Pain in the gluteal muscle

Most often it is felt in m. gluteus maximus (large muscle), but can also be localized in m. piriformis – the piriformis muscle and other structural components of the buttock. The causes of pain symptoms are varied and can be either independent signals of muscle damage or reflected pain due to diseases of the internal organs, spinal column and vascular system.

What we mean by the buttock is one of the gluteal muscles, gluteus maximus or gluteus maximus. Its functions are varied – it is responsible for hip extension when lifting up, for knee rotation, partially for upright walking, the muscle functions especially actively when running, jumping, and squats.

Causes of pain in the gluteal muscle

The most common causes of pain in the gluteal muscle relate to pathologies of the spinal column in the lumbosacral region. Such diseases account for about 75% of the causes that provoke pain in the buttocks, and the nature of the pain is very similar to lumbodynia and rheumatic pathologies, which greatly complicates an accurate diagnosis.

The main causes of pain in the gluteal muscle:

  • Osteochondrosis of the lumbosacral zone, radiculopathy, intervertebral hernia.
  • Osteoarthritis of the hip joint.
  • Diseases of the joints of the sacroiliac zone (osteomyelitis of the femur or ilium).
  • Injuries to the spine, sacrum, coccyx (muscle strain, hematoma, fracture).
  • Compression of the sciatic nerve from the piriformis muscle (piriformis syndrome).
  • Lumbago, when there is hypertonicity of the muscles of the lumbar region, as well as the hips and buttocks.
  • Pathologies of the pelvic organs in women – adnexitis.
  • Diseases of the rectum – proctitis, paraproctitis, hemorrhoids, perirectal abscess.
  • Myalgia as a primary syndrome associated with infectious diseases and hypothermia.
  • Myositis is an inflammatory process in the muscle tissue of the buttocks.
  • Polymyositis.
  • Various types of arthritis of the iliac joint, including psoriatic arthritis.
  • Lumbar stenosis.
  • Occlusion of the iliac arteries or aorta.
  • Tumors of the retroperitoneal region.
  • Chronic gluteal compression syndrome.
  • Malignant processes – lymphosarcoma, myeloma pathology, metastases of the ilium.
  • Tuberculosis of bone.

The causes of pain in the gluteal muscle can also be secondary signs of such diseases:

  • Femoral neck fractures.
  • Inguinal hernia.
  • Bursitis (trochanteric).
  • False intermittent claudication.
  • Tendinitis of the tendon related to the gluteus medius muscle.

Symptoms of pain in the gluteal muscle

Sensations and symptoms of pain in the gluteal muscle are very different in the descriptions of patients and can be as follows:

  • The pain in the buttock arose spontaneously, radiates to the back, then to the leg, intensifies when you get up from a chair or when walking.
  • Pain in the gluteal muscle prevents me from stepping on my leg; it is numb.
  • The pain is felt in the middle of the buttock, it spreads down the entire leg, accompanied by a lumbago in the lower back.
  • The pain in the buttock has not subsided for a week, and intensifies when climbing stairs.
  • The pain in the gluteal muscle is constant, does not subside when lying down, and there is a sensation of nagging, cramping pain. The pain may be relieved by warming the buttock.

Obviously, the clinical manifestations and symptoms of pain in the gluteal muscle depend on the root cause, time of occurrence, and concomitant diseases. Here are several options for describing the symptoms of the following most common pathologies:

  • The most typical cause of pain in the buttocks is degenerative disease of the spine, osteochondrosis. With such pathologies, pain spreads over the surface of the buttock and radiates along the posterior thigh. The symptom intensifies with awkward movements, physical activity and can subside at rest, in a lying position, with massage and warming up.
  • Stenosis, blockage of the aorta or iliac artery. The pain varies in intensity during the first 30 minutes, so it can be considered paroxysmal. The pain gradually subsides on its own, without the use of any treatment, but often recurs at night. In addition to pain in the gluteal muscle, stenosis is accompanied by weakness, pain in the leg, tingling and numbness of the foot, and often partial lameness.
  • Piriformis syndrome. The clinical picture is characterized by nagging, dull pain, often accompanied by a burning sensation in the muscles of the buttock, sacrum and hip region. The pain subsides in a horizontal position and becomes more active during movement, especially during long walking. Symptoms of pain in the gluteal muscle can be radiating, radiating to the knee area, to the toes, and disrupting normal gait.
  • Lumbodynia is characterized by severe, throbbing, shooting pain in the back, buttocks, thighs, often the symptom radiates to the leg.
  • A purulent-inflammatory process in the bone tissue of the thigh – osteomyelitis. The symptoms are characterized by sharp, acute pain, all movements are impaired, the pain does not subside even at rest, and is accompanied by fever, dizziness, and nausea. The acute hematogenous form of osteomyelitis can provoke a coma.

    • Diagnosis of pain in the gluteal muscle

    Diagnosis of pain in the gluteal muscle, first of all, should be differential, that is, its primary task is to exclude serious, life-threatening pathologies.

    General, standard algorithm for examining patients with pain in the buttocks and thighs after collecting anamnesis:

    • Determining the specifics of pain – intensity, character, duration, dependence on posture, etc.
    • Determination of muscle tone of the buttocks and lower back
    • Examination of motor activity, sensitivity
    • Biomechanical tests aimed at clarifying the area of ​​muscle damage

    X-ray

    • Identifying possible spinal injuries
    • Determination of displacement of intervertebral discs or vertebrae
    • Determination of possible congenital anatomical abnormalities in the structure of the spine and pelvis
    • Exclusion of a possible tumor process in the spine
    • Detection of osteoporosis, osteochondrosis

    Computed tomography

    CT performs similar tasks to X-rays, but with more detailed visual results (transverse and three-dimensional sections of the spine)

    MRI – magnetic resonance imaging

    Allows you to identify disorders in the soft tissues surrounding the spine and joints

    Isotopic contrast scintigraphy

    Detects metastases, abscesses, osteomyelitis, nonunion of the vertebral arches

    CBC, urine test

    To exclude or confirm the inflammatory process, rheumatism

    ENMG – electroneuromyography

    Determines muscle tone, innervation disturbances in compression syndrome

    Ultrasound of the hip joint, puncture

    Prescribed strictly according to indications for the tumor process

    The stages included in the standard diagnosis of pain in the gluteal muscle are carried out in the following sequence:

    • Conversation with the patient.
    • Inspection.
    • Palpation of muscle tissue, manual diagnosis.
    • Determination of the volume of active and passive movements.
    • Biomechanical tests, muscle testing, physical tests (Trendelenburg test, Thomas test, Patrick robe and others).
    • The stabilometry method is to determine the ratio of tonic and clonic reflex muscle contractions.
    • Inspection of areas close to the buttocks.
    • X-ray.
    • Electromyography.

    Other examination methods can be prescribed based on the results of previous actions.

    Treatment of pain in the gluteal muscle

    Most often, the treatment of pain in the gluteal muscle is the correction of the primary disease that has formed the muscular-tonic syndrome. If the source of the pain impulse is blocked, reflex tonic pain subsides and regresses. If pain in the gluteal muscle is an independent symptom and at the same time a source of pain, treatment is carried out using local and general effects:

    • Rest and immobilization of the spine.
    • Therapeutic stretching.
    • Massage the affected muscle.
    • Warming compresses.
    • Warming physiotherapeutic procedures.
    • Manual therapy
    • Local use of NSAIDs – non-steroidal anti-inflammatory drugs.
    • Prescription of myelorelaxants in tablet form.
    • It is possible to prescribe post-isometric relaxation (PIR).
    • Correction of excess body weight.
    • Physiotherapy.

    If the pain symptom is caused by a serious pathology of the spine, radicular syndrome, novocaine blockades may be prescribed.

    To summarize, we can say that the treatment of pain in the gluteal muscle depends on the etiology and pathogenetic mechanisms of the main disease provoking the symptom. Therapeutic tactics should be determined not only by the intensity of pain and the speed of development of the process, but also aimed at relieving pain and neutralizing its relapses. Unfortunately, muscle pain in the gluteal, pelvic, and lumbar regions is often treated symptomatically, without taking into account serious consequences and complications, including the possibility of chronic pain syndrome. The most progressive therapeutic complexes are prescribed after a thorough examination and exclusion of threatening pathologies; treatment includes many medicinal methods (based on anti-inflammatory non-steroidal drugs, glucocorticoids, vasoactive and antioxidant agents), as well as non-medicinal methods, including so-called traditional methods. The leaders in non-drug therapy are massages, manual post-isometric relaxation (muscle stretching) and physiotherapy.

    Surgical treatment of pain in the gluteal muscle is practically not used; such measures are rarely needed in unsuccessful long-term treatment of elderly patients with damage to the hip joints.

    Prevention of pain in the gluteal muscle

    Preventive measures to prevent the development of pain in the buttocks are similar to actions to prevent diseases of the spine and surrounding soft tissues. In general, it can be noted that the advice concerns well-known truths – a healthy lifestyle, physical activity, which are familiar to almost everyone, but few people adhere to them.

    Prevention of pain in the gluteal muscle, recommendations:

    • Regular fitness and sports activities. Systematically performed exercises can strengthen muscle tissue in general, buttock muscles in particular.
    • When maintaining static postures due to the work process (working in an office, sitting at a desk), it is necessary to do warm-ups every 20-30 minutes. Changing posture, walking, and bending help restore blood flow, provide nutrition to muscle tissue, and reduce the risk of venous stagnation.
    • For existing spinal diseases, it is necessary to comprehensively treat the underlying pathology and minimize the load on the lumbosacral area.
    • The pelvic area of ​​the buttock should not be exposed to hypothermia. This primarily applies to representatives of the fair sex, who neglect the testimony of weather forecasters and prefer short skirts and other fashionable items that do not correspond to weather conditions.
    • At the first sensation of pain, you should not treat your buttocks or lower back on your own. It would be more advisable to consult a doctor, identify the true cause of the pain and use specific treatment methods. Self-medication can transform acute pain into a chronic, sluggish and difficult to treat disease.

    Pain in the gluteal muscle is not a disease, but a symptom that indicates many different pathologies and conditions. Some of them can be treated quite quickly and simply, others require longer therapy, but in any case, only a doctor can determine the severity of muscle damage in such an important area of ​​the body for a person. That is why the main advice for the prevention of muscle pain in the buttock is this: timely medical examination and diagnosis are the key to successful treatment and the return of normal motor activity.

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