Pain in Lower Back and Upper Buttocks: Causes and Treatment Options

Q: Pain in Lower Back and Upper Buttocks: Causes and Treatment Options

Hello： If you are experiencing long-term soreness after an injury, it is recommended to follow up at the hospital for further evaluation and advice. <br>Thank you!

Pain in the lower back and sides of the upper buttocks?

Hello, doctor.
I would like to ask about the sudden pain I have been experiencing in my lower back, around the sacrum, and on both sides of my buttocks over the past two days.
What could be the cause? Which department should I consult for this issue? Four years ago, I was in a car accident and fell to the ground.
I later sought treatment from a traditional Chinese medicine practitioner who provided traction therapy, which helped a bit.
However, whenever I sit for a long time, I experience pain and numbness from my lower back to my buttocks.
Additionally, I was in another car accident two years ago and fell again, and since then, my lower back pain has not subsided.
I feel very uncomfortable after sitting or standing for extended periods, and bending over causes severe pain.
I would like to know if this condition can still be treated.
Thank you very much for taking the time to answer my questions! Thank you!

Ting, 30~39 year old female. Ask Date: 2015/10/04

Dr. Wang Shouji reply Orthopedics

Hello: If you are experiencing long-term soreness after an injury, it is recommended to follow up at the hospital for further evaluation and advice.
Thank you!

Reply Date: 2015/10/04

More Info

Understanding pain in the lower back and upper buttocks can be complex, especially considering your history of trauma from car accidents. The symptoms you're experiencing—pain radiating from the lower back to the buttocks, particularly after prolonged sitting or standing—are not uncommon and can stem from various underlying issues.

Possible Causes of Your Pain
1. Muscle Strain or Sprain: Given your history of falls and accidents, it's possible that you have strained or sprained muscles in the lower back or gluteal region. This can lead to inflammation and pain, especially after periods of inactivity or prolonged positions.

2. Herniated Disc: The trauma from your accidents may have caused a herniated disc, where the soft material inside the disc bulges out and presses on nearby nerves. This can result in pain that radiates down the legs or into the buttocks.

3. Sciatica: If a herniated disc is pressing on the sciatic nerve, it can cause sciatica, characterized by pain that travels down the leg, often accompanied by numbness or tingling.

4. Myofascial Pain Syndrome: This condition involves trigger points in the muscles that can cause referred pain in other areas, including the lower back and buttocks. Stress, poor posture, and prolonged sitting can exacerbate this condition.

5. Degenerative Disc Disease: Over time, the discs in your spine can degenerate, leading to pain and discomfort, particularly after sitting or standing for long periods.

6. Sacroiliac Joint Dysfunction: The sacroiliac joint connects the spine to the pelvis. Dysfunction in this joint can lead to pain in the lower back and buttocks, especially with certain movements or prolonged positions.

Treatment Options
1. Physical Therapy: A physical therapist can help you with exercises to strengthen the muscles around your spine and improve flexibility. They may also use modalities like ultrasound or electrical stimulation to relieve pain.

2. Medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce inflammation and alleviate pain. If these are ineffective, a healthcare provider may prescribe stronger medications.

3. Chiropractic Care: Chiropractic adjustments may help realign the spine and relieve pressure on nerves, potentially reducing pain.

4. Acupuncture: Some patients find relief through acupuncture, which can help alleviate pain by stimulating specific points in the body.

5. Injections: If conservative treatments fail, corticosteroid injections into the affected area may provide temporary relief from inflammation and pain.

6. Surgery: In severe cases, such as significant herniation or structural issues, surgical intervention may be necessary to relieve pressure on nerves or stabilize the spine.

When to See a Doctor
Given your history of trauma and persistent pain, it would be advisable to consult a healthcare provider. You may want to start with a primary care physician, who can evaluate your symptoms and refer you to a specialist, such as an orthopedic surgeon or a neurologist, if necessary. They may recommend imaging studies, such as X-rays or MRI, to assess the condition of your spine and surrounding structures.

Conclusion
While your symptoms may be concerning, there are various treatment options available that can help manage your pain and improve your quality of life. Early intervention is key, so seeking medical advice sooner rather than later is recommended. With the right approach, many individuals find significant relief from their symptoms and can return to their normal activities.

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