Symptoms
Most of the affected patients experience severe pain in the buttocks area, especially when walking, sitting and/or bending down. The quality of the pain perceived by those affected ranges from stabbing to piercing or burning. Pain in the buttocks can occur either centred on a single point or over the entire buttocks.
In addition, diseases that cause pain in the buttocks tend in most cases to cause pain in the back and thighs. Depending on the cause, the pain perceived by the patient can either occur at rest or only after a longer period of stress. In addition, some of those affected describe the feeling of significant fatigue of the buttock and thigh muscles. The occurrence of general symptoms (e.g. fever) is also possible in some of the underlying diseases.
Causes for pain in the buttocks
Buttock pain can have a variety of causes. In most cases there is no actual disease. The symptoms perceived by the patient are therefore caused by external triggers (for example a new bicycle saddle) and disappear within a very short time without medical intervention.
The classic “muscle ache” is also one of the typical causes of pain in the buttocks area. However, the most common reasons for the occurrence of buttock pain are functional disorders of the body’s locomotor and support organs (tendons, ligaments and muscles). In this context, various forms of functional disorders can be distinguished.
Many of the patients affected show so-called “myofascial pain”. These are tensions of the muscles and/or tendons which are mainly caused by postural defects and monotonous movement sequences. Typically, these patients can be palpated during the physical examination.Other common causes of buttock pain are: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 pain in the buttocks that can extend from the hips to the thighs. In most cases, the symptoms are similar to those of a classic slipped disc in the lumbar spine.
The distinction between a piriformis syndrome and a herniated disc of the lumbar spine is difficult even for the experienced physician. The name of this syndrome comes from the piriformis muscle, which can exert internal as well as external pressure on the sciatic nerves. The development of the piriformis syndrome is usually the result of prolonged, monotonous strain.
For this reason, athletes (for example, endurance runners) are particularly affected. However, pain in the buttocks area provoked by irritation of the sciatic nerve can also be caused by accidents or falls on the buttocks. In addition, bending forward, incorrect bending or lifting heavy objects from a straddle position often leads to such pain symptoms.
and symptoms of piriformis syndrome. Another cause of pain in the buttocks can also be a torn muscle fibre in the buttocks. The muscle fiber tear often occurs when the muscles are still unheated and the muscles are stretched and strained beyond the physiological level.
A strong, stabbing pain can be felt, which can also pull towards the back or thigh. Depending on the severity of the injury, there may also be bruising or swelling in the affected area. If you suspect a rupture of a muscle fiber, you should immediately stop the strain and cool and spare the affected area.
Furthermore, diseases of the sacroiliac joint can lead to pain in the area of the buttocks. In this context, a blockage of the joint can often be detected in the affected patients. Due to the blockage, the interplay of the individual ligaments, tendons and muscles in the area of the joints between the cross and the pelvis is disturbed (so-called sacroiliac joint; short: ISG).
The consequences of this functional disorder are muscle tensions and recurring blockages which lead to severe pain in the buttocks. In most cases, mechanical factors are the reason for the functional disorder in the affected patients. Above all, postural deformities and sporting overloading often play a role in the development of the disease.
In addition, unilateral leg shortening, increased forward curvature of the lumbar spine and degenerative joint changes (e.g. hip joint arthrosis) can also be the cause. Although functional changes lead to pain in the buttocks much more frequently, direct damage to the sciatic nerve can also be responsible for the development of the symptoms. In most cases, direct damage to the nerve is caused by irritation directly at the nerve root.
In these cases, the affected patients feel a stabbing pain that starts from the buttocks and goes down the leg in a defined skin area. The direction in which the patient feels the pain corresponds approximately to the course of a lateral trouser seam. In exactly this area there is also the development of tingling and/or numbness.
Due to the throttling of the nervous innervation of the leg muscles caused by the nerve damage, 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 diseases of the bone structure (e.g. osteoporosis) can lead to damage of the nerve root.
Patients who suffer from long-lasting or regularly occurring pain in the buttocks area should urgently consult a doctor and clarify the causal disease. The most important step in the diagnosis of buttock pain is the detailed doctor-patient consultation (technical term: anamnesis). During this conversation, both the intensity and the quality of the pain experienced should be revealed.
The temporal relationship between physical activity and the occurrence of the pain can also provide an initial indication of the underlying problem.The doctor-patient consultation is usually followed by an extensive physical examination, during which attention is paid to pain triggers and possible malpositions of the body axis. As a rule, the imaging of buttock pain is done by making an MRI of the pelvis – or, more rarely, a CT scan. These methods allow a more specific diagnosis compared to the classic X-ray image.
