PTD0816_BehindIt suddenly happens: Your butt hurts when you sit down. What can you do about it? Because a myriad of musculoskeletal problems can cause pain in the buttocks, this problem is tricky to diagnose. Among our first goals will be to answer these questions:

  • Is the pain chronic or acute?
  • Is the pain truly in your buttocks (and not just radiating there from somewhere else)?
  • Is the pain actually made worse by sitting?

While only a comprehensive examination can give us definitive answers, two likely culprits are inflamed cluneal nerves and piriformis syndrome.

The cluneal nerves are located in the lower back/upper buttocks area; they can become pinched in the iliac crest, the curved part of the hipbone atop each side of your buttocks, and cause pain. The condition’s full name is medial superior cluneal nerve entrapment, or cluneal neuropathy.

To determine whether you have cluneal neuropathy, your physician may perform a cluneal nerve block by injecting a mixture of steroid and anesthetic medications into its vicinity. If the pain disappears, then we know the cause was indeed cluneal neuropathy. From a physical therapy viewpoint, if we suspect cluneal neuropathy, our initial treatment options might be more conservative, with modalities including deep tissue massage and nerve gliding (a specialized stretching procedure for elongating nerves).

Buttocks discomfort and pain after sitting too long are prime symptoms of piriformis syndrome, as well. The piriformis is a very small muscle in the lower back, located near the sciatic nerve. Pinning down whether the piriformis is malfunctioning is difficult, and we may try to do so in conjunction with your orthopedic physician.

To treat the piriformis, we’ll concentrate on improving the muscle’s flexibility and strength through specific techniques and exercises. After it has improved substantially, we will strive to recondition the entire lower back/buttocks area to keep it moving well and healthily.

Don’t suffer with any kind of pain indefinitely, especially pain that prevents you from sitting. Call us today. We’ll evaluate your condition and recommend strategies to help your healing begin right away.