Referred Pain (Buttock)
What is referred pain?
Referred pain is a term given to pain that is felt in one region of your body although it originates from another. This is commonly seen in clinical practice, particularly in patients with buttock pain.
There are several structures in the body that, when injured, may cause the patient to experience pain in the buttock region (figure 1). This can occur even though there may be nothing wrong with the buttock itself.
Figure 1 - The Buttock Region
Causes of referred pain to the buttock
The lower back, hip and sacroiliac joint are some of the most common areas of the body that, when injured, may cause referred pain to the buttock. Some of the more common conditions which may cause these symptoms include:
Signs and symptoms of referred pain to the buttock
Patients with buttock pain that is referred from another source may or may not experience symptoms from the originating source. Patients typically experience a dull ache in the buttock that is poorly localized and may vary in severity or location. They may also experience pain or stiffness in other locations in the body such as the lower back, front of the hip, thigh, groin, or lower leg. Occasionally pain may also be felt in the ankle or foot. These symptoms are usually experienced on the same side of the body as the buttock pain, although sometimes, the opposite side or both sides may be affected. Occasionally patients may also experience pins and needles or numbness in the affected leg. This most commonly affects the foot and can sometimes affect the other leg or both legs.
Patients with referred pain to the buttock normally experience restricted movement and abnormalities on assessment (such as tenderness on palpation) in the specific region of the body causing the pain. Local assessment of the buttock may demonstrate no significant abnormalities although patients may experience tenderness on firmly touching the buttock region and "trigger points" are usually detected on assessment. Buttock or hip weakness is commonly present along with decreased balance/control in single leg stance when compared to the unaffected side. In long standing cases of buttock pain that is referred form another source, patients may develop muscle tightness in the gluteal (buttock) muscles or sometimes in other muscles around the hip joint, such as the hip flexors or adductors.
Diagnosis of referred pain to the buttock
A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose referred pain to the buttock and the underlying cause of symptoms. Further investigations such as X-rays, MRI or CT scans are often required to assist with diagnosis.
Treatment for referred pain to the buttock
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