Muscle Swelling: Causes and When to See a Doctor

A lump has formed?

I have noticed a swollen area next to my perineum over the past couple of days.
There is no pus or open wound, just a simple swelling that is quite painful.
I would like to know what could be causing this and what condition it might be.
I am currently applying anti-inflammatory medication and plan to see a doctor if it doesn't improve in a week.
Which specialty should I consult?

En, 20~29 year old female. Ask Date: 2015/10/09

Dr. Ke Fangxu reply Surgery

If there is no fever, the likelihood of an anal abscess is lower.
Next, anal fissures or acute thrombosed external hemorrhoids are two issues that can also be triggered by constipation.
It is recommended that you first purchase hemorrhoid cream at the pharmacy for topical application, and avoid constipation by minimizing the time spent on the toilet.
If there is no improvement after one week of using the medication, you should consult a colorectal surgeon.

Reply Date: 2015/10/09

More Info

Muscle swelling, especially when localized and accompanied by pain, can be concerning and may arise from various underlying causes. In your case, the swelling near the gluteal area (the "屁溝旁邊") without any visible wounds or pus suggests a few potential conditions that could be responsible for the symptoms you are experiencing.

Possible Causes of Muscle Swelling
1. Muscle Strain or Injury: One of the most common causes of localized muscle swelling is a strain or injury. This can occur due to overexertion, sudden movements, or even prolonged sitting or standing. The muscle fibers may become inflamed, leading to swelling and pain.

2. Tendonitis: Inflammation of the tendons, which connect muscles to bones, can also cause localized swelling and pain. This is often due to repetitive use or strain.

3. Bursitis: The bursa is a small fluid-filled sac that reduces friction between tissues. Inflammation of the bursa (bursitis) can lead to swelling and pain in the surrounding muscle area.

4. Infection: While you mentioned there is no pus or visible wound, it is still possible for a deep tissue infection to cause swelling and pain. Conditions like cellulitis can occur without an obvious external injury.

5. Hematoma: If there was any trauma to the area, even if you did not notice it, a hematoma (a localized collection of blood outside of blood vessels) could form, leading to swelling and pain.

6. Other Conditions: Less commonly, conditions such as deep vein thrombosis (DVT), muscle tumors, or systemic conditions like inflammatory myopathy could also present with swelling and pain.

When to See a Doctor
Given that you are experiencing pain and swelling, it is wise to monitor your symptoms closely. If the swelling does not improve within a week, or if you notice any of the following symptoms, you should seek medical attention promptly:
- Increased swelling or redness
- Fever or chills
- Severe pain that does not improve with rest or over-the-counter pain relief
- Difficulty moving the affected area
- Any signs of systemic illness (e.g., fatigue, malaise)

Which Specialist to See
For your symptoms, starting with a visit to a primary care physician or orthopedic specialist would be appropriate. They can perform a physical examination, assess your symptoms, and determine if imaging studies (like an ultrasound or MRI) are necessary to evaluate the swelling further. If they suspect an inflammatory or infectious process, they may refer you to a rheumatologist or infectious disease specialist.

Conclusion
In summary, muscle swelling can arise from various causes, and while some may resolve with conservative treatment, others may require medical intervention. It is prudent to keep an eye on your symptoms and seek medical advice if they persist or worsen. Early diagnosis and treatment can help prevent complications and promote a quicker recovery.

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