How Is A Diagnosis Made

A medical exam will help determine whether the SI joint is the source of your pain. Evaluation includes a medical history and physical exam. Your physician will consider all the information you provided, including any history of injury, location of your pain, and problems standing or sleeping.

There are specific tests to determine whether the SI joint is the source of pain. You may be asked to stand or move in different positions and point to where you feel pain. Your doctor may manipulate your joints or feel for tenderness over your SI joint.

Imaging studies, such as X-ray, CT, or MRI, may be ordered to help in the diagnosis and to check for other spine and hip related problems.

A diagnostic SI joint injection may be performed to confirm the cause of pain. The SI joint is injected with a local anesthetic and corticosteroid medication. The injection is given using X-ray fluoroscopy to ensure accurate needle placement in the SI joint. Your pain level is evaluated before and 20-30 minutes after injection, and monitored over the next week. Sacroiliac joint involvement is confirmed if your pain level decreases by more than 75%. If your pain level does not change after the injection, it is unlikely that the SI joint is the cause of your low back pain.

Buttock And Hip Pain May Include Sciatica Symptoms

If youve ever felt pain in the hip, pain in the center of the buttock, or pain down the back of the leg, you may likely be suffering piriformis syndrome that may cause sciatica symptoms. What is the piriformis muscle? It is located in the buttock region and runs from your sacrum to the outer hip bone . The piriformis muscle works overtime especially in people who are runners. The muscles in and around the gluteal region help with 3 bodily movements:

Woman runner on the beach standing while stretching her knee to her chest. Photo Source: 123RF.com.

Why Do You Have Pain In Right Butt Cheek

It could be due to damage to your nerves or it could only be muscular pain. Here are some possible causes:

1. Sciatica

Modern day lifestyles have increased the risk of sciatica and sciatic nerve pain. People today spend a lot of their time sitting and lounging, and combine it with poor posture and you have a perfect recipe for disaster. Only a small percentage of people know how to sit with a posture while keeping the hips and spine in a neutral position. Poor posture can put more stress on some of your muscles, which would result in pain. Similarly, unbalanced exercise routines can create an unnatural environment around your sciatic nerve, which in turn will lead to sciatic pain in the buttock, posterior pelvis, butt cheeks, legs, hips, and feet.

2. Muscle Injuries

Also called strains, muscle injuries occur when excessive stress on the muscle fibers leads to a tear. Pain may set in quickly or take some time to become severe, but it usually happens after you perform a certain activity. Sub-acute muscle pain is likely to be dull and achy, and it gets better with rest. Application of ice and pain medications like ibuprofen may help resolve the issue in a couple of weeks or so.

3. Weakened Abductor Muscles

4. Tight Piriformis

5. Pregnancy Pain

Don’t Miss: Mri For Back Pain Cost

Back Related Hip Pain

Pain experienced in the upper buttock regions sometimes has nothing to do with a condition in this area.

Lower back issues are often associated with pain that extends from the back into the upper buttock or pain that occurs only in the upper buttock.There are two main ways this might occur:

Referred pain

Referred pain is pain felt in a part of the body other than its actual source. For example, if there is a problem in the lumbar discs or joints, small nerve endings serving these structures generate danger messages that are transmitted along small nerve fibres into the spinal cord.

However, this area of the spinal cord also receives information from structures in the hip and pelvis.The brain is unable to distinguish where the information came from, so you might feel pain in any one or a combination of these areas .

Pain in the buttock may be referred from joints or intervertebral discs of the mid-lower lumbar spine.

Referred pain:

Peripheral Nerve

Piriformis Stretches To Relieve Piriformis Syndrome

Discomfort from too much sitting? Inactive glutes? Buttock and leg pain? Though small in size, the piriformis could have a big impact on keeping the human movement system moving smoothly. Addressing an overactive piriformis may be part of the solution.

Within this article, you will find some valuable stretches to relieve piriformis syndrome.

For further validation on the effectiveness of stretching from a corrective exercise perspective, enroll in the Stretching and Flexibility Coach course by NASM.

You May Like: What Will The Er Do For Shoulder Pain

When Should I Go Back To The Doctor

Leading up to your hip replacement, you were likely aware of what kind of complications you had in that area as well as the severity of the pain. You will know that if pain in the buttocks or the pelvic region is worse than that of a sprain, then it would be an ideal time to take medications. Should it be worse than that , then it is time to visit the doctor again.

Piriformis Syndrome Exercises To Avoid

There are certain exercises you should avoid if you have piriformis syndrome. If youre an office worker that sits regularly, you should likely avoid doing exercises in a sitting position as this could make your condition worse. Specific exercises that you should avoid are those that overwork the aggravated area, such as the exercise known as the clam.

Recommended Reading: Lower Back Pain From Bed

Causes Of Piriformis Syndrome

Your anatomy may be behind your piriformis syndrome. This is known as primary piriformis syndrome and occurs when you have a split piriformis muscle, split sciatic nerve, and/or an atypical sciatic nerve path.

Secondary piriformis syndrome is far more common and is caused inflammation of soft tissues, or both, resulting in nerve compression. Direct trauma to the buttock can lead to inflammation, scarring and contractures of the piriformis muscle

This might be the result of a major event like a car accident or a fall. However, the most common cause is likely the gradual tightening of the piriformis muscle due to poor muscle fitness. Activities, such as long distance running or prolonged standing without proper stretching and strengthening of piriformis muscle is a common scenario in patients with piriformis syndrome.

Getting To The Bottom Of Buttock Pain

Getting to the bottom of buttock pain can sometimes prove a diagnostic dilemma, due to the number of potential local sources of nociception and relative complexity in anatomical relationships within the posterior hip region. This is compounded by pelvic structures and more remote sources within the lumbar spine. Perhaps this conundrum sometimes leads health and exercise professionals to oversimplify the differential diagnosis of buttock pain and identifying the associated impairments.

The most common things that patients are told when attending for treatment of buttock pain:

We owe it to those disabled by buttock pain, often unable to sit, sleep well or undertake physical activity, to expand our knowledge in this space, increasing awareness of a larger spectrum of possible diagnoses and their presentations optimising your Test Kit if you like. We are often focused on gathering tools for our treatment tool kit along our professional journey. However, the tools will only be effective if we have an understanding of the person we are treating and the mechanisms and impairments underpinning the condition with which they are suffering.

You May Like: Pain Relief For Hip Arthritis Uk

Read Also: Natural Remedies For After Birth Pains

Sciatica Vs Piriformis Syndrome

First, its important to know that sciatic and piriformis syndrome has many of the same symptoms. Thats why its so easy to mistake them for each other. However, the primary symptoms of piriformis syndrome include:

• Pain in the buttocks that is worse when sitting
• Pain in the opposite sacroiliac joint
• Pain when sitting or standing for 20 minutes
• Iain when sitting or squatting down
• Pain that is felt from the sacrum down the back of the thigh that usually stops just above the knee
• Pain that lessens with movement
• Numbness of the foot

The main thing to remember is that the underlying causes of these conditions are different. Sciatic is a series of symptoms that are caused by another issue, such as a herniated disc. Piriformis syndrome occurs when your sciatic nerve is irritated or compressed by your piriformis muscle, deep in your pelvis.

Osteoarthritis Of The Spine

The bones in your spine are separated by spongy discs, which act as shock absorbers. With age, these discs can wear or shrink, which narrows the space between the spinal joints, or facet joints. The facet joints are a series of small joints in the lower back that contain the same type of cartilage that is found in your knees, explains Louw. Disc changes can lead to more strain on the joints, which can cause the cartilage to wear down and the facet joints in the vertebrae to rub against one another, leading to the pain and stiffness of OA. It is not uncommon for these joints to refer pain into the buttocks, especially with prolonged standing or even walking, says Louw.

Read Also: Fly After Hip Replacement Surgery

You May Like: National Spine And Pain Mclean

Summit Orthopedics Offers Comprehensive Sports Medicine Expertise

From Olympians to pro athletes to kids in youth sports and those that just want to be more activeSummit Orthopedics delivers expert care by fellowship-trained sports medicine physicians. If you are recently injured or concerned about ongoing pain, Summit Orthopedics sports medicine specialists have the expertise to evaluate your discomfort and develop a plan to quickly and safely help you get back to being active.

Start your journey to stronger, healthier athletic condition. Find your sports medicine expert, request an appointment online, or call us at to schedule a sports medicine consultation.

Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Plymouth, MN, Vadnais Heights, MN, and Woodbury, MN, as well as several additional community clinics.

Whats Causing The Pain

Dr. Elson says pain in the side of your hip most often results from one of the following conditions:

Tendinitis. This is an inflammation of the tendons that connect the gluteal muscles in your buttocks to the hip bone. Tendinitis develops because of muscle imbalance. It could be from a lack of activity, crossing your legs, or even sitting on a wallet, Dr. Elson says.

Overuse injury. When you walk or run, weak hip and buttock muscles can tighten and irritate the iliotibial band a long band of connective tissue that runs from the knee to the hip. It merges with the gluteal muscles to stabilize the leg.

Tight muscles in the buttocks and hip. If the gluteal muscles and IT band are too tight, they pull at the thighbone where they attach, and that causes pain on the side.

Spine problems.The body isnt always smart in recognizing where the pain is coming from, Dr. Elson explains, and spine arthritis, a pinched nerve, or bones in the spine rubbing together can create pain in the side of your hip.

Dont Miss: Piriformis Syndrome After Hip Replacement

Recommended Reading: Tens Placement For Shoulder Pain

A Fat Wallet Can Trigger Piriformis

You might not think of too much cash as a source of pain, but a fat wallet can trigger piriformis syndrome. The condition can affect men who wear their wallet in the back pocket of their pants. This puts chronic pressure on the piriformis muscle and can aggravate the sciatic nerve over time. You can avoid this problem by keeping your wallet in a front pocket or jacket pocket.

What’s Causing The Pain

Dr. Elson says pain in the side of your hip most often results from one of the following conditions:

Tendinitis. This is an inflammation of the tendons that connect the gluteal muscles in your buttocks to the hip bone. “Tendinitis develops because of muscle imbalance. It could be from a lack of activity, crossing your legs, or even sitting on a wallet,” Dr. Elson says.

Overuse injury. When you walk or run, weak hip and buttock muscles can tighten and irritate the iliotibial band a long band of connective tissue that runs from the knee to the hip. It merges with the gluteal muscles to stabilize the leg.

Tight muscles in the buttocks and hip. If the gluteal muscles and IT band are too tight, they pull at the thighbone where they attach, and that causes pain on the side.

Spine problems. “The body isn’t always smart in recognizing where the pain is coming from,” Dr. Elson explains, “and spine arthritis, a pinched nerve, or bones in the spine rubbing together can create pain in the side of your hip.”

Recommended Reading: Severe Knee Pain After Synvisc Injection

Pain In Right Butt Cheek: Find The Cause And Crack It

A number of factors can contribute to pain in butt cheek. You will be able to handle things better if you could identify the underlying cause first. Do you feel it on specific times? Do you feel more pain when stretching or sitting? It could be nerve, muscle, or joint pain. Let’s find out more about it.

How Is Buttock Pain Treated After A Hip Replacement

If youre experiencing buttock pain after a hip replacement, there are a few things you can do to treat it. First, you can try icing the area for 20 minutes at a time. You can also take over-the-counter pain medication, such as ibuprofen.

If the pain is severe, your doctor may prescribe stronger medication. They may also recommend physical therapy to help stretch and strengthen the muscles around the hip. If your pain is caused by a pinched nerve, your doctor may recommend a nerve block.

Don’t Miss: Swollen Cheek Tooth Pain Home Remedy

Diagnosing And Treating Piriformis Syndrome

Getting to the root of your back and leg pain requires the knowledge and training of a specialist. Patients who visit The Spine Institute of Southeast Texas receive a thorough evaluation, including a physical exam and imaging tests. Signs of nerve inflammation when the hip is flexed or externally rotated help confirm a piriformis syndrome diagnosis.

Relieving compression on the sciatic nerve is key to achieving relief from piriformis syndrome symptoms. Treatment often begins with physical therapy. A physical therapist works with you to perform stretching exercises that ease the tension in the piriformis muscle. In piriformis syndrome, the piriformis muscle is often contracted and shortened.

Nonsteroidal anti-inflammatory drugs or steroids can ease pain and inflammation. Patients who continue to experience painful symptoms may be referred for surgery. Dr. Jones II specializes in minimally invasive spine surgery.

Surgery for piriformis syndrome involves relieving the pressure on the sciatic nerve. Restoring space for the sciatic nerve improves blood supply to the nerve so that it has a chance to regenerate.

Pain On Right Upper Buttock Cheek That Does Not Radiate

Hello, I have had a pain on my upper buttock cheek for a while now (a could of months at least. The pain does not radiate down my leg and I can sit comfortably. But It does not go away. It feels worse when I get up in the morning and I feel particularly stiff. Any ideas? Thanks!

Welcome, welcome, welcome, @simona70. You have landed on Connect where 110,000 other folks including me have found helpful information about conditions and creative suggestions about treatments. I have just gone through a year of sharp rather debilitating pain in my right buttock if you will. It got me wondering and worryingwhat if it is this, or what if it is that? I made my own diagnosis of a hip issue that would require surgery. Much to my happy surprise, I was told by my knee surgeon that it was one of five bursas in that area and appropriate injections just might keep it under control.

Can you share with me what has been done to help you understand the cause of your pain and discomfort? Have you had imaging done including an MRI? Perhaps you have also tried using heat to calm the area on your buttock cheek. Moist heat might be even more helpful.

Can you further describe what “particularly stiff” means to you? Is it a sharp pain that locks up that area? Would you describe the pain as what might be called “bruised”. Have you had a fall? Overused the area? Let’s see what other members might just recognize your symptom.

You May Like: Pain Management Doctors In Texarkana

Questions For Diagnosing The Cause Of Buttock Pain

To diagnose your condition, your doctor or health care provider will ask you several questions related to your symptoms including:

• In what part of the buttocks do you feel pain or discomfort?

• When did the pain start?

• How long does the pain last?

• Are there any activities that cause or aggravate the pain?

• Are you experiencing any other symptoms?

Piriformis Muscle Injury Symptoms

The piriformis muscle is a target for repetitive motion injury . RMI occurs when a muscle is driven to perform beyond its level of capability, not given enough recovery time and must perform again. The typical response from the piriformis muscle or any other muscle is to tightenthe muscle’s defensive response. In runners, piriformis muscle tightness can manifest itself in several ways.

The anatomy of the lower back/sacrum illustrates the piriformis muscle and sciatic nerve. Photo Source: Shutterstock.

Recommended Reading: Shoulder Pain Causing Chest Pain