Why does the flesh on one side of my butt hurt?

It stands to reason that people who work at a desk for a long time or sit for a long time are very likely to suffer from buttock pain. And the pain should be on both sides. It is rare that only one side of the body is painful. So what happens if there is pain in the entire buttocks? What are these diseases? What should we pay attention to if this happens?

The piriformis muscle originates from the front of the 2nd, 3rd, and 4th sacral vertebrae, is distributed on the inner surface of the pelvis, enters the buttocks through the greater sciatic foramen, and ends at the greater trochanter of the femur. This muscle is prone to traumatic inflammatory changes due to acute or chronic injuries, or anatomical variations, which can stimulate or compress the nerves and cause low back and leg pain. This is called piriformis syndrome, also known as femoral nerve pelvic outlet syndrome.

Piriformis muscle injury is often caused by violent movements such as abduction, external rotation or internal rotation of the lower limbs. Its symptoms are very similar to those of intervertebral disc herniation, but the patient has no low back pain or spinal signs. There is obvious tenderness and radiating pain in the piriformis muscle. The pain is relieved after raising the straight leg 60° and the local pain disappears. The pain disappears after piriformis muscle block.

The main complaint is pain in the buttocks and thighs, which is mostly chronic and sometimes acute. It worsens after walking or activity, and intermittent claudication may occur, which is relieved by bed rest. The straight leg height test may be positive, and may be accompanied by numbness of the calf and outer side of the foot. There is usually no radiating pain when coughing or sneezing. Patients with severe symptoms may experience severe knife-like or tearing pain, and have difficulty walking. Physical examination may reveal atrophy of the gluteal muscles and tenderness in the sciatic margin. Rectal examination may touch the swollen and deformed piriformis muscle, which may induce the above symptoms.

① Patients with piriformis syndrome have no obvious tenderness or deformity in the waist and no restriction of movement;

② The piriformis muscle tension test is positive; the piriformis muscle tension test is a method to check for piriformis muscle damage. The specific steps are as follows: The patient lies supine on the examination bed, straightens the affected limb, and performs adduction and internal rotation. If there is radiating pain in the sciatic nerve, the affected limb is quickly abducted and externally rotated, and the pain is immediately relieved, which means the piriformis muscle tension test is positive. It is a commonly used examination method for piriformis syndrome.

③After locally blocking the tender point with a long needle, the pain is relieved immediately.

2. Pseudosciatica

The gluteus minimus or piriformis muscle in the buttocks becomes swollen after being strained, compressing the sciatic nerve and causing pain. The buttock pain caused by pseudosciatica is that the waist does not hurt but the buttocks hurt the most, but there will be a feeling of tenderness.