Pain in the gluteus muscle

The pain in the gluteus muscle is most often felt in m. Gluteus maximus (large muscle), but can also be localized in m. Piriformis - pear-shaped muscle and other structural constituents of the buttock. The causes of the pain symptom are varied and can be both independent signals of muscle damage, and reflected pain in the disease of internal organs, the spine and the vascular system.

What we mean by the buttock is one of the gluteus muscles, gluteus maximus or the gluteus maximus muscle. Its functions are diverse - it is responsible for the extension of the thigh when climbing upwards, for the rotation of the knee, partly for the upright leg, the muscle is especially active when running, jumping, squatting.

[1], [2]

Causes of pain in the gluteus muscle

The most common causes of pain in the gluteus muscle are the pathologies of the vertebral column in the lumbosacral section. Such diseases account for about 75% of the causes that provoke a pain symptom in the buttocks, and the nature of the pain is very similar to lumbulgia and rheumatic pathology, which makes it difficult to accurately diagnose.

The main causes of pain in the gluteus muscle: 

• Osteochondrosis of the lumbosacral zone, radiculopathy, intervertebral hernia.
• Osteoarthrosis of the hip joint.
• Diseases of the joints of the sacroiliac zone (osteomyelitis of the femoral or iliac bone).
• Injuries of the spine, sacrum, coccyx (muscle tension, hematoma, fracture).
• Compression of the sciatic nerve from the side of the pear-shaped muscle (pear-shaped muscle syndrome).
• Lumbago, when hypertension occurs in the muscles of the lumbar region, as well as the thighs and buttocks.
• The pathology of the pelvic organs in women is adnexitis.
• Diseases of the rectum - proctitis, paraproctitis, hemorrhoids, peri-rectal abscess.
• Myalgia as a primary syndrome associated with infectious diseases, hypothermia.
• Myositis is an inflammatory process in the muscle tissue of the buttocks.
• Poliomyositis.
• Various types of arthritis of the iliac articulation, including psoriatic arthritis.
• Lumbar stenosis.
• Occlusion of the iliac artery or aorta.
• Tumors of the retroperitoneal region.
• Syndrome of chronic compression of gluteal muscles.
• Malignant processes - lymphosarcoma, myeloma pathology, ileal metastases.
• Tuberculosis of the bone.

The causes of pain in the gluteus muscle may also be secondary signs of such diseases: 

• Fractures of the neck of the thigh.
• Inguinal hernia.
• Bursitis (faithful).
• False intermittent claudication.
• Tendonitis of the tendon belonging to the middle gluteus muscle.

[3], [4]

Symptoms of pain in the gluteus muscle

The sensations, the pain symptoms in the gluteus muscle, are very different in the descriptions of patients and can be as follows: 

• The pain in the buttock appeared spontaneously, gives in the back, then in the leg, increases when you get up from the chair, when walking.
• The pain in the gluteus muscle does not allow to step on the leg, it is numb.
• The pain is felt in the middle of the buttock, it spreads down the entire leg, accompanied by lumbago in the lower back.
• The pain in the buttock does not subside for a week, increases with climbing the stairs.
• The pain in the gluteus muscle is constant, does not subside in the prone position, sensation of drawing, spasmodic pain. The pain may decrease from the warming of the buttock.

Obviously, the clinical manifestations, the symptoms of pain in the gluteus muscle, depend on the underlying cause, time of onset, concomitant diseases. We give several variants of the description of the symptomatology in the following, most common pathologies:

1. The most typical cause of the pain symptom in the buttocks is degenerative spinal cord injury, osteochondrosis. With such pathologies, the pain spreads over the surface of the buttocks and radiates over the posterior region of the thigh. Symptom increases with awkward movements, physical exertion and can calm down at rest, lying down, with massage and warming.
2. Stenosis, occlusion of the aorta or iliac artery. The pain is intense for the first 30 minutes, so it can be considered paroxysmal. The pain sensation gradually subsides independently, without the use of any treatment, but often recurs at night. In addition to pain in the buttock muscle, stenosis is accompanied by weakness, pain in the leg, tingling and numbness of the foot, often partial lameness.
3. Pear-shaped muscle syndrome. The clinical picture is characterized by dragging, blunt pains, often accompanied by burning in the muscles of the buttocks, in the sacrum and hip area. The pain subsides in a horizontal position, is activated in movement, especially with prolonged walking. Symptoms of pain in the gluteus muscle can be irradiating, they are given to the knee area, to the toes, they disrupt the normal gait.
4. Lumbalia is characterized by a strong, throbbing, firing pain in the back, buttocks, thighs, often a symptom radiating to the leg.
5. A purulent-inflammatory process in the bone tissue of the hip is osteomyelitis. Symptomatic features sharp, acute pains, all movements are disrupted, pain does not subside even at rest, accompanied by fever, dizziness, nausea. Acute hematogenous form of osteomyelitis can provoke a coma.

Diagnosis of pain in the gluteus muscle

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

General, standard algorithm for examining patients with pain in the buttocks, hips after anamnesis:

Method of examination	The task of the survey
Visual inspection	Determination of the specificity of pain - intensity, nature, duration, dependence on the posture and so on Determination of muscle tone of buttocks and lower back Examination of motor activity, sensitivity Biomechanical tests aimed at clarifying the area of muscle damage
Radiography	Identification of possible injuries of the spine Determining the displacement of the intervertebral discs or vertebrae Determination of possible congenital anatomical abnormalities in the structure of the spine, pelvis Exclusion of a possible tumor process in the spine Detection of osteoporosis, osteochondrosis
CT scan	CT performs similar X-ray problems, but with a more detailed visual result (transverse and three-dimensional sections of the spine)
MRI - magnetic resonance imaging	It allows to reveal violations in soft tissues surrounding the spine, joints
Isotope contrast scintigraphy	Detects metastases, abscesses, osteomyelitis, non-vertebral arches
UAC, urinalysis	To exclude or confirm the inflammatory process, rheumatism
ENMG - electroneuromyography	Determines muscle tone, impaired innervation in the compression syndrome
Ultrasound of the hip joint, puncture	Appointed strictly according to the indications for the tumor process

Stages, which provides a standard diagnosis of pain in the gluteus muscle, are carried out in the following sequence:

• Talk 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's robes and others).
• The method of stabilometry is the determination of the ratio of tonic and clonic reflex muscle contractions.
• Inspection of nearby zones to the buttocks.
• X-ray.
• Electromyography.

The rest of the survey methods can be assigned based on the results of previous actions.

[5], [6]

Treatment of pain in the gluteus muscle

Most often, the treatment of pain in the buttock muscle is a correction of the primary disease that formed the muscular-tonic syndrome. If the source of the pain pulse is blocked, the reflex tonic pain subsides, regresses. If the pain in the gluteus muscle is an independent symptom and at the same time a source of pain, the treatment is carried out with the help of local and general influences: 

• Rest and immobilization of the spine.
• Therapeutic stretching.
• Massage of the affected muscle.
• Warming compresses.
• Warming physiotherapy procedures.
• Manual therapy.
• Local use of NSAID drugs - non-steroidal anti-inflammatory drugs.
• Purpose of myelorelaxants in tablet form.
• Perhaps the appointment of post-isometric relaxation (IRP).
• Correction of excess body weight.
• Physiotherapy.

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

Summarizing, we can say that the treatment of pain in the gluteus muscle depends on the etiology and pathogenetic mechanisms of the main symptom provoking the disease. Therapeutic tactics should be conditioned not only by the intensity of pain and the rate of development of the process, but also aimed at arresting pain and neutralizing their relapses. Unfortunately, muscular pains in the gluteal, pelvic, lumbar region are 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 careful examination and elimination of threatening pathologies, the treatment includes a variety of medical methods (the basis is anti-inflammatory non-steroid drugs, glucocorticoids, vasoactive and antioxidant agents), as well as non-drug methods, including so-called alternative methods. Leaders in non-drug therapy are massages, manual post-isometric relaxation (muscle stretching) and physioprocedures.

Surgical treatment of pain in the gluteal muscle is practically not used, rarely such measures are necessary with ineffective long-term treatment of elderly patients in hip joint lesion.

Prevention of pain in the gluteus muscle

Preventive measures that prevent the development of pain symptoms in the buttocks are similar to those for preventing diseases of the spine and surrounding soft tissues. In general, it can be noted that the councils deal with well-known truths - a healthy lifestyle, motor activity, which are familiar to almost everyone, but few adhere to them.

Prevention of pain in the gluteus muscle, recommendations: 

• Regular employment by fitness, sports. Systematically performed exercises allow you to strengthen the muscle tissue in general, the muscles of the buttocks in particular.
• If you keep static poses caused by the work process (work in the office, sitting at the table), you need to do warm-ups every 20-30 minutes. Change of posture, walking, slopes help restore blood flow, provide nutrition to muscle tissue, reduce the risk of venous stasis.
• With existing diseases of the spine, it is necessary to treat the main pathology in a complex way and minimize the burden on the lumbosacral zone.
• Do not expose the pelvic area of the buttocks to hypothermia. This is especially true of the fair sex, who disregard the testimony of the weather forecasters and prefer short skirts, and other fashion novelties that do not meet the weather conditions.
• At the first painful sensations it is not necessary to treat independently buttocks, a loin. It would be more appropriate to consult a doctor, identify the true cause of pain and apply specific methods of treatment. Self-medication can translate acute pain into a chronic, lethargic and poorly treatable disease.

The pain in the gluteus muscle is not a disease, but a symptom that indicates a variety of different pathologies and conditions. Some of them are treated fairly quickly and simply, others require longer therapy, but in any case, only a doctor can determine the severity of muscle damage so important to the human body area. That is why the main advice on the prevention of muscle pain in the buttock is this: timely medical examination, diagnosis is the key to successful treatment and the return of normal motor activity.