‘Achy Buttock Pain that is irritated by Sitting Down’
Deep Achy Buttock pain for a prolonged period of time is an ailment that people of all ages can suffer from. The pain can often by located at one particular point in the buttock, namely the ischial tuberosity bone which serves as the attachment point of for the 3 hamstring muscle tendons. If the pain is spread around a larger area of the buttock then we can assume that the sciatic nerve is being compressed either in the Lumbar Spine (Lower Back) or by the piriformis hip muscle that also sits deep in the buttock.
Correctly diagnosing buttock pain as Ischial Tuberosity Tendinitis can be difficult as the sciatic nerve branches to the ischial tuberosity region of the buttock where it can become compressed and irritated. The Physical therapist can rule out the nerve involvement through carrying out nerve stress tests that will illicit a pain response in the buttock region if they are indeed responsible for the pain. In addition if the Patient’s buttocks symptoms are further aggravated by bending the spine forwards or extending the spine backwards then the Lumbar spine must be considered as the cause of sciatic nerve pain referred to the buttock.
Signs & Symptoms
Deep Achy Buttock Pain
Aggravated by sitting on a chair for a prolonged period of time
Stretching of the hamstring muscles can irritate the buttock pain.
Achy buttock pain can be especially felt after activities such as Walking, Running and squatting movements (which involves constantly bending your knees and returning to a standing position).
Other Possible Causes of Buttock Pain
Piriformis muscle compression of sciatic nerve
Sciatic nerve compression in the Lumbar Spine by Disc or facet Joint Degeneration
Inflammation of the Ischiogluteal Bursa that sits between the hamstring tendons and the ischial tuberosity bone
Impingement of the ‘Posterior Cutaneous nerve of the thigh’, this nerve supplies sensation to skin of the lower buttock and thigh.
Treatment & Management
Mobilisation of the lumbar spine coupled with nerve gliding techniques can be used the buttock pain is indeed originating from the lumbar spine. If the pain is diagnosed as upper hamstring tendonitis at the ischial tuberosity then rest from aggravating activities followed by a hamstring strengthening program of staged progressions that those not involve any early stage stretching of the hamstring muscles is required.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Clonmel & Thurles.Contact Number: 0504 26672, Email your queries to: email@example.com