Buttock pain: 5 possible causes (And what to do?)

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The pathologies involved in buttock painCalled "buttock pain" in medical parlance, are numerous. Generally they are 

Often, the buttocks are only irradiations of a consecutive back pain to nerve compression sciatica by herniated disc.

In any case, a precise diagnosis is essential for adequate treatment. Discover, in this article, some of the most common causes of pain buttocks.

Anatomical bases of the buttock

The buttocks are protuberances located between the root of the lower limbs and the trunk, behind the hip. They consist mainly of 3 muscles:

  • The greater gluteal (gluteus maximus) : the most superficial. It represents the most powerful muscle in the human body.
  • The gluteal medium (gluteus medius) : located on the side between the gluteus maximus and gluteus minimus.
  • The small gluteal (buttocks small) : the deepest.

These muscles attach to the pelvic bones, represented essentially by the iliac bone and the sacrum, and are inserted via their tendons on theupper end of the femur. They are involved in the movements of the pelvis and lower limbs.

In addition to the glutes, the gluteal region is also made up of 5 small deep muscles which extend from the ischial tuberosity (part of the pelvic bone) and the sacrum to the upper end of the femur (greater trochanter more precisely):

  • The piriform,
  • The twins (upper and lower),
  • The internal shutter,
  • The femoral square.

These 5 muscles have as main actions the rotation external (lateral) and adduction of the thigh.

At the level of the buttock runs the biggest nerve of the human body: the nerf sciatica. The latter arises at the level of lumbosacral plexus here alone ensures the motor and sensory innervation of the entire lower limb with its various nerve ramifications.

To know everything about the sciatic nerve, see the following article.

Buttock pain: 5 possible causes

Buttock pain can have several origins:

  1. Nervous (e.g. sciatica).
  2. tendon (ex : gluteus medius tendonitis).
  3. Muscular (ex : piriformis syndrome).
  4. bone (ex : pelvic fracture, sacrum or coccyx).
  5. Articular (e.g. sacroiliitis).

It can also be the result of a affection anorectal (pilonidal abscess, hemorrhoids, etc.), a lesion perineal or just be a pain projected internal organs (kidney pain, menstrual pain, etc.).

1. Sciatica

La pain lumbosciatica, commonly called "sciatica", is linked to a lesion in the spine. Usually a hernia discal, channel lumbar narrow or an Osteoarthritis vertebral.

This pain is caused when the nerf sciatica (or one of its branches) is compressed between two vertebrae. Its topography depends on the compressed nerve root (sciatica L3, L4, L5, S1).

Schematically, the pain begins in the lumbar region and then sometimes goes down to the toes passing through the buttock, thigh and leg. It therefore follows the path of the sciatic nerve.

2. Gluteus medius tendonitis

It corresponds to a inflammation of the gluteus medius (gluteus medius) tendon. The latter is involved in stabilizing the coxo-femoral joint (the hip).

The gluteus medius tendonitis is usually the result of a hypersolicitation ou overuse of this muscle. The runners are therefore the most frequently affected.

This condition is manifested by pain in the side of the buttock. It occurs during certain situations putting tension on the gluteus medius tendon, including prolonged standing, climbing stairs, prolonged walking, running or sleeping on your side.

It is also possible to reproduce the pain by pressing at the level of the upper end of the femur, more precisely at the level of the large trochanter (bony projection where the tendon of the gluteus medius is inserted).

To know everything about gluteus medius tendonitis, see the following article.

3. Piriformis Syndrome

Le piriformis syndrome corresponds to a compression and irritation of the sciatic nerve, during its crossing of the gluteal region, by a contracted piriformis muscle excessively.

This condition is manifested by pain buttocks similar to those of "sciatica" : behind the buttock, sometimes descends along the lower limb, electric shock type…

Its causes are comparable to those of gluteus medius tendinitis, i.e. situations leading to overuse of the hip (walking a lot, running too long…).

4. Bone fractures

If the butt pain appeared after a trauma, it is possible that it is the sign of a fracture at the level of the bones of the pelvis or the lumbar vertebrae.

This type of fracture usually occurs for violent trauma, in particular in the context of an accident on the public highway, a traffic accident or a fall with reception on the buttocks or lower back.

pain associated with a coccyx fracture or sacred are often sharp in the buttocks.

In people with brittle bones (advanced age, osteoporosis, vitamin D and/or calcium deficiency, etc.), a vertebral compaction or an isolated pelvic fracture may occur for trauma Minors, even spontaneously. The diagnosis is then less obvious.

5. Sacroiliitis

It is one of the most frequent rheumatic affections. It corresponds to a inflammation of the sacroiliac joints (between the sacrum and the iliac bone).

Clinically, sacroiliitis is manifested by lower back pain ou to the buttocks which radiate to the posterior part of the thighs. Its symptoms are often very similar to those of sciatica, which sometimes makes its diagnosis quite difficult.

The buttock pain full sacroiliitis are from inflammatory type. That is to say, they readily occur at night (causing nocturnal awakenings), are not relieved by rest and lead to morning joint stiffness (morning derusting).

What to do to relieve pain in the buttocks?

Devant any worrying buttock pain (not yielding spontaneously, recurrent, increasing in intensity, etc.), a medical consultation is necessary.

The doctor will try to find the origin of the pain, in particular thanks to a meticulous questioning, a complete physical examination (with emphasis on the dorso-lumbar and buttocks regions) and any additional examinations (biological assessment, standard X-ray, ultrasound, MRI, etc.).

At the end of the clinical and paraclinical investigations, the origin of the buttock pain can be determined. The therapeutic attitude will then obviously depend on the cause. Here are some examples :

  • Sciatica: analgesic drugs and non-steroidal anti-inflammatory drugs are the first-line treatments for lumbosciatica. Corticosteroid infiltrations are reserved for painful attacks that are resistant to the usual treatments. But the only curative treatment is the lifting of the compression of the sciatic nerve (surgical cure of a hernia).
  • Tendonitis: resting the hip joint, taking painkillers and anti-inflammatories. It is also possible to inject corticosteroids directly into the site of the inflammation to relieve pain. Surgery will only be considered as a last resort, after several months of failure of conservative treatment.
  • Piriformis syndrome: rest, analgesics and anti-inflammatories may be sufficient. However, corticosteroid injections are sometimes useful to relieve severe pain. The care at a physiotherapist or osteopath can be effective, thanks to exercises and manipulation techniques aimed at stretching the piriformis muscle (and therefore lifting the compression of the sciatic nerve).
  • Bone fracture: the treatment obviously depends on the characteristics of the fracture (seat, type of fracture line, displaced or not, complicated or not, etc.) and the terrain (age, history, etc.).
  • Sacroiliitis: treatment is based on analgesics, anti-inflammatories, application of ice to painful areas, physiotherapy and muscle relaxants. Punctual injections of corticosteroids and lidocaine (anaesthetic) can be performed three or four times a year. As for surgery, it is only considered as a last resort (fusion of the joint between the pelvic bone and the sacrum).

What about natural remedies?

Although they are not supported by solid scientific evidence, several natural products and grandmother's remedies are used to treat buttock pain, especially for their anti-inflammatory power.

Here is a non-exhaustive list of plants and essential oils that are effective in controlling pain and inflammation. The products are available on the site Country. Use promo code LOMBAFIT15 if you wish to obtain one of the following products, or any remedy aimed at relieving your symptoms and improving your quality of life:

  • Turmeric. Thanks to its antioxidant and anti-inflammatory powers very powerful, turmeric is one of the most used plants in a culinary and therapeutic context. The composition of turmeric is essentially made of essential oils, vitamins (B1, B2, B6, C, E, K) and trace elements. But it is to its composition rich in curcumin and curcuminoids that we owe them and calm skin of this spice.
  • Ginger. In addition to the special flavor it brings to the kitchen and its aphrodisiac properties, ginger is a root well known for its anti-inflammatory powers. the gingerol gives it its anti-inflammatory action. It is an active component acting on the inflammatory pain related to chronic joint inflammatory diseases, including rheumatoid arthritis, lupus, rheumatic diseases, etc. It has been proven that this active element is also effective in acting on the inflammation linked to arthritis and sciatica. Ginger also has other benefits thanks to its high potassium content and its richness in trace elements (calcium, magnesium, phosphorus, sodium) and vitamins (provitamin and vitamin B9).
  • Omega-3s. Omega-3s are polyunsaturated fatty acids that play a very important role in the functioning of our body. They are provided by food in three natural forms: docosahexaenoic acid (DHA), alpha linolenic acid (ALA) and eicosapentaenoic acid (EPA). Beyond their action on the brain and the cardiovascular system, omega-3s prove very effective against inflammation. Indeed, they have the ability to act on the inflammatory mechanisms in osteoarthritis by slowing down cartilage destruction, thus they reduce the intensity of osteoarthritis pain. Since sciatica is most often linked to inflammation secondary to a herniated disc, it can also respond to omega-3s if you consume them regularly. 
  • Lemon eucalyptusEucalyptus is a plant most often used in the form of herbal tea or essential oil. She would have anti-inflammatory effects which give it the ability to act on the bone and joint pain in general and the pain of sciatica in particular.
  • wintergreen. Wintergreen is a shrub from which a very interesting essential oil is extracted. It is one of the most used essential oils in aromatherapy. This oil extracted from the shrub bearing the same name, is used in massage to relieve sciatica and act like a analgesic. Indeed, it provides a heating effect thanks to its ability toactivate blood circulation locally.

References

[1] J.-J. Labat, R. Robert, T. Riant, J.-M. Louppe, O. Lucas, and O. Hamel, “Sciatica of the buttocks”, Neurosurgery, flight. 55, no 4‑5, p. 459-462, 2009.

[2] G. de Bisschop and E. de Bisschop, “In the context of buttock and pelvic-perineal pain, focus on myofascial pain”.

[3] JJ Labat, M. Guérineau, M. Bensignor, and R. Robert, “Parietal and musculoskeletal components of pelvic-perineal pain”, Pelvi-perineology, flight. 6, p. 367‑378, 2005.

[4] D. Wendling, C. Prati, É. Toussirot, and P. Ornetti, “Spondyloarthritis, spondyloarthropathy: diagnostic and classification criteria”, Journal of rheumatism monographs, flight. 77, no 1, p. 43-47, 2010.

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