Buttocks Pain
The most frequent comment I get from patients who are experiencing buttock discomfort is this one. Because they are either too active or not active enough, glutes are held responsible for everything. According to some physiotherapists, the pelvis isn’t even secure; it seems to have a life of its own and is always moving in all directions.
Because so many hip-related tissues may be uncomfortable, buttock pain can be challenging. Diagnosis gets considerably more difficult when sacroiliac joint or lower back pain is included. Many physiotherapists provide a general diagnostic and typical therapy to make things easier. Unfortunately, this method may impair function and quality of life by transforming a curable illness into a chronic pain issue.
We discussed this intricacy with Dr. Alison Grimaldi, a hip pain specialist and adjunct senior research fellow at the University of Queensland, on the Physio Explained podcast. This is what we discovered about identifying the cause of buttock discomfort.
Commence by referring to the source
Identifying the potential local and distant causes of buttock pain is the first step in the diagnosis process. Knowing these guarantees that therapy focuses on the actual issue and aids in directing clinical reasoning. Unlike ambiguous terms like “deep gluteal syndrome,” specific diagnoses provide patients with direction and clarity.
Avoid Ignoring Remote Causes
Always keep the lumbar spine in mind. Buttock discomfort may be caused by disc abnormalities, nerve compression, or facet joint difficulties. Pain that travels down the leg, occasionally below the knee, or from the lower back into the buttocks are clues. Spinal stenosis may be indicated by bilateral symptoms. Spinal involvement is often indicated by worsening discomfort while bending, lifting, or performing repetitive lumbar motions. Keep in mind that leg and buttock discomfort does not always indicate lumbar spine problems.
Sources of Local Pain
Imagine your body as a computer, with the software (muscles, tendons, ligaments, and bursae) and the hardware (bones and joints). Think about a hip joint issue if you have mid-buttock discomfort and a lack of hip mobility. Pay special attention to the patient’s history; problems putting on socks or shoes, discomfort during rotation, or instability while bearing weight may all point to the underlying reason.
Pain in the Sacroiliac Joint (SIJ)
Buttock discomfort is sometimes mistakenly attributed to the SIJ, which results in needless and occasionally detrimental therapies. Mid or lower buttock soreness is a common symptom of true SIJ pain, particularly when standing up, rolling over in bed, or doing deep squats. Additional indicators might include pelvic trauma, hard impact, a history of pregnancy, or pain close to the PSIS. Clinical examinations including the Gaenslen’s test, compression, and posterior shear may assist in confirming SIJ involvement. Although it is uncommon, true instability shouldn’t be disregarded.
A New Perspective on ” Glutes”
Muscles that are either too tight or too weak are often blamed. But keep in mind that the neurological system sends impulses to muscles. The body may use weakness or inactivity as a defensive mechanism. While usage may sometimes make up for muscle atrophy or variations in skeletal structure, nerve injury or inactivity can decrease glute activation.
It’s crucial to remember that not all “overactive” piriformis or gluteal muscles need vigorous therapy. During exercise, high muscular activation can only be an indication of inefficiency rather than actual strength. Selecting activities and signals that promote healthy function rather than instill dread or perpetuate harmful ideas is the aim.
Preventing Misdiagnosis and Unfavorable Results
Why is a precise diagnosis important? Because one-size-fits-all solutions are seldom effective. Patients may get stuck in painful and frustrating cycles if they receive too many massages, generic activation exercises, or needless injections. Many need specialized care depending on the precise cause of their discomfort.
Knowing the real cause of buttock pain enables medical professionals to treat patients with evidence-based, efficient treatment and to arm them with knowledge. Let’s move beyond blaming the glutes and start addressing what’s really going on.
