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why do I have so much pain in my buttocks

I am a 71 year old woman, generally fit, but have recurring pain in my buttocks, much worse over the past several months. It is now so bad that I can barely sit down anywhere without agonizing pain. This pain feels like I have been slapped because it is a burning sensation. I have been told it  may be piniformis syndrome and have done some exercises with no relief. I have a theory that it might be herpes affecting the nerve, but have had no confirmation of this. I have booked an appointment with a chiropractor and am hoping for some relief without breaking the bank. Has anyone experienced this, and do they have some suggestions as to what can be done about it?
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Avatar universal
Sciatica
Helpful - 0
1 Comments
Thanks, rjb, yes, it would sound feasible to have sciatica. However, I have had sciatica twice before and it is usually a shooting pain down my leg whereas this is a constant pain resulting in a stinging pain.
20803600 tn?1546262537
COMMUNITY LEADER
Spinal Stenosis can cause stinging, burning pain.  Stenosis is a narrowing of either the canals in which the spinal nerves pass through or the central canal where the spinal cord travels.
That narrowing can cause pressure on the nerves and cause the stinging pain you are experiencing.
Chiropractors can't offer treatment for stenosis. Your best option would be consulting a board certified spine surgeon.
That does not mean you need surgery, but they are best equipped to diagnose and suggest treatment options.
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3 Comments
Hi backhurtz -that's a great nickname - thanks so much for replying. I don't think I have spinal stenosis, but will definitely take a look at my last MRI results again. I do know I have arthritis of the lower spine. I am trying the chiropractor because if it piniformis syndrome I think they can help, although I don't fancy the expense of going week after week. I remember doing that once before and it did no good whatsoever. After about 6 visits, I insisted I got my money back. This is a different chiropractor recommended by my family doctor. I shall keep my options open with regard to a surgical specialist and hope I don't need surgery.  
Hi Maureen,
Arthritis can lead to spinal stenosis. There are two areas of the spine in which stenosis (narrowing) happens, the foramen, where the spinal nerves exit between each vertebral level and the central canal.  The stenosis can lead to compressed nerve roots . This can be mild, moderate or severe, but all three can cause the type of pain (neuropathy) you describe.
Most people who see a spine surgeon don't require any surgery, but they are the best in diagnosing spine conditions and evaluating whether there is nerve involvement.
How recent is your last MRI?
Hi again, thanks for your detailed reply. I have looked at my MRI report (October 2018) and this is  the conclusion:

Degenerative spondyloarthropathy, relatively stable compared to prior exam. No high=grade stenosis. No focal or extruded disc protrusion. Diffuse facet joint arthrosis again noted.

I went to see the chiro last Wednesday and he helped me a lot. But when I went back the next day something went very wrong. I can't sit anywhere in any position now without extreme pain. I had no pain when driving before, but can barely sit in my driver's seat now. To be honest, I am very depressed about this and my quality of life has diminished tremendously. I have another app. next Monday and am praying that he can do something to ease this as it is now totally unbearable, even Codeine has no effect on the pain.
20803600 tn?1546262537
COMMUNITY LEADER
Hi Mureen,
I'm sorry to read your appt didn't go well and you are in more pain.
No high grade stenosis doesn't mean there isn't narrowing that could be effecting the nerve roots, it just means it's not severe. There are degrees of stenosis, mild, moderate, severe.
With degenerative arthritis, bony overgrowth can occur over time, and can cause the narrowing to effect the nerves, and it can even be somewhat positional, meaning you might find the stinging burning eases when you lay down or stand slightly leaning a bit forward or worsens as you sit, or vice versa.
That was part of the reason I suggested a consult with a spine surgeon before going the chiropractic route, to make sure there is no danger of nerve damage.
I went the chiropractor route too, and after he adjusted me when he should not have, I immediately lost the strength in my legs, and feeling, and collapsed on the floor. I was in surgery days later.
Chiropractic care has its place, and IF there are no dangers to an adjustment, then I encourage people to go that route if it helps after you know there is little risk.
Have you tried moist heat, alternating with ice , 15 minutes on, then off for twice as long.
Make sure you wrap a heating pad or ice pack in a towel so you don't damage your skin.
Helpful - 0
1081992 tn?1389903637
"recurring pain in my buttocks" (plural)
Hi, Maureen. Do you mean on *both* sides at the same time? In Piriformis Syndrome, that would be very unusual, but not impossible. Also, the one sided pain in PS typically, but not always, gets very severe right when standing up after a prolonged sit-down. As opposed to during the sitting.

If you search online, you can see lots of spine specialists offering a free MRI review. I don't know how that works, but maybe @backhurtz can comment on that.
Helpful - 0
1 Comments
Ken, you always have great advice. I wanted to comment on the "Free MRI review." That is typically part of a marketing strategy that practices utilize. Any spine specialist is going to review the MRI during your office visit. Maureen you have a lot of great feedback here! I too would encourage you to see a spine specialist. Don't shy away from letting them know you are looking for conservative treatment. I wish you all the best!
20803600 tn?1546262537
COMMUNITY LEADER
MRIs are a great diagnostic tool, and in the reports, they list any anatomical finding. MRI looks at the soft tissues of the spine, discs, but aren't so great at seeing the bone structures of the spine.
Most of the spine surgeons I have ever dealt with, look at the actual MRI, not just the report.
They can miss things,  and sometimes a CT scan is also required to get a more complete picture of bone and soft tissues surrounding the spine.
Helpful - 0
1081992 tn?1389903637
@uomeasmile, I had first read about the free reviews from you :)  In fact, I posted a question about this on the radiology forum, if you care to take a look:
https://www.medhelp.org/posts/Radiology-/-regarding-free-spine-MRI-reviews/show/3040594

And/or @backhurtz, you might know the answer. Have you ever done it? I believe the patient sends a disc of the images in.
Helpful - 0
Avatar universal
Hi everybody, thank you so much for your detailed replies and apologies for not getting back to you sooner.

I have not seen a spine surgeon as yet but may do so later. At present, I am still with the chiropractor and although things were not good at first, I am hanging in there and must say he has done wonders on my buttocks (plural). I can now sit down without pain, just discomfort which is a big improvement. I have decided to carry on with him for the time being.

Just to complicate matters, I have bursitis in that hip (all on right side of my body), a cyst behind the patella on my right knee and tremendous pain down the IT band. The pain in my knee and hip are manageable, but the pain in my right thigh is bad when walking, and dreadful at night, so much so that it wakes me several times and I need to get pain-killers in order to go to sleep.

The chiropractor is of the opinion that the pain in the thigh is referred pain from the buttock, but has not ruled out the possibility that it is a result of the bursitis in the right hip. We have both agreed that we shall keep up with the treatment for a while, then he himself said that he may have to refer me to a surgeon should there not be much improvement.

MRIs are not a problem as I have excellent insurance (thank goodness). Once again I am so grateful for your help.
Helpful - 0
363281 tn?1643235611
Hello~It sounds like your chiropractor is on the right track. I was going to suggest seeing one when I saw this post, but you beat me to it.   Also, has he suggested any massage therapy or even acupuncture, sometimes these help along with the adjustments.

I hope the treatments help and you get better, having this kind of pain is no fun.
Helpful - 0
2 Comments
Thanks for writing, Sassie. I am due for an appointment today at the chiro (I have now met my Medicare deductible so it is free from now on - great insurance - Americo). I am very pleased with what he has done so far because I can really sit without any pain. I lost a great deal of weight (unintentionally) last year so have no cushion (if you see what I mean) to sit on.

I am hoping the chiro can do something with my right thigh as that is unbearable sometimes. I hate taking Codeine because of the possibility of addiction so only take one now and then.

Thanks so much for thinking of me.
That is great news, I truly think the chiro will be able to help that right thigh issue, it would be wonderful to get off that nasty Codeine.

It is my pleasure to help and give ideas, feel free to write anytime, either here on via a personal message. :-)
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