to sit or walk properly and may feel overall discomfort. Surgical intervention is usually necessary. Pain in the buttocks may also be related to bleeding in the gluteal muscle. This is most common in people with an increased tendency to bleed and with injuries to the buttocks. Buttock pain can also be associated with fibromyalgia syndrome, which is often difficult to treat.
When should you see a doctor?
Sudden pain in the buttocks always requires medical clarification. A visit to the doctor is particularly advisable if there is recurrent discomfort that increases in intensity as it progresses. If the buttock pain is associated with other symptoms, a medical professional must be consulted for further clarification. Accompanying symptoms such as chills and fever indicate a bacterial infection that may have already formed an abscess in the buttock region, which must be removed immediately. Fatigue and exhaustion indicate fibromyalgia that requires treatment. If the pain occurs mainly after lying down, a doctor should also be consulted. There may be an inflammation of the spine (ankylosing spondylitis), which can lead to permanent bone damage if left untreated. If a pinched nerve is suspected, the family doctor should be consulted to avoid unpleasant sequelae such as piriformis syndrome. Pain in the buttocks after an accident or fall should be clarified immediately and treated if necessary. If the pain is severe and affects essential body functions, a trip to the emergency room is recommended.
Treatment and therapy
Treatment of pain in the buttocks depends on the cause. At the beginning, the pain is usually harmless, occurs only rarely and disappears at the latest after taking a commercially available painkiller. However, the cause cannot be eliminated with such self-medication, so going to the doctor is absolutely advisable. The cause of buttock pain can best be determined by an imaging examination. MRI or computer tomography are more suitable than X-ray, as they give the doctor a better insight. If minor injuries to the gluteal muscle are responsible for the pain, rest and cooling are the best means of treatment. The injured region should be cooled with ice packs. Once the injuries have healed, the pain usually disappears completely. Permanent overuse of the gluteal muscle can be caused by postural deformities. In this case, physiotherapy is the method of choice to remedy the symptoms. In this case, the pain in the buttocks can only be alleviated by consistently avoiding incorrect posture and overstraining. If a strain of the gluteal muscle is the cause of the pain, heat helps to alleviate the symptoms. Heat ointments or patches are ideal for treatment in these cases, allowing the muscle to relax and the pain to subside. Continuous training of the gluteal muscle can further alleviate the discomfort. Appropriate instructions or training methods are shown to the affected person during physiotherapy.
Prevention
Poor posture and incorrect movements are very often the cause of pain in the buttocks. In order to avoid incorrect stress on the gluteal muscle in the first place, some precautions should be observed even during everyday movements. Lifting heavy objects, frequent bending and sporting activities without prior warming up are, along with sitting too long at the computer, the main reasons for incorrect stress on the gluteal muscle. Such complaints can often be remedied with a few changes in everyday life. If a heavy load has to be lifted, many people bend forward with their upper body and then lift the weight. This causes an overload of the gluteal muscle. Large loads should always be lifted from the knees, first bend at the knees, then lift the load with the strength of the legs protects the gluteal muscle and the back.When doing sports, the muscles should always be warmed up beforehand, otherwise painful strains can occur, including in the gluteal muscle area. Sitting at a desk for a long time can also lead to an overload of the gluteal muscle. It is recommended that when sitting for long periods of time, always stand up once in between, loosen up the muscles and then continue to work.
This is what you can do yourself
Various self-measures and home remedies help with pain in the buttocks. Discomfort as a result of hemorrhoids or minor injuries can be relieved by rest and cooling. For strains, on the other hand, heat helps, for example in the form of heat ointments, hot baths or warm compresses. In addition, the gluteal muscle should be strengthened by regular exercise. Physiotherapy or yoga can counteract permanent overuse of the gluteal muscle. Acutely, it helps to turn the office chair around and lean against it with a cushion between the backrest and the abdomen. Stretching exercises also bring relief. The spine in particular should be exercised regularly to strengthen the pelvis and buttocks. If the pain in the buttocks is caused by a wound, a visit to the doctor is recommended. In addition, the complaints can be alleviated by increased intimate hygiene and protection of the affected area. Quick help is promised by pain-relieving home remedies such as chamomile tea or applications with tea tree oil and sage. If the pain is severe, antibiotics and other preparations from the pharmacy can help. Often, bed rest and regular walks already help to relieve the pain in the buttocks. Rapid relief is also promised by massages, especially pressure-point massages for the buttock area or Ayurvedic massages that stabilize the flow of energy in the body.
