Pain in the buttocks occurs with soft tissue lesions, neurological disorders, diseases of the lumbar spine with neurological symptoms, pathologies of nearby joints. It can be pressing, aching, arching, twitching, sharp, dull, constant, intermittent, short-term. Sometimes associated with physical activity, body position. Diseases that cause pain in the buttocks are diagnosed according to a survey, an external examination, the results of additional studies: ultrasound, radiography, MRI, CT, etc. Rest is recommended before the diagnosis is made, in some cases, painkillers may be taken.
The most common traumatic cause of the development of a symptom is a bruise. The injury occurs as a result of a fall on the buttocks, more often observed in winter. It is characterized by moderate pain, gradually subsiding over several days, swelling, bruising. Movement is not impaired or impaired slightly.
With severe bruises, blows with a hard object on the gluteal region, hematomas are formed. The pain is initially pressing and aching, later bursting, increases with continued bleeding into the hematoma cavity. During the examination, a local dense edema is detected. In the future, the pain decreases, a fluctuating formation is formed.
In the area of the buttocks, superficial and deep pyoderma are often detected. This zone is a frequent localization of vulgar ecthyma. With superficial pyoderma, pain is slight or moderate, combined with itching, burning. The buttock swells, conflicts, a bullous rash or pustules form on it. Purulent foci are opened with the formation of erosions, the pain becomes raw. It is possible to attach a secondary infection with the development of a severe purulent process.
Of the deep pyoderma on the buttocks, boils and carbuncles are most often found. Accompanied by rapidly growing pain, which after 1-2 days becomes twitching, bursting, throbbing, depriving sleep. The degree of violation of the general condition depends on the size of the purulent focus. A limited dense swelling of a purple hue with one or more rods in the center is determined. After maturation of the abscess, the stem is surrounded by a yellowish rim. Palpation is sharply painful, fluctuation is detected.
The buttock area is the most common localization of post-injection abscess. The onset of a purulent process may go unnoticed, since after an injection, a painful infiltrate is normally formed. A distinctive feature of the abscess at the initial stage is the intensification, and not the subsidence of pain. Subsequently, the injection site turns red, swells, the pain becomes twitching, pulsating. It becomes impossible to sit on the buttock. Symptoms of intoxication, general hyperthermia are revealed.
Pararectal dermoid cysts are sometimes localized in the buttock area. In the absence of infection, the disease is asymptomatic or manifests itself as minor pressing pains. With suppuration, pain sensations become sharp, arching, pulsating, disrupt night sleep, accompanied by weakness, weakness, hyperthermia, and symptoms of intoxication. Palpation reveals severe pain.
Purulent bursitis develops when the mucous membrane of the sac located between the gluteus maximus muscle and the posterior surface of the greater trochanter becomes infected. It is manifested by symptoms of a deep abscess: increasing pain, fever, deterioration in general condition, restriction of movements. Due to the deep localization of the bag, it may be difficult to determine the type of abscess.
In bedridden patients, bedsores form on the buttocks. The pain syndrome is noted already at the initial stages of the formation of a bedsore, but due to its slight severity, it often goes unnoticed. Possible burning, itching, discomfort, increased local sensitivity.
Pain in the buttocks
The symptom is often observed in arthritis of the hip joint. The disease develops gradually. At first, patients are disturbed by dull aching pains in the buttock, inguinal region, on the outer side of the joint. Subsequently, pain becomes the cause of limitation of movements, gait disturbances, the appearance of lameness. The pain worsens after being in a stationary position. The cause of pain may be the following pathologies:
Dull transient pain can be observed in various forms of seronegative spondyloarthritis, including against the background of Bechterew's disease, Reiter's disease, Behcet's syndrome, chronic bowel disease. Soreness in the upper outer quadrant of the buttock is typical of inflammation of the sacroiliac joint. Features of the symptom are determined by the type of sacroiliitis:
Myalgia in the area of the gluteal muscles develop after a significant load, usually during sports training. They have a pulling, sometimes burning character. Sharply increase at the beginning of movements, subside a little after warming, light massage, a little warm-up. They remain for 2-3 days, gradually disappear.
Biceps tendonitis is more common in runners. Accompanied by deep pain in the buttock, radiating from behind to the thigh. At first, the symptom bothers only with intense exertion, later it occurs with any movements, sometimes it is observed at night. With enthesopathy of the ischial tuberosity, pain is localized at the point of attachment of the muscle to the bone protrusion, at first it is mild, and subsequently progressive.
Bursitis of the sciatic bursa of the gluteus maximus is manifested by pain in the projection of the buttock, aggravated by sitting on a hard surface, bending forward. It develops with repeated traumatization (falls on the buttocks, pressure and blows to the buttocks), more often diagnosed in figure skaters, people involved in equestrian sports.
Pain in the buttock is typical of radicular syndrome observed in a number of diseases of the spine. It has a aching, burning, baking, shooting character, depends on the position of the body, is combined with paresthesia, in severe cases - with paresis, hyporeflexia, and sensory disturbances. Detected in the following diseases:
The cause of radicular syndrome can also be infectious processes: tuberculosis, syphilis, osteomyelitis of the spine, spinal meningitis. In addition, burning, shooting, pulling, braining, baking pains in the buttock, radiating along the back surface of the limb, are found in such neurological pathologies as:
Other diseases that are accompanied by pain in the gluteal region include:
The initial examination is carried out by an orthopedic traumatologist. Depending on the characteristics of the pathology, the patient may be redirected to a neurologist, rheumatologist, surgeon, and other specialists. The diagnostic plan includes the following procedures:
Physical examination
Patients with buttock pain are given rest. For severe pain, an anesthetic is given. With diagnosed diseases of the spine and neurological diseases, the use of warming and anti-inflammatory ointments is effective. Intense pain, a violation of the general condition, hyperthermia are the reason for an immediate appeal to a specialist.
Conservative treatment includes drug and non-drug therapy. Patients may be prescribed:
Taking into account the characteristics of the disease, the following surgical interventions are performed:
In the postoperative period, dressings are performed, antibiotic therapy, painkillers are prescribed. Subsequently, rehabilitation measures are carried out.