Persistent Lower Back and Upper Buttock Pain: Causes and Treatments

Pain in the lower back and upper buttocks?

I have been experiencing pain for about six months, which comes and goes.
When I perform actions that involve tightening my buttocks, I feel pain, and sneezing is extremely painful to the point that I try to hold back my sneezes.
When I suddenly stand up from a chair, I feel pain and a lack of strength, almost like I’m going to collapse.
I went to the hospital for an examination, and they said it was muscle inflammation, but why would the muscle be inflamed? Why has the inflammation lasted so long? What kind of treatment do you recommend, and what further examinations should I undergo?
Yesterday, during class, I tripped and fell, landing on my palms and knees, which caused significant swelling and bruising on my knee, and I also have abrasions.
Now, the pain in my lower back has worsened! I couldn't sleep well last night; lying down was painful, and I couldn't turn over without severe pain, so I was afraid to move.
Even getting up this morning was very difficult.

Jia Rong, 20~29 year old female. Ask Date: 2019/04/26

Dr. Yin Xinbei reply Rehabilitation

Although it may have progressed to chronic inflammation, the pain and weakness experienced when sneezing could also be associated with lumbar nerve compression issues.
It is recommended to seek further examination and treatment at a hospital.

Reply Date: 2019/04/26

More Info

Persistent lower back and upper buttock pain can be quite debilitating, especially when it interferes with daily activities and sleep. Based on your description, it seems that you have been experiencing this pain intermittently for about six months, with specific movements exacerbating the discomfort. The fact that you feel pain when sneezing or transitioning from sitting to standing suggests that there may be underlying issues related to muscle strain, inflammation, or possibly even nerve involvement.

Possible Causes of Your Pain
1. Muscle Strain or Sprain: This is one of the most common causes of lower back pain. It can occur due to overuse, improper lifting, or sudden movements. Given that you mentioned a recent incident where you fell and landed on your knees, it's possible that you may have strained the muscles in your lower back or buttocks during that fall.

2. Myofascial Pain Syndrome: This condition involves trigger points in the muscles that can cause referred pain in other areas. The pain you feel when performing specific movements, such as squeezing your buttocks, could indicate the presence of trigger points in the gluteal muscles or lower back.

3. Inflammation: Muscle inflammation can occur due to repetitive strain or injury. If your muscles are inflamed, they can remain sensitive and painful for an extended period, especially if the underlying cause is not addressed.

4. Nerve Compression: Conditions such as a herniated disc or spinal stenosis can lead to nerve compression, resulting in pain that radiates to the buttocks and legs. This is often accompanied by weakness or numbness.

5. Injury from the Fall: The recent fall you experienced could have exacerbated any pre-existing conditions or caused new injuries, such as bruising or inflammation in the muscles and connective tissues around the lower back and buttocks.

Recommended Treatments and Next Steps
1. Rest and Ice: Given the recent injury, it's crucial to allow your body some time to heal. Applying ice to the affected area can help reduce swelling and inflammation.

2. Physical Therapy: A physical therapist can provide targeted exercises to strengthen the muscles around your lower back and improve flexibility. They can also teach you proper body mechanics to prevent further injury.

3. Pain Management: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help alleviate pain and reduce inflammation. However, consult with a healthcare provider before starting any medication, especially if you have other health conditions.

4. Diagnostic Imaging: If your pain persists despite conservative treatment, it may be beneficial to undergo imaging studies such as an MRI or X-ray to rule out any structural issues like herniated discs or fractures.

5. Activity Modification: Avoid activities that exacerbate your pain, such as heavy lifting or prolonged sitting. Incorporating gentle stretching and strengthening exercises can also be beneficial.

6. Follow-Up with a Healthcare Provider: If your symptoms do not improve or worsen, it is essential to seek further evaluation from a healthcare professional. They can provide a more comprehensive assessment and tailor a treatment plan specific to your needs.

Conclusion
Persistent lower back and upper buttock pain can stem from various causes, including muscle strain, inflammation, or nerve issues. Given your recent fall and ongoing symptoms, it is advisable to pursue a combination of rest, physical therapy, and possibly diagnostic imaging to determine the underlying cause of your pain. Early intervention can lead to better outcomes and help you return to your normal activities with less discomfort.

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