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Buttock Pain

Buttock pain is a common complaint by patients. We see a lot of patients have been told that their pain is due to inflammation in a muscle called the pyriformis or the sacroiliac joint. We find that the most common cause of this type of pain is due to a herniated disc in the lumbar spine, which in turn inflamed the lumbar nerves. Rarely is buttock pain due to the pyriformis muscle or the sacroiliac joint.

Lumbar Radiculopathy (Sciatica)

Facet Joint Syndrome

Herniated Discs

Sacroiliac Joint Pain

Piriformis Syndrome

This page offers the answers to some of the most common questions related to pain occurring within the buttock area, as well as the procedures used to diagnose and treat it effectively. Click on the questions to reveal the answers. Additional questions and answers about spine-related pain and our procedures are featured in the Ask the Doctors section.

Who is a good candidate for these procedures?

People who have experienced any of the following are good candidates for our procedure:

  • If you have had buttock pain for at least four weeks with little relief. It doesn’t matter if your pain is constant or sporadic.
  • If you have undergone physical therapy and achieved only minimal results.
  • If you have had a complete exam by your physician and he/she tells you that they cannot find anything wrong.
  • You also may have an MRI that did not indicate any problems—but you still experience pain. This is very common.

Will your physician be able to diagnose my problem during my first visit?

Your first visit usually consists of an office consultation where the physician will narrow the diagnosis to possible cause of your pain.

Why is so much emphasis placed on developing the diagnosis?

Each of the three possible sources of buttock pain requires a very specific treatment to provide you with best potential of relieving your problem. If the cause of your pain is not correctly identified, there’s a very good chance that your pain will continue.

That’s why we focus on diagnosing your situation. It’s absolutely critical that we isolate the root cause of your pain. That way, we can deliver the best possible treatment for you.

If my MRI is negative, is it still possible that I can have an irritated nerve in my back that is causing the pain?

Yes. An MRI is an indirect image of the spine and does not always show everything. In addition, an MRI usually is taken while you are laying down. Nerves can shift when you change positions, especially if your pain is worse with when you stand or sit. The disk can leak part of its “jelly” center—or nucleus—around the nerves, which can cause significant chemical inflammation and pain. Our procedures can dramatically reduce the pain and inflammation resulting in increased circulation and healing.

I read a newspaper article about a new treatment for back pain that involves traction on a disk using a special machine that can even reverse disk herniations. Should I try this treatment?

Unfortunately, the “latest and greatest” spine treatments are easily peddled in America. Studies have shown that treatment for pain has a placebo response rate between 20% and 30%. That means that any “snake oil” or sugar pill will make about 25% of people feel better—at least temporarily.

About 80% of all initial back injuries also resolve spontaneously and most disk herniations will resorb in time without any treatment. So, it is easy to see how these new “treatments” can claim success by using a few patients who felt better. The same goes for magnets, many balms and tonics.

  • Texas Orthopedic Hospital
  • Fondern orthopedic group LLP
  • Spine Interventional Society