Pain behind the thigh just under the buttocks : surely a sciatica

Pain behind the thigh just below the buttock is not uncommon. In fact, you do not take it into account, because it does not hurt too much. However, when this pain becomes severe during its movement, you need to put the flea in your ear. You may be faced with Piriformis syndrome which is nothing more than irritation of the sciatic nerve. Piriform syndrome is a condition in which the muscle piriformis, located in the buttocks area, has spasms and causes pain in the buttocks area. Piriformis muscle can also irritate the nearby sciatic nerve, causing pain, numbness, and tingling in the back of the leg and foot (similar to sciatica pain).

Causes of such pain

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You have certainly discovered that when you sit for too long, you have numbness in your buttocks. Sometimes it’s a real pain, like a stabbing felt at the level of the sciatic nerve. For others, the pain behind the thigh just below the buttock is perceived as pain in the pelvic bone or large hip. If this pain is not always unpleasant, sometimes it blocks some people in the fulfillment of their daily task.

The causes of such pain, are variable. In fact, it can arise from a problem in the buttocks or some other part of your body. Pain can come from the muscles of the lower back or thighs.

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Muscle Piriformis

Piriformis muscle is a small muscle located in the deep part of the buttocks (behind the large buttocks).

  • begins in the lower part of the spine and connects to the upper surface of each femur
  • Helps with hip rotation, and leg and foot rotation
  • spreads diagonally, the sciatic nerve passes vertically directly below it (although in some people the nerve can pass through the muscle).

Manifestations of this

A pain behind the thigh just in under the buttock can manifest itself in different ways. It can be:

From a sciatica

Sciatica is how pain occurs in the sciatic nerve (the longest nerve in the body) . The sciatic nerve goes from the lower back part to the end on your feet. Next, understand that when the sciatic nerve is irritated or compressed, the pain radiates throughout the body. The pain behind the thigh, therefore, is not impossible to feel. Pain caused by the sciatic nerve can hurt a lot or not.

Tendinopathy of hamstrings

Here, the pain is more noticeable when you sit down and feel it in your hamstrings. The pain gradually spreads to the bottom of the buttock precisely in the pelvic bone. In terms of intensity, the pain in the buttocks at this level of the body is very high comparable to tooth rabies that do not does not end.


To determine the sources of gluteal pain, ostearthrosis is a usually made diagnosis. In fact, the pain behind the thigh just below the buttock can be due to osteoarthritis. Osteoarthritis is nothing more thanthe wear of one of the joints in his body . When osteoarthritis occurs in the back, gluteal pain can be felt.

Symptoms generated by such pain

As we told you at the beginning of the article, the pain behind the thigh just below the buttock can be due to piriform syndrome . This pain can spread to other parts of the body or not. Symptoms of piriform syndrome are tingling or numbness. However, numbness is a rare fact unlike tingling. Symptoms of Piriform syndrome worsen depending on the position you take. The pain can be severe if you are sitting or lying down and less while standing. Some activities become like walking after an unpleasant practice because they force you to stretch your piriformis. Some patients even suffer from pelvic pain.

The exact causes of piriform syndrome are unknown. Possible causes are as follows:

  • spasms in the piriformis muscle, either by irritation of the piriformis muscle itself or by irritation of a nearby structure such as contraction of the sacroiliac muscle or hip joint
  • in response to inflammatory lesions or spasms of the piriformis muscle due to injury or
  • spasm bleeding
  • the muscle piriformis muscle area Piriformis.

All these problems, or a combination of these problems, can affect the piriformis muscle (and cause pain in the buttocks) and can affect the adjacent sciatic nerve (and cause pain, tingling or numbness in the back of the thigh, calf or foot). There is no simple diagnostic test for piriform syndrome that causes irritation of the sciatic nerve. Diagnosis is established mainly on the basis of the patient’s symptoms and physical examination, and after excluding other possible causes of the patient’s pain.

Most often, patients describe acute sensitivity in the buttocks and sciatica pain that descends from the back to the back of the thigh, calf and foot. Typical symptoms of piriform syndrome may include

  • dull pain in the buttocks
  • pain that descends to the back of the thigh, calf and foot (sciatica)
  • pain when of climbing stairs or slopes
  • increased pain after a long time
  • reduced amplitude of movement of the hip joint
  • Piriformis often worsen after a long session, walking or running, and can improve after a supine position.

Diagnosis and treatment of pain

Diagnosis of piriformis syndrome Medianosis piriformis syndrome is based on an examination of the patient’s medical history, physical examination and possibly diagnostic tests.

Piriform syndrome is often diagnosed after the exclusion of other possible conditions that can cause the patient’s symptoms, such as a herniated lumbar disc or dysfunction of the sacroiliac joint.

Physical examination

Physical examination will include a hip and leg examination to see if movement increases pain in the lower back or in the lower extremities (sciatica).

Usually hip movement recreates pain. The test will also identify or exclude other possible causes of sciatica, such as tests for local sensitivity and muscle resistance.


Medical history includes a thorough examination of the patient’s symptoms, such as positions or activities that improve or worsen symptoms, duration of symptoms, whether symptoms started gradually or after an injury, and treatments that have been developed. Tested.

It will also include a review of conditions that may be present in the patient’s family, such as arthritis.

An injection of anesthesia with or without steroids can help confirm if the piriform muscle causes symptoms.

Almost all approaches to the treatment of piriform syndrome consist in focusing on careful and progressive elongation of the piriformis muscle.

Stage of diagnosis

X-rays and other spinal imaging studies do not detect whether the sciatic nerve is irritated in the piriform muscle. However, diagnostic tests (such as X-rays, MRI, and nerve conduction tests) can be performed to exclude other conditions that may cause symptoms similar to those of piriform syndrome.

The diagnosis of pain behind the thigh just below the buttock is usually reduced to that of piriform syndrome. However, the results are not always conclusive at first glance. Therefore, it is necessary to go far and make a thorough diagnosis. To do this, an MRI can be done to determine if it is actually piriform syndrome . Magnetic resonance neurography can also be done to clearly see the sciatic nerve. Pain can be due to changes in the nerve or swelling of the nerve. As a last resort, you can do electromyography.

Stage of treatment

To treat piriform syndrome and make pain go away, you will need rest, anti-inflammatory drugs, muscle relaxants, therapies for piriform or osteopathy.

Elongation for piriform syndrome

A variety of stretching exercises for pyriforms, hamstrings and hip extenders can help reduce painful symptoms along the sciatic nerve and restore the patient’s range of movement.

Lie on your back, both feet flat on the floor and both knees bent. Bring your right knee to your chest, grab your knee with your left hand, bring it to your left shoulder and hold it straight. Repeat for each side. Lie on your back, both feet flat on the floor and both knees bent. Support the ankle of the right leg on the knee of the left leg. Bring your left thigh to your chest and hold the stretch. Repeat for each side. AdvertisingEach elongation of the piriform should be kept for 5 seconds at first, then the time should be gradually increased until it is held for 30 seconds, and repeated three times a day.

Elongation of hamstrings

Stretching the hamstrings (the large muscle at the back of each thigh) is important to relieve any type of sciatica. There is several ways to lengthen hamstrings:

Place two chairs facing each other. Sit on a chair and place the heel of one leg on the other chair. Lean forward, leaning on the hips until you feel a slight pull on the back of your thigh, and continue to stretch.Lie on the floor with both straight legs. Raise one leg and stretch it by holding a towel on the back of the foot until you feel a slight pull along the back of your thigh.Again, try to increase the stretch to hold it for 30 seconds and repeat the operation three times a day.

Amplitude of motion exercises

A physiotherapist, physiatrist, chiropractor or other qualified health specialist can develop a personalized program that includes exercises Stretching and amplitude of movement to help stretch muscles and reduce spasms.

Deep tissue massage

Deep massage (manual relaxation) Conducted by a physiotherapist or other qualified specialist is supposed to improve the healing process by increasing blood flow in the area and decreasing muscle spasms.

Deep tissue massage In addition to stretching and physiotherapy, most approaches to treating piriform syndrome will include additional therapies, which are discussed on the next page.

Depending on the severity of sciatica type pain and other symptoms, a number of therapeutic options may be recommended by a health professional.

A comprehensive approach to the management of piriform syndrome may include a combination of The following non-surgical treatments:

  • Thermotherapy and ice cream for piriformis syndrome
  • Ice Packs and Ice Massage
  • When the pain begins, lie down in a comfortable position on the stomach and place an ice bag on the sore area for about 20 minutes. Repeat as needed every 2 to 4 hours.

Use of ice to relieve pain under the buttocks It may be more useful to combine this with a gentle icy massage. Lie on your stomach and ask someone to gently massage the painful area with a large cube of ice. If the ice is applied directly to the skin (instead of using a cold bag), limit the application to 8-10 minutes to avoid an ice cream burn.

If certain specific activities are often followed by increased pain, it may be wise to apply ice immediately after the activity.


Some people find it useful to alternate hot and cold. If you use a heating pad, lie down on your stomach and place the cushion on the sore area for 20 minutes. Be careful not to fall asleep on the cushion, as this can cause skin burns.

Electrotherapy for piriform syndrome

Electrostimulation to reduce pain behind thighs Apply electrical stimulation to the buttocks using a Transcutaneous Nerve Stimulation Unit (TENS) or Interferential Current Stimulator (ICS) can help block pain and reduce muscle spasms related to consyndromepiriformis.