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left buttock pain - worse during period
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left buttock pain - worse during period

I have for four years had a painfull left buttock (or actually also little below the buttocks, down in the external side of the leg - it's hard to say exactly where). In the beginning, I thought it was a hamstring injury from yoga, but now, after 4 years without any yoga, it keeps on bothering me a lot  (and it doesn't seem to be located in the hamstring anymore). It "wakes up" after biking, bending over, or even just sleeping on my left side. What I have realized lately (I should have noticed this earlier!) is that the pain is getting much worse during the menstrual period. What could this pain be due to? I have seen a PT (massage, light streching), had x-rays of the pelvis etc...but no cause has been found!
Thank you so much in advance for advice!



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547368_tn?1332173665
Hello Sisi,

Welcome to the Pain Management forum. I am sorry to hear about your pain. I have similar pain and can relate to the agony it can bring.

There are multiple things that could be causing your pain. X-rays are good at looking for bone fractures or obvious deformities. I suggest that you have an MRI of your spine to determine if you have structural issues. Your symptoms sound similar to sciatica. Sciatica is not a condition, it is a symptom. Often it is produced by compression or inflammation of the sciatic nerve.

If the MRI is negative you may want to consider your SIJ (sacroiliac joint). The only reliable way to determine if you have SIJ problems is through a good clinical exam and a follow up SIJ injection. I see a D.O. (Doctor 0f Osteopathy) that finally diagnosed my years of buttock, hip and leg pain as SIJ Dysfunction.

I hope you will let us know how you are doing. I will look forward to your updates with interest. If you have specific questions regarding SIJ issues feel free to either add it here or you may send me a PM. Best of luck to you.

Take Care,
Tuck
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547368_tn?1332173665
Sorry I forgot to address the fact that you pain is worse during your menstrual cycle.

I don't know about most woman but I have found that what ever spot on my body that hurts or is injured is worse when I menstruate. In my opinion that is due to the hormone fluctuation and the additional fluid that our bodies often retain during that time.

Others will offer their opinions but that is what I have found to be true over the years.

Peace,
Tuck
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874521_tn?1375890587
Tuck is correct that sounds very much like sciatica or SIJ dysfunction.
My pain symptoms are the same and its interesting you mention its worse during menstration...I had sciatica for years only at this time of the month, it was years before it became constant...
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Avatar_n_tn
Thank you VERY much for this information!!!
I had been thinking of a sciatica, but as my pain is not a shooting pain, I abandoned this idea. However, thanks to your reply, I have been reading up on SIJ dysfunctions this morning, and I am stunned: I am almost certain that this is the problem!!! The symptoms, everything, fit. In addition, on wikipedia, it says "The hormonal changes of menstruation, pregnancy, and lactation can affect the integrity of the ligament support around the SIJ, which is why women often find the days leading up to their period are when the pain is at its worst." So I think you definitely have given me a very good starting point for my search. THANK YOU! I will keep you updated with my progress! Sisi
PS Opus, did you manage to get rid of your pain?
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547368_tn?1332173665
So glad that we were able to help.

If you did your research you know that SIJ Dysfunction is often missed or misdiagnosed. After my PCP diagnosed me with it she sent me to a neurologist. He told me there was nothing wrong with me and that I did not have SIJ. Just what I had been told by multiple specialist and PCP before him. He did very reluctantly agreed to send me for an MRI which I had never had and of course did not reveal the SIJ. It did show multiple spinal nerve root cysts. I was than sent to a neurosurgeon and was told they were inoperable and he sent me for the injections to determine the true diagnosis. Of course my PCP was correct and I had numerous apologies from specialist but it certainly did not help my condition. Because it went so long untreated and undiagnosed the damage is so severe that it can not be successfully treated. I am telling you all this because I don't want it to happen to you.

Hang in there and be assertive as your suspicion may be meant with resistance. It took years and multiple physicians before I stumbled quite by accident into my current PCP that diagnosed me in two weeks.  If your current PCP won't listen to you I suggest that you see a D.O. that is able to so manipulations and is knowable in SIJ. I just plan got lucky. I have to avoid lifting, reaching and bending so maybe that info will help you. I know the pain you are experiencing so good luck to you and feel free to post anytime.

Take Care,
Tuck
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Avatar_n_tn
Many thanks for sharing your story with me!
It's amazing how often people are misdiagnosed! I am sorry to hear you're a part of them!
But tell me - the spinal nerve roots cysts did not have anything to do with your pain? It's due to the SIJ alone?
The other thing your mail made me wonder about is the actual treatment of SIJ dysfunctions. What I have been reading so far, is that it's tough to treat. Do you believe - if caught "fast" - it can be dealt with by manipulating the joint and some PT?
I am not so keen on getting cortisone injections etc...I've had them for knee pain with no success.
I'd also like to hear more about your case: what is your pain level now (if you avoid lifting etc..)? Do you use a "SIJ belt"?
I used to love to do yoga, but I guess I should avoid all forward bending...but then again, on the other hand, maybe an increased flexibilty could ease the "load" on the joint (I mean, if muscles do not pull so hard on the joint)..what's your opinion about this?
So many thanks for helping me! Good to have your story in mind when I'll be facing the reluctant doctors!
Take care
Sisi
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547368_tn?1332173665
You are correct that the spinal nerve cysts were not the cause of my chronic pain, just an addition.
SIJ Dysfunction is very tough to treat, indeed nothing has helped and I am now disabled due to it. However I have personally met others with this condition that have had it successfully treated when caught early. Others require on-going treatment but maintain their functioning level.  
My pain is constant and even with medication it averages a 6-7. Often by late afternoon it is higher. Any activity makes it worse but lifting, bending or reaching can put the SIJ out of place. It is those times that I hit a 9 or 10. That is where my D.O. is so helpful. The better alignment in your hips and pelvic girdle the less your pain. Your SIJ may be out of place and only a D.O. (in my opinion) can successfully treat it. Chiropractors have only hurt me and aggravated my condition. I do though I know there are great ones (several close family members are Chiropractors) out there and they do offer help for others. I have not been one of them.
A belt has not helped.
If you have supporting structures to strengthen (I don't) Yoga or better yet Pilate's I am told can be effective. I have other major structural issues that make the SIJ worse and impossible to treat. If you don't your prognosis may be better.
Please let us know how you are progressing.
  
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Avatar_n_tn
Oh, gosh, you are really suffering! A 6-7 even with medication, that must be unbearable. It must be impossible not have it interfere with everything in your life! Have you considered surgery? I would not advice surgery in general after a "lateral release" on my knees that actually made them worse, but I guess some people would..
I hope, thanks to you, that I can catch my SIJ (if that's really what it is, and I am getting pretty convinced) early, and not reach this pain level. My warmest thoughts to you, and wishes for significant improvement for you. Of course I will let you know anything I might learn about this condition over the next period of time.
All the best,
Sisi
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547368_tn?1332173665
Hi Sisi,

I've sent you a PM. Surgery is not a real choice for SIJ Dysfunction but I do appreciate the input.

I'll look forward to your updates.Hope you soon will find some answers. Pain is no fun!!!
Tuck
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1840831_tn?1318882520
Its amusing the way professional doctors told me sciataca could only be caused by slipped discs, psyhical ailments!


Mine was cause by endometriosis and IBS!
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