Pain in the lower back and buttocks. What are the symptoms of the disease, how to treat it?

Pain in the buttocks indicates the presence of pathologies, such as:

• lumbosacral radiculitis,
• formation of phlegmon and abscesses,
• osteomyelitis,
• furuncle
• or is considered a consequence of muscle overexertion.

Pain in the buttocks can also be caused by:

• osteochondrosis,
• coccyx cyst,
• intervertebral hernia.

If there is a disease in the lower parts of the spine, due to the location of the nerves, the pain may radiate to the legs or buttocks.

To diagnose the cause of pain, the patient should determine the nature, intensity and painful location. We recommend that you contact experienced proctologists.

The buttocks are considered symmetrical parts of the body and represent, figuratively speaking, a “layer cake”. The first, top layer is the skin. The second is the tissue of the left and right gluteal muscles, respectively. The third layer is represented by subcutaneous fat, which is located directly under the muscles and, in comparison with other parts of the body, is considered the most developed.

Pain in the butt occurs in any of the balls. A painful process in the buttocks indicates the consequences of an injury, the presence of an infectious or inflammatory process in the body, or muscle pathologies.

Symptoms that accompany pain in the butt

Pain in the butt is accompanied by a number of symptoms that worry the patient.

• discomfort and pain during bowel movements;

The appearance of pain in the butt is caused by anal fissures and hemorrhoids. The causes of anal fissures are poor hygiene, constipation, and mechanical damage to the mucous membranes.

Symptoms of cracks are:

1. constant pain in the butt,
2. bleeding,
3. difficulty in defecation and discomfort.

Anal fissures often appear in women after natural childbirth.

• pain in neighboring areas;

In addition to the gluteal region, the patient has pain in the lower back, sacrum, coccyx, and thigh. The pain syndrome is accompanied by increased tone in the gluteal muscles, muscles of the lower back and lower extremities. As a result of changes in the spine and increased muscle tension, movement in the spinal column and hip joint is limited.

• general disturbance of health: malaise, weakness;

The patient feels severe weakness of the thigh and lower leg muscles, decreased sensitivity, and discomfort. Sometimes pain in the body is accompanied by discomfort in the buttock area. The patient complains of lack of appetite and worsening condition after eating. In this case, advice from a nutritionist and urologist is necessary.

• elevated temperature;

The patient's condition is accompanied by an increase in temperature. This process indicates inflammation or infection.

• headaches and dizziness;

There are complaints of headaches, migraines, dizziness. Sometimes cases of loss of consciousness are possible.

• nausea and vomiting;

Inflammatory processes in the buttocks are closely related to the gastrointestinal tract. The patient complains of nausea and vomiting, and belching.

• bowel dysfunction;

The patient develops fecal disturbances, upset and constipation, flatulence, bloating in the abdomen, discomfort in the buttocks and other organs.

• loss of consciousness and loss of coordination;

In severe cases, sharp pain in the buttock and increased body temperature are accompanied by impaired consciousness - the patient falls into a coma;

Treatment

Pre-hospital assistance

Patients with pain in the buttock are given rest. For severe pain, an anesthetic is given. For diagnosed diseases of the spine and neurological diseases, the use of warming and anti-inflammatory ointments is effective. Intense pain, poor general condition, and hyperthermia are reasons to immediately contact a specialist.

Conservative therapy

Conservative treatment includes drug and non-drug therapy. Patients may be prescribed:

• Protective mode
  . Bed rest or exercise limitation is recommended. Sometimes the use of additional devices is indicated: walkers, crutches, canes.
• NSAIDs
  . Used for rheumatic and degenerative processes. Used in the form of tablets, injections, topical agents: gels, ointments, creams.
• Antibiotics
  . Necessary for infectious diseases. Treatment of specific infections is carried out according to special protocols. For nonspecific infections, broad-spectrum drugs are prescribed; after determining the sensitivity of the pathogen, antibiotic therapy is adjusted.
• Physiotherapy
  . To reduce pain, stimulate resorption, activate blood circulation, accelerate healing or improve nerve conduction, referrals are given for electrophoresis, laser therapy, UHF, and electrical stimulation. According to indications, exercise therapy, massage, kinesiotaping, acupuncture, and manual therapy are used.

Causes of pain in the buttocks

Medical experts identify the following causes of butt pain:

• herniated intervertebral discs in the lumbar region;

Acute severe pain radiating to the buttock is observed with herniated intervertebral discs in the lumbar region. Pain first occurs in the lower back - directly in the place where the affected disc is located, then goes down to the buttock and lower along the back of the thigh. The pain occurs only on the right or left, depending on which side the nerve is affected. Weakness occurs in the leg on the affected side, skin sensitivity is impaired, and discomfort is noted in the anal area.

• lumbosacral radiculitis;

The patient feels discomfort in the buttocks. The condition is accompanied by nagging pain.

• excessive muscle tension;

Severe pain in the butt indicates excessive muscle tension. Such symptoms are observed in athletes and people involved in physical labor.

• sciatic nerve neuralgia;

With neuralgia of the sciatic nerve, the patient experiences severe pain in the thigh and anus. The pain intensifies with movement and turning.

• infections of the female genital tract;

Severe cutting pain in the anus can be observed in women who have problems with the female genital organs. To establish an accurate diagnosis, you should visit a gynecologist.

• arthritis and arthrosis;

With arthritis and arthrosis, inflammation of the joints of other organs is recorded in the patient. The main symptom of this disease is pain between the buttocks while walking. To prevent the development of arthritis and arthrosis, the patient should visit a neurologist and orthopedist. Health care providers will prescribe medications, healing ointments, exercise therapy, and physical therapy.

• infection;

Pain in the anus after diarrhea indicates the presence of an infectious disease in the human body. The patient undergoes tests and visits a urologist.

Diagnosis of the causes of lumboischialgia

When pain in the lower back radiates to the leg and buttock, you need to consult a chiropractor or neurologist. Our center’s specialists use an integrated approach to diagnosis and treatment, so they can quickly make the correct diagnosis. Diagnosis begins with a survey of the patient, during which the nature of the complaints, as well as the characteristics of work and rest, are clarified. The doctor must carefully examine the patient, palpating the spine, as well as conducting special functional and neurological tests. This allows you to get a complete picture of the patient’s condition, detect signs of neurological deficit and assess the extent of damage.

In order to establish the exact cause of lower back pain radiating to the leg and buttocks, instrumental diagnostic methods are prescribed. They almost always start with assessing the condition of the bones, intervertebral discs, ligaments and muscles of the spine. For this purpose the following are assigned:

• X-ray;
• CT;
• MRI.

The most complete and accurate picture of the state of the soft tissue structures of the spine is provided by magnetic resonance imaging. The method involves conducting a study of the body using powerful magnetic fields that do not have a negative effect on the human body. Therefore, it has practically no contraindications, with the exception of the presence of metal foreign bodies or implants in the body. If there are any, the patient is referred to a CT scan or x-ray. But only MRI allows one to determine the size of protrusions and intervertebral hernias with millimeter accuracy and detect the slightest degenerative-dystrophic changes in the discs, as well as signs of compression of nerve structures.

In our clinic you can also learn in more detail about the composition of your body and the state of the vascular system, which is involved in the blood supply to internal organs, musculoskeletal muscles, and the brain. Our experienced doctors will explain the data obtained to you in detail. Bioimpendansometry calculates the ratio of fat, muscle, bone and skeletal mass, total fluid in the body, and basal metabolic rate. The intensity of recommended physical activity depends on the state of muscle mass. Metabolic processes, in turn, affect the body's ability to recover. Based on the indicators of active cell mass, one can judge the level of physical activity and nutritional balance. This simple and quick test helps us identify disturbances in the endocrine system and take the necessary measures. In addition, it is also very important for us to know the condition of blood vessels for the prevention of diseases such as heart attacks, hypertension, heart failure, diabetes and much more. Angioscan allows you to determine such important indicators as the biological age of blood vessels, their stiffness, stress index (which indicates heart rate), and blood oxygen saturation. Such screening will be useful for men and women over 30, athletes, those undergoing long-term and severe treatment, as well as everyone who monitors their health.

In this case, body composition analysis gives us information that adipose tissue predominates in the body, and the bone-muscle component is in relative deficiency. These data will help the rehabilitation doctor competently draw up a physical activity plan, taking into account the individual characteristics of the patient.

If during the examinations no abnormalities in the condition of the spine are found, the patient is referred for consultation to a proctologist, gynecologist or urologist, since pain in the lower back radiating to the leg and buttock can be accompanied by proctitis, paraproctitis, prostatitis, adnexitis, uterine prolapse, prostate adenoma and other similar diseases.

Diagnosis and treatment of pain in the butt

The treatment process for pain in the buttocks depends entirely on the nature of the pathology. The patient needs to see a proctologist and attend an initial consultation. The doctor will examine the affected organ and perform palpation. If purulent discharge, bleeding and infectious processes are detected, then we suggest performing an operation to remove anal fissures.

For pain in the butt resulting from an injury, the patient is prescribed painkillers and warming ointments that can relieve swelling. Non-steroidal medications relieve pain and promote rapid healing of soft tissues.

For boils, patients are prescribed Vishnevsky ointment and ichthyol ointment. In untreated cases, medical workers use massages, warm compresses, and physical therapy.

After consulting a doctor, the patient begins to engage in physical therapy. Improves muscle tone and strengthens. Doctors at the private clinic “KDS Clinic” have developed a special gymnastic system that will relax injured muscles and reduce pain.

Diagnosis of piriformis syndrome

In addition to the examination, checking tendon reflexes, posture and gait, the doctor prescribes instrumental research methods to the patient. Among them, the most informative is considered to be radiography of the spine in the lumbar region, as well as the joints of the sacrum with the pelvic bones. In addition, comprehensive results can be obtained by magnetic resonance scanning of the lumbar and sacral area. Radioisotope scanning is used in cases of suspected cancer or infection in the area of ​​the piriformis muscle and nearby organs.

A clear confirmation of piriformis syndrome is the diagnostic injection of an anesthetic solution into the muscle, which can be done under the guidance of an x-ray or computed tomography. If the pain disappears after the injection, then the diagnosis is made without doubt.

Pinched pudendal nerve

The sacrotuberous ligament arises from the ischial tuberosity and attaches to the sacrum and coccyx, while the sacrospinous ligament lies at a 90-degree angle to it, deeper to the sacrotuberous ligament and attaches to the ischium. The thickness of these ligaments can lead to pinching of the pudendal nerve, called Alcock's canal syndrome or cyclist's syndrome.

In addition to pain in the gluteal region, symptoms of pudendal neuralgia include sexual dysfunction, rectal pain, fecal incontinence, and urinary incontinence. Thus, a pinched pudendal nerve can significantly impact quality of life.

This may be caused by prolonged sitting, especially when riding a bicycle, or a recent change of bicycle saddle. Symptoms are typically worsened by sitting, but sitting on the toilet has been reported to relieve pain by relieving pressure on the nerve.

Exercises

Principles for selecting exercises:

• Try limiting exercise to 15 or 20 minutes per day to improve patient compliance and adherence.
• Avoid stretching at the beginning of treatment for tendinopathy to reduce the strain on the tendon and possibly return to it later when the pain has subsided.
• When treating tendinopathy, aim to keep pain below 5 on a scale of 10 and not worsen for 24 hours afterwards, especially when performing functional exercises such as step-ups, single-leg squats, dynamic lunges and split squats. .
• When performing the piriformis stretch with the hip flexed at 90 degrees, the hip should be externally rotated. The piriformis muscle is an abductor and external rotator of the hip below 45-60 degrees of hip flexion, but functions as an internal rotator above 60 degrees of hip flexion.
• Combine exercises with neurodynamic techniques such as sciatic nerve glides.
• Recommend glute strengthening in the form of bird-dog exercises, split squats, and functional loading exercises.
• Progressive loading with emphasis on hip extensors, abductors and external rotators.

Hamstring tendinopathy

Hamstrings start at the ischial tuberosity (very close to the sciatic nerve). Proximal hamstring tendinopathy is common among long-distance runners and athletes performing sagittal plane exercises (eg, sprinting, hurdles) or change-of-direction exercises such as soccer and hockey movements.

Symptoms:

• History of repeated flexion loads. During flexion movements such as deadlifts and other flexion activities, the proximal hamstring tendon is subjected to tensile loading at its insertion on the ischial tuberosity.
• Deep localized pain in the area of ​​the ischial tuberosity.
• The pain is worse when sitting, driving, lifting heavy objects, and running uphill. This occurs due to shear forces between the hamstring attachment and the ischial tuberosity as hip flexion increases. During running, force peaks in the late swing phase and has a second peak in the early stance phase.
• Positive straight leg raise test.
• A positive stoop test, which indicates sciatic nerve compression but does not rule out hamstring tendinopathy.
• Thickening on palpation around the ischial tuberosity.

Pain assessment should be performed as stress assessment tests are performed:

• Transition from a bridge with one leg bent at the knee to a bridge with a long lever.
• Deadlift on one leg.
• Three passive stretch tests (flexed-knee stretch, modified flexed-knee stretch, and Puranen-Orava test) have moderate to high validity and high sensitivity and specificity for diagnosing proximal hamstring tendinopathy.

Nature of pain

Complaints from patients when pain radiates to the right buttock are not typical. The nature of the pain may be:

• pulling;
• burning;
• sharp;
• sharp;
• shooting through;
• irradiating.

Pain in the right buttock may bother:

• temporarily or permanently;
• standing, sitting, lying down;
• during active physical activity and at rest.

The pain can be localized:

• in the upper part of the buttock;
• in the middle of the buttock;
• below the buttocks.

At the same time, painful sensations can affect either the right or left side of the right buttock.

The main areas of irradiation of gluteal pain:

• small of the back;
• sacrum;
• pelvic organs;
• thigh of the right limb (back or front surface, left or right side of the thigh);
• calf of the right limb (back wall of the leg below the knee);
• foot of the right limb.

Symptoms

• Pain in the tailbone when sitting is a manifestation of the consequences of injuries, a sedentary lifestyle, microtrauma from sports;
• Aching pain can occur with pelvic inflammation, osteochondrosis or hemorrhoids;
• Sharp burning pain is characteristic of injuries to the coccyx when falling backward;
• Pain when standing up, radiating to the tailbone, is a symptom of various diseases: from prolapse of the perineum to pathology of the pelvic bones. They may also be a sign of the formation of adhesions and scars after surgery or difficult childbirth;
• Acute pain that occurs when moving is most often caused by a pinched nerve.

To correctly identify the disease, it is necessary to undergo an examination. For coccydynia, palpation diagnostics, urological examination, MRI, radiography and CT may be prescribed. After research, treatment is prescribed that corresponds to the nature of the disease.

Statistics show that women more often than men suffer from pain in the coccyx, as they are more susceptible to pelvic diseases and lumbar osteochondrosis.