Mar 22 2024 This Week in Cardiology
19 Causes Of Pain In The Right Hip And Lower Abdomen
Pain in your side by the hip bone can occur with gas, indigestion, or other temporary ailments. But if the pain is severe or occurs with other symptoms, it may be an early indicator of a more serious health issue.
Pain in the lower right abdomen near the hip bone can be caused by many conditions, ranging from indigestion after a spicy meal to medical emergencies, such as appendicitis, which require surgery to treat.
In many cases, the presence of other symptoms can help identify the source of your abdominal pain and whether you'll need to speak with a doctor.
We'll take a look at 19 potential causes of pain in the lower right abdomen, how they're diagnosed, and your treatment options.
Many common causes of lower right abdominal pain are temporary and will pass without any treatment. Others may persist and require rest or medications for relief.
1. IndigestionIndigestion refers to the abdominal pain and feelings of fullness and nausea that result when you're having trouble digesting something. Possible causes include:
Gas in your intestine is usually brought on by bacteria in your digestive tract or by swallowing too much air. You may feel lower abdominal pain as gas moves through your intestine.
3. ConstipationBeing constipated means having infrequent bowel movements or having difficulty passing stools.
You may experience pain in the abdomen and feel as though something is blocking bowel movements in the rectum.
4. Muscle pull and strainA strained or pulled muscle refers to any tear, excessive stretch, or rupture of a muscle, typically from a sports injury or an accident.
When it's an abdominal muscle, it can feel like a sharp pain, coupled with swelling, bruising, and stiffness. You may also have difficulty flexing the muscle or even standing up straight and walking.
5. Muscle spasmA muscle spasm is an uncomfortable, unintentional muscle contraction. It can feel like an annoying little twitch or, if it lasts for more than a couple of seconds, a muscle spasm can hurt quite a bit.
Straining your abdominal muscles during a workout can cause a spasm. You may also be more likely to experience a spasm if you're dehydrated or have low levels of electrolytes, such as magnesium, calcium, and potassium.
6. GastroenteritisInflammation of the gastrointestinal tract may be caused by a bacterial, viral, or parasitic infection. Symptoms include lower abdominal pain, cramping, fever, and abnormal sweating.
7. GastritisWeakness in your stomach lining or a certain type of bacterial infection (Helicobacter pylori) can cause gastritis, an inflammation of the stomach lining.
You may experience symptoms such as pain in the upper and lower abdomen, as well as nausea and vomiting.
Some of the more serious causes of pain in the lower right abdomen near the hip bone may require surgery or long-term medical treatment.
8. AppendicitisYour appendix is a small finger-like pouch extending down from the large intestine. When it becomes infected and inflamed, the result is appendicitis. If untreated, the appendix can burst, infecting the abdominal cavity.
Appendicitis is a leading cause of pain in the lower right abdomen, but it usually has other symptoms, such as vomiting, abdominal swelling, and fever.
You should seek immediate medical attention if you have pain in the lower right abdomen along with the above symptoms.
9. Kidney stonesKidney stones can develop when small crystals of calcium, uric acid, or other chemicals form in your kidneys.
They can result in intense pain in the side of the abdomen, as well as blood in the urine and painful urination.
10. Kidney infectionA kidney infection often starts as a urinary tract infection. In addition to abdominal pain, it can also cause back pain, fever, chills, and a burning sensation when urinating.
11. Inflammatory bowel disease (IBD)IBD is actually a group of intestinal diseases that include ulcerative colitis and Crohn's disease. It is a chronic condition and can impact a person's quality of life.
Symptoms can vary, depending on the type of IBD. They can include abdominal pain, diarrhea, and bloating.
12. Irritable bowel syndrome (IBS)Unlike IBD, IBS doesn't cause inflammation or injure the bowel. It's also not clear what causes IBS.
Stress and certain foods, such as dairy, wheat, and citrus, can trigger symptoms. Common symptoms of IBS include lower abdominal pain, diarrhea, excess gas, and mucus in the stool.
13. HerniaA hernia occurs when an organ or other body part pushes through the wall of muscle or tissue that normally contains it.
There are several different types of hernias. A hernia can be painful and get worse when lifting something. It can also cause swelling.
An inguinal hernia occurs when tissue pushes through the abdominal wall and into the inguinal canal. The canal surrounds the spermatic cords in males and the uterus ligament in females.
While both sexes can develop inguinal hernias, men are far more likely to experience this painful condition.
Symptoms include a sharp pain on one side of the groin and pain that's triggered by coughing, exercising, or bending over.
If you're female, here are some potential causes of pain in the lower right abdomen.
14. Menstrual painMenstrual cramps in the lower abdomen can occur before or during your period. The pain may even radiate down into your legs. Some pain and cramping during menstrual periods is common.
However, if you experience severe pain (dysmenorrhea), which is causing you to miss work, school, or other daily activities, you should speak with a doctor.
15. Ovarian cystAn ovarian cyst is a small fluid-filled sac that forms on your ovary. It can cause a lot of pain in the lower abdomen as well as back pain and painful intercourse.
16. Pelvic inflammatory disease (PID)Pelvic inflammatory disease (PID) is an inflammation of the reproductive organs, often caused by a sexually transmitted infection (STI) or other infection. In addition to abdominal pain, you may experience pain during intercourse and a burning sensation when urinating.
17. EndometriosisEndometriosis occurs when tissue — like the kind that lines the inside of the uterus — starts to grow elsewhere, such as the ovaries, bowel, or around the pelvis.
Depending on where the endometrial tissue is growing, symptoms can include pain in the pelvic region, painful periods, and painful bowel movements.
18. Ectopic pregnancyWhen a fertilized egg doesn't attach itself to the uterus but instead settles into a fallopian tube or elsewhere in the abdominal cavity, it's called an ectopic pregnancy.
It can cause sharp pain in the side of the abdomen and pelvis.
If you're male, there are some additional potential causes of pain in the lower right abdomen.
19. Testicular torsionWhen the spermatic cord, which carries blood to the scrotum, becomes twisted, it's called testicular torsion.
Pain is usually felt in the scrotum and the side of the lower abdomen. There may also be swelling in the scrotum, as well as nausea and fever.
To diagnose the cause of your lower right abdominal pain, a doctor will review your symptoms and medical history and do a physical exam.
The exam may include applying gentle pressure to your abdomen to check for swelling or tenderness. Other diagnostic tests may include:
UltrasoundAn ultrasound uses sound waves to create images inside the body. It can be used to help detect tumors, examine the ovaries and uterus during pregnancy, examine a man's prostate, and look for other concerns.
CT scansComputed tomography (CT) scans are made up of layers of X-rays taken at different angles to provide a more detailed view than a standard X-ray.
MRI scansMagnetic resonance imaging (MRI) uses a magnetic field and radio waves to produce detailed views of organs and other soft tissue.
EndoscopyAn endoscope is a long, thin, flexible tube that can be inserted down the throat and through the esophagus and as far as the small intestine to look for bacterial infections and other signs of trouble.
Blood testsA blood test can reveal a lot about a person's health, such as the elevation of white blood cells, which can indicate an infection.
If you're experiencing pain in your lower right abdomen, it can be beneficial to speak with a doctor. Based on your healthcare needs, you may want to ask for a referral to a specialist.
Specialists include:
The right treatment for your lower right abdomen depends on the cause of the problem. Treatment approaches include:
TimeConditions that usually just need time to heal include:
Indigestion and gas problems may be avoided by skipping certain food triggers. IBD and IBS, however, are chronic conditions that require continuous monitoring and careful food choices.
AntibioticsBacterial infections, such as appendicitis and PID, usually require antibiotics.
Surgery and other proceduresCauses that usually require surgery to remove the cause of the pain include:
Physical therapy can help you manage pain and movement while you are recovering from an injury or health condition.
Pain in the lower right abdomen can sometimes indicate a medical emergency, such as appendicitis.
However, it's usually a much less serious problem that's temporary and may not require any medical intervention.
The key is to pay attention to all of your symptoms. Note when they started and think about whether you've had similar pains before.
If you think spicy food is to blame, a simple dietary change may be all that's needed to avoid this problem in the future.
The Groin Triangle: A Patho-anatomical Approach To The Diagnosis Of Chronic Groin Pain In Athletes
AbstractChronic groin pain is a common presentation in sports medicine. It is most often a problem in those sports that involve kicking and twisting movements while running. The morbidity of groin pain should not be underestimated, ranking behind only fracture and anterior cruciate ligament reconstruction in terms of time out of training and play. Due to the insidious onset and course of pathology in the groin region it commonly presents with well-established pathology. Without a clear clinical/pathological diagnosis, the subsequent management of chronic groin pain is difficult. The combination of complex anatomy, variability of presentation and the non-specific nature of the signs and symptoms make the diagnostic process problematical. This paper proposes a novel educational model based on patho-anatomical concepts. Anatomical reference points were selected to form a triangle, which provides the discriminative power to restrict the differential diagnosis and form the basis of ensuing investigation. This paper forms part of a series addressing the three-dimensional nature of proximal lower limb pathology. The 3G approach (groin, gluteal and greater trochanter triangles) acknowledges this, permitting the clinician to move throughout the region, considering pathologies appropriately.
Chronic groin pain is a common presentation in sports medicine practice. Studies in professional sports have found groin injury to be the fourth most common injury affecting soccer players,1 the third most common injury in Australian rules football2 and it also has a high prevalence in ice hockey3 and rugby.4 5
This gives an incomplete portrayal, however, as the morbidity attached to chronic groin pain means it is behind only fracture and joint reconstruction in terms of lost time from injury.4 5
All these sports involve kicking and twisting movements while running. These actions place a strain on fascial and musculoskeletal structures that are fixed to a number of bony anatomical points in close proximity. The resultant tissue damage and/or entrapment of anatomical structures may cause pain.
This paper sets out a method based on patho-anatomical principles for a systematic examination of the chronically painful groin, which enables the clinician to discriminate more easily between pathological conditions and target their investigation and subsequent management to specific diagnoses.
THE GROIN TRIANGLEThe specific anatomical landmarks and borders of the groin triangle are set out in fig 1.
Figure 1The groin triangle. AL, adductor longus; ASIS, anterior superior liac spine; Gr, gracilis; IlioPS, iliopsoas; Pec, pectinius; RF, rectus femoris; Sar, sartorius; TFL, tensor fasciae latae; 3G, the 3G point; VL, vastus lateralis; VM, vastus medialis.
APEX POINTS OF THE GROIN TRIANGLEThe anatomical apex points of the triangle are as follows: the anterior superior iliac spine (ASIS); the pubic tubercle and the 3G (groin, gluteal and greater trochanter triangles) point.
The 3G pointFrom anthropometric measurements, the authors defined a new reference point at the apex of the triangle. This point was termed the "3G point" in reference to the three-dimensional pathology and the groin, gluteal and greater trochanteric regions. The relationship of this point in the anterior coronal plane was the mid-distance point between the ASIS and the superior pole of the patella, and in the posterior coronal plane double the distance from the spinous process of the L5 lumbar vertebrae to the ischial tuberosity in the line of the femur.
ANATOMICAL RELATIONS OF THE BORDERS OF THE GROIN TRIANGLE Superior border of the groin triangleThe line between the pubic tubercle and the ASIS forms the superior border of the triangle. This corresponds to the anatomical position of the inguinal ligament, a thickening of the aponeurosis of the external oblique muscle. Superior to this line, working from the pubic tubercle medially to the ASIS laterally the following structures will be encountered: the rectus abdominis and rectus abdominis sheath insertions; internal oblique, external oblique and transversus abdominis insertions and aponeuroses; inguinal canal, medially the superficial inguinal ring and conjoint tendon, more laterally the canal and further laterally the deep inguinal ring; the ilioinguinal, iliohypogastric and genital branch of the genitofemoral nerve; the conjoint tendon of ilio-psoas as it passes under the lateral third of the inguinal ligament; the visceral contents of the abdomen and pelvis.
The insertion of the rectus abdominis and its sheath are intimately related to the aponeuroses of the obliques and transversus abdominis. The junction of where these structures converge at the pubic bone revolves around the inguinal canal. The internal inguinal ring is located at a point between the mid-inguinal point (situated midway between the anterior superior iliac spine and the pubic symphysis) and the midpoint of the inguinal ligament.6 The transversalis fascia and the conjoint tendon, a confluence of internal oblique and transversalis fasciae, form the posterior wall of the canal. The superficial inguinal ring, the opening in the external oblique aponeurosis is situated a centimetre above and lateral to the pubic tubercle. The anatomy of the ilioinguinal and iliohypogastric and genital branch of the genitofemoral nerves is extremely variable, between them they supply the skin of the lower abdomen, medial thigh and scrotum.7
Medial border of the groin triangleThe line from the pubic tubercle to the 3G point inferiorly forms the medial border of the triangle. Although neither the medial or lateral borders of the triangle comprise a muscular line, in both instances they work to separate the clinically important "groups" of structures that lie on either side of them. Medial to the border lie the adductor muscles, from superficial to deep—adductor longus, gracilis, adductor brevis, adductor magnus.
The adductor longus and gracilis tendons are the most commonly affected and lie in an almost continuous site of origin along the body of the pubis. The other adductor muscles (brevis and magnus) arise more posterolaterally along the inferior pubic ramus. The ramus forms a direct continuum between the pubic body and the ischial tuberosity. The obturator nerve divides in the obturator canal (2–3 cm long canal situated in the anterosuperior aspect of the obturator foramen containing the obturator nerve, artery and vein) to anterior and posterior divisions. The anterior branch innervates the adductor longus, brevis, gracilis and, occasionally, the pectineus; it supplies sensory innervation to the skin and fascia of the inner distal thirds of the medial thigh.8
Lateral border of triangleThe line from the ASIS superiorly to the 3G point forms the lateral border of the triangle: femoro-acetabular joint; trochanteric bursa; tensor fasciae latae and iliotibial band.
Although the surface marking of the femora-acetabular joint lies within the triangle, the pathology of the joint is usually referred to as the greater trochanter, as such it is considered in this section. Gluteal bursae underlie the gluteus maximus and gluteus medius tendons proximal to their insertions. The iliotibial band or tract is a lateral thickening of the fasciae latae in the thigh. Proximally it splits into superficial and deep layers, enclosing tensor fasciae latae and anchoring this muscle to the iliac crest.
Within the triangleWithin the triangle the following structures are encountered: conjoint tendon of the iliopsoas muscle; rectus femoris muscle; femoral canal.
The psoas arises as a series of slips, each of which arise from the adjacent margins of the vertebral bodies and the intervening discs from the lower border of T12 to the upper border of L5. The iliacus arises from the upper two-thirds of the concavity of the iliac fossa and the inner lip of the iliac crest, as well as the ventral sacro-iliac and iliolumbar ligaments and the upper surface of the lateral part of the sacrum. The two muscles converge and pass downwards and medially beneath the inguinal ligament over the hip joint and into the lesser trochanter of the femur. The passage of this conjoined tendon over the hip joint is facilitated by the iliopsoas bursa, which is in some cases in direct communication with the hip joint. The rectus femoris arises via a direct head from the anterior inferior iliac spine and a reflected head arising from the superior acetabular rim and joint capsule. The femoral ring is the base of the femoral canal. Its surface marking is medial to the femoral artery, palpable at the mid-inguinal point. The femoral ring is bounded in front by the inguinal ligament, behind by the pectineus, medially by the crescentic base of the lacunar ligament and laterally by the fibrous septum on the medial side of the femoral vein.
Nerve entrapmentThe classic distribution of the cutaneous innervation of the area incorporated in the triangle and their potential neuropathies is shown in fig 2; these, however, must serve as a guide only, as in vivo considerable variation occurs.7 26 28–30 The clinician will appreciate that in addition to paraesthesias, a compressed nerve can give rise to pain. The additional possibility of referred or radicular pain from T12, L1, L2 and L3 must also be considered.
Figure 2Neuropathy of the proximal lower limb. ASIS, anterior superior liac spine; Gr, gracilis; RF, rectus femoris; 3G, the 3G point; VL, vastus lateralis; VM, vastus medialis.
A PATHO-ANATOMICAL APPROACH USING THE GROIN TRIANGLEThe diagnostic process of history and examination is often abbreviated. There is a growing tendency to rely on investigational studies as the initial diagnostic step (eg, proceeding to magnetic resonance imaging of a painful groin in the absence of a clear differential diagnosis). The authors propose a four-step approach to the diagnostic process emphasising history and examination and limiting investigation to the final step as follows.
Step 1: define and alignDefine the anatomical points and borders of the triangle on the patient (ASIS, pubic tubercle and 3G point).
Step 2: listen and localiseListen to the patient's history and obtain as many localising factors as possible, then pinpoint the pain in relation to the groin triangle.
Step 3: palpate and re-createCarefully palpate the identified area and determine which anatomical structures are painful. The use of provocative manoeuvres/examinations (eg, exercise) to re-create the patient's pain can be a critical diagnostic step. To describe all of the manoeuvres in detail is beyond the scope of this text; readers are referred to reviews on this topic.32 43
Step 4: alleviate and investigateWhen a number of anatomical structures are in close proximity, clinical presentations can be very similar. The manner in which pain can be removed may be very helpful. A decrease in pain following abstinence from aggravating activity is revealing. If a distinct structure can be identified, the elimination of symptoms following guided injection of local anaesthetic into the structure is invaluable. The authors recognise that a number of conditions discussed in this text may only be diagnosed definitively following radiological investigation; in these instances the most discriminative, evidence-based investigation is recommended.
SPECIFIC SCENARIOS USING A PROBLEM-ORIENTED APPROACHThe diagnostic stepwise approach using the groin triangle is summarised in tables 1–5. The triangle is used to localise the pathology to a particular area. We refer the reader to the specific table relating to that border of the triangle. This provides a differential diagnosis and clarifies the most discriminative evidence-based tests.
Table 1 Patho-anatomical approach: pubic tubercle region (diagnoses appear in order of frequency in an athletic population) Table 2 Patho-anatomical approach: medial to the groin triangle (diagnoses appear in order of frequency in an athletic population) Table 3 Patho-anatomical approach: superior to the groin triangle (diagnoses appear in order of frequency in an athletic population) Table 4 Patho-anatomical approach: lateral to the groin triangle (diagnoses appear in order of frequency in an athletic population) Table 5 Patho-anatomical approach: within the groin triangle (diagnoses appear in order of frequency in an athletic population) PUBIC TUBERCLEBecause many potentially anatomical structures converge at this point, we propose a marking of the structure in similar fashion to a clock face (fig 3, table 1). This schematic representation of the anatomy of the area serves as a guide to what may be palpable following invagination of the scrotum. The examining clinician can therefore "walk their finger" around the tubercle assigning each part of the clock face to the relevant attachment as highlighted in fig 3. The authors recognise the variability of structures in this area, having based diagrams on cadaveric studies performed prior to this paper.55 We have employed the term "pubic bone stress injury" for what is often in the literature called "osteitis pubis". We feel this is a better reflection of the clinical picture in the absence of any evidence of an inflammatory process.
Figure 3The pubic clock.
The topic of incipient hernia is included as disorders of the posterior and anterior inguinal walls. These are diagnoses of exclusion and, outside of the most experienced hands, probably inseparable. These may represent different ends of a spectrum of pathology in the area as a result of differing sporting activity.3 19 22 23 56
MEDIAL TO THE TRIANGLEAdductor longus pathology is the most common cause of pain in this area; differentiation of enthesis-related problems from those at the musculitendinous junction is important. The abnormal mechanics that arise as a result of adductor dysfunction play a critical role in the generation of a chronic pain/dysfunction cycle in the area (fig 4, table 2).
Figure 4Medial to the triangle. AB, adductor brevis; AL, adductor longus; AM, adductor magnus; Gr, gracilis; S, sartorius.
SUPERIOR TO THE TRIANGLERectus abdominis pathology tends to be well localised to its insertion at the pubic tubercle, often making it the most clearcut diagnosis in this area. This may arise as a primary diagnosis, or develop secondary to pubic overload originating from adductor or iliopsoas pathology (fig 5, table 3).
Figure 5Superior to the triangle.
LATERAL TO THE TRIANGLEAs a cause of recalcitrant groin pain, pathology of the femoro-acetabular joint should not be underestimated. The joint is prone to degenerative, inflammatory and infective processes. The long-term contribution of acute or repetitive trauma to the development of degenerative conditions such as osteoarthritis is of particular concern in the sports setting (fig 6, table 4).
Figure 6Lateral to the triangle. RF, rectus femoris; TFL, tensor fasciae latae; VL, vastus lateralis.
WITHIN THE TRIANGLEPathology of the iliopsoas muscle may cause pain that is referred in the area superior to the triangle, but the conjoint tendon is the most palpable structure within the triangle when the hip is flexed. This is a common, although underdiagnosed, cause of groin pain.57 It is particularly prone to irritation when overloaded secondary to dysfunction of other muscular structures around the groin, such as the adductors (fig 7, table 5).
Figure 7Within the triangle.
INTRA-ABDOMINAL PATHOLOGYDiscussion of this topic is beyond the scope of this paper; gastrointestinal and genitourinary pathology may mask as groin discomfort or pain. Key discriminating symptoms may be signs of systemic illness, systemic inflammatory response and no correlation between exercise and symptoms or signs. Any or all of the above in conjunction with a negative musculoskeletal examination serve to alert the examining physician to focus their examinations beyond the musculoskeletal system.
What this paper addsThis paper outlines a novel educational approach to the categorisation of pathologies in the groin area in an athlete.
Pain-generating structures are categorised according to their anatomical position, around a triangle based on easily located anatomical landmarks.
This categorisation, with accompanying high-quality diagrams, focuses the diagnostic process. Discriminative questioning and evidence-based examination presented in tabular form facilitate accurate differential diagnosis.
This paper presents a method of teaching the causes of chronic groin pain. By offering a systematic means of limiting the differential diagnosis through history examination, diagnostic manoeuvres and, when necessary, directed investigation, this method may help the less experienced clinician with the diagnostic process.
The groin triangle is one section of the "3G" approach to teaching the causes of chronic pain in the proximal lower limb. This paper should therefore be read in conjunction with the gluteal and greater trochanter triangle papers to address the three-dimensional nature of the region fully.
Experience and a thorough knowledge of the anatomy of the region remain vital in any complete understanding of groin pain. By providing a means of focusing the differential diagnosis in a structured manner, practitioners who lack expertise may approach this problem with more confidence.
What's Causing This Pain In My Buttocks?
Pain in the buttocks can be caused by many conditions, which range in terms of severity. If the pain doesn't go away over time, gets worse, or is accompanied by other symptoms, it's best to talk to a doctor.
You might not have paid much attention to your buttocks, given that they're behind you. But you will notice if they start to hurt. Your buttocks are mainly composed of fat and gluteal muscle, but they can be prone to injury and disease.
A number of conditions can cause pain in the buttocks, from minor muscle strains to infections. Most of these conditions aren't serious, but some warrant a visit to your doctor.
Call for an appointment if the pain doesn't go away, it gets worse, or you also have symptoms like these:
Here are some of the conditions that can cause pain in your buttocks, as well as tips to help you figure out which one you might have.
Sciatica isn't a condition, but a symptom. It's a sharp or burning pain that radiates down your sciatic nerve, which runs from your lower back through your buttocks and down each leg.
You can also have numbness or tingling in the affected leg. These stretches may help you find relief.
Sciatica is often caused by a herniated disk or narrowing of parts of the spine that then presses on the sciatic nerve. You're more likely to get sciatica in your 40s and 50s, because the conditions that cause it become more common with age.
Although studies vary on how many people get the condition, some researchers estimate that as many as 40 percent of people have experienced sciatica.
Bursitis is a common condition in which the fluid-filled sacs called bursae that cushion the bones become inflamed. Areas like the shoulder, hip, elbow, and knee are most often affected.
You also have a bursa — called the ischial bursa — in your buttocks. Bursitis that affects the ischial bursa is called ischial bursitis.
Symptoms include:
You can develop bursitis in the ischial bursa if you injure the bursa or sit for a long time on hard surfaces. This type of bursitis is sometimes called "weaver's bottom" or "tailor's seat" after the professions that commonly cause it. These exercises may help ease your symptoms.
Each of the bones in your spine is separated and cushioned by small pads filled with a jelly-like material. These are called disks.
A disk can become herniated if its outer layer tears, letting some of the inner material slip out. A herniated disk can press on nearby nerves, causing pain, numbness, and weakness.
If the affected disk is in your lower back (lumbar spine), you'll likely feel the pain in your buttocks. The pain can also radiate down your leg. Other symptoms include:
You're more likely to get a herniated disk as you get older, because disks degenerate with age. Other risks include obesity and working in a job where you lift or pull heavy objects.
As you get older, the disks in your back can wear down. As the disks shrink, you lose the cushioning that keeps the bones of your spine from rubbing against each other.
Degeneration of disks in the lower back can cause pain in the buttocks and thighs. The pain may get worse when you sit, bend, or lift something. Walking or other movement can relieve it. You might also have numbness and tingling in your legs.
The piriformis is a muscle that runs down your lower back to the top of your thigh. You also have a nerve that runs from your lower spine through your buttocks to the back of your thigh, called the sciatic nerve.
Injuries or overuse can inflame the piriformis muscle to the point where it presses on the sciatic nerve. This pressure can cause a type of pain called sciatica that runs from your buttocks down the back of your leg.
The pain may get worse when you walk upstairs, run, or sit. You might also have numbness or tingling. The piriformis stretch may help relieve these symptoms.
Piriformis syndrome is often misdiagnosed as other types of back pain. About 6 percent of people who are diagnosed with low back pain actually have piriformis syndrome.
A cyst is a hollow sac that can form in different parts of your body. Cysts often contain fluid, but a pilonidal cyst contains tiny pieces of hair and skin. These cysts form at the cleft between the buttocks. You can get one of these cysts if a hair grows into your skin (ingrown hair).
Along with the pain, you may notice:
Pilonidal cysts are more common in men than women, and in people who sit for long periods of time. You can also get them from friction — for example, while riding a bike.
A perirectal abscess (also called a perianal abscess) is a pus-filled cavity that forms in a gland near the anus, the opening through which stool leaves your body. The abscess is caused by a bacterial infection.
This type of abscess is common in babies. Adults are more likely to get an infection if they have diarrhea, constipation, or another problem with bowel movements.
Some people have an abnormal connection between the inside of their anus and their skin. This is called a fistula. Bacteria can get trapped in this connection and cause an abscess to form. Your doctor may recommend surgery to remove the fistula.
Your sacroiliac joint connects the sacrum — the triangular bone at the base of your spine — to your pelvic bone. When this joint becomes inflamed, it can cause pain in your lower back that may radiate down your buttock to your upper leg.
Activities like walking, running, or climbing stairs can aggravate the pain, but there are options for relief. Physical therapy can help improve strength and maintain flexibility in the joint.
Sacroiliac joint pain is often misdiagnosed as another type of low back pain. About 10 to 25 percent of people with low back pain have a problem with their sacroiliac joint.
Arthritis is a disease that causes pain and stiffness in your joints. There are about 100 different types of arthritis, which together affect more than 54 million Americans.
Some types are caused by a gradual wearing down of the joints with age and activity. Others are due to an immune system attack on the joints.
Arthritis in the hip joint can cause pain that radiates to the buttocks. The pain and stiffness may be worse in the morning, and gradually improve as you move the joint. Medication and physical therapy can help with pain management.
The aorta is the main blood vessel from the heart. It splits into two smaller vessels called the iliac arteries that then continue to get smaller and bring blood to the legs. A blockage in these blood vessels from atherosclerosis can cause buttock pain.
The pain occurs when walking and can be achy in nature. It may force you to stop walking, after which the pain goes away. There can also be weakness and hair loss in the lower legs.
To treat pain in your buttocks, you should see your primary care provider, a rheumatologist, or an orthopedic specialist. Your doctor will tailor your treatment to the cause of your pain.
Your doctor may recommend:
Home remedies can help relieve your symptoms until a treatment plan is in place.
You can
If the pain hasn't improved in a few days or it's getting worse, see your doctor. They'll perform a physical exam and possibly take imaging tests, such as X-rays, to look for the cause of the pain.
Once your doctor knows what's behind your buttocks pain, they'll work with you on a treatment plan suited to your needs.
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