Pain in the butt - Can't sit down
I have had very intense pain at my sitz bones for over 7 months and am unable to sit down. when I sit, it feels like I am sitting on two hot pokers or rocks and it is really unbearable. So, I have been standing for seven months. I've been to a couple of spine and pain management doctors, an orthopedist, a chiropractor, a neurologist, an acupuncturist, and a massage therapist. The original diagnosis was ischial bursitis but that ha not appeared on any images. I don't have any issues with any of my lumbar disks. I'm in constant pain even when standing or lying down though those activities do not hurt as much as sitting. Has anyone heard of anything like this before?
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@richman54660 @vklittle61 @jelizabeth @bkruppa I posted a lot of information about myofascial release and what it can do in another discussion. It's cross listed under the Bone, Joint Muscle Group and Neuropathy. This is a way to treat tight tissue and nerve entrapment without surgery all over the body. Here's a link
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
I've also checked out the pelvic book you talk about and that looks like good information too. My physical therapist has talked abut all of this.
@bkruppa I mentioned this already. The single biggest thing that helped my pain and tension (I still have some sitting pain) was finding a therapist who does what is called "injury massage". He uses intense ultrasound while stretching you. He went up and down my legs, thighs and lower back. It took several 1 hour sessions and it's an expensive out of pocket deal. He thinks he's really "remodeling" the tissue. He also says if the pain varies and changes with time, it's not structural (i.e. not ligaments/bones, etc.). For me it's nerve compression from my myofascia/muscles (soft tissue) due to overuse/martial arts breakfalls ("scar tissue"), etc. He got rid of all the muscle knots in the lower legs. Regular massage won't change that - although as @jenniferhunter said myofascial release helped me (yes I had a John Barnes trained guy) but I had trigger points across whole regions - so the ultrasound really helped the most the quickest.
Some chiropractors have a high frequency vibrator called an RRT (rapid release). These might work well if the tension is close to the surface. Many have lasers and some have electrical stimulation, too (and you can do some TENS/EMS, too, yourself as you can buy those on Amazon). I am concerned chiropractors like to do their "adjustments". I don't particularly need or want the adjustment - especially since two discs are desiccated and bulging. I just like their other tools. Chiropractors often have the stuff.
Last, try an inversion table (talk to your Dr. about that - if the spine is too deteriorated or if high blood pressure it's not good). You don't spend a lot of time doing it - just a little - perhaps twice per day. That can take the pressure off the spinal nerve. I'm pretty sure that is what is causing my pain and tension (when I had it) - a pinched spinal nerve due to lower lumbar DDD. A pinched nerve can affect everything below it. pain, Sciatic pain, sitting pain, excessive sweating, affects the bowels (IBS like symptoms), etc. (they mention that in the headache in the pelvis book, too). However, more aggressive stretching and other exercises, too, that I detailed before are doing the trick for me. Keep trying different types of massage. You may not fully cure this but you might make it better. Stretches, vigorous walking, if tolerated, any other good exercises that are tolerated (I like TRX suspension training core exercises and lower body - TRX is the best for core strengthing I have found (no back aches since Christmas when I started TRX)) and extremely deep inspirations (lumbar nerve plexus runs through there and can not only cause pain but tension in the diaphragm) , try anti-inflammatory supplements (resveratrol + quercetin + rutin + turmeric in modest doses). It should help.
One more good book to read is "life after pain" by Dr. Jonathan Kuttner. He mentions chronic pain as well as meditation / mindful techniques. Also, maybe it won't help your wife - but try the deep breathing - really deep inspirations when you need it. Almost to the point of hyperventilating. That really helped me - but I had chains of trigger points and tension up and down my body and it wreaked havok. Often, when we are in pain, we tense up our muscles and don't breathe right. I'm trying to avoid drugs and injections for as long as possible. If massage works, try and find therapists / chiropractors with different tools and try them out. Some are reasonably priced and / or might be covered by insurance.
@richman54660 @bkruppa That's a lot of good information. My physical therapist has all the same "stuff" and she has used cold laser, ultrasound, and a Dolphin Neurostimulator (Blocks nerve pain impulses) on me. She also has an "Arc Barrel" which is a curved padded thing to stretch on; like as if you sliced a piece off the side of a cylinder and laid it on the ground. I had a few sessions where I laid across that and she also did her myofascial release at the same time. When you add your body's stretch, it's like having another pair of hands working on you. The key to remodeling the fascia is to be gentle enough so the body adapts, because aggressive work brings on the body's response to protect by adding more guarding and tension, and if stretched to the point where the fascia will tear, you've just created scar tissue that will add to the problem. My PT also has a "Power Plate" which is a vibrating platform that you can stand on, lay on, etc, and it comes with a cushion that matches the height, so you can have part of your body on the cushion, and part on the plate. That is good for when you want the vibrations on just the legs/arms, etc, and not on the entire body. This does get the fascia moving from vibration. If you stand on this, you'll feel the vibration up through your head an neck as well which I don't want to do, but prefer using it with the cushion. You can also stretch on it with normal muscle stretches and add the vibration into that to get the fascia moving sooner.
I agree that a chiropractic adjustment isn't a good idea if you have a bulging spinal disc. When you have damage to a disc, the fibrous outer layer develops small cracks. With aging, discs dry out and shrink a bit, which helps the cracks open up a bit, and it doesn't take much to cause the fissures to open and release the jelly like nucleus inside the disk. All I had to do was turn my head, and the cracks opened squeezing out the jelly. Then because of the uneven pressures on a disc that lost it's shock absorbing jelly, over a couple years, my spine attempted to stabilize itself by growing bone spurs. All of that was eventually pressing on my spinal cord and required surgery. Another problem can be spinal instability and having one vertebrae slip past another because the disc isn't preventing the abnormal movement. Keeping good muscle core strength will help stabilize the spine. These issues would also be the reason that imaging is important before anyone does any physical manipulation on your neck or spine. If a person has instability in the cervical spine near the skull, the potential for serious injury and paralysis exists. As patients, we should ask questions and require imaging and evaluations before any physical therapy or manipulation. Your provider should be taking these safeguards, but as the patient, the ultimate watch dog is us, and we need to speak up, and be ready to stop and re-evaluate our safety, and get other opinions, etc.
@dailypain @vklittle61 Hello, I just came across this page via a google search for "sitting pain". I have the same problem and it has been going on for 9 years now (I'm 31 years old). It hurts to sit and it can be unbearable at times. The pain is bilateral and started at my sit bone and now radiates down my hamstrings. I've been to multiple doctors, tried physical therapy, etc. Recently I had an MRI of my hips and the doctor found a torn labrum on each of my hips along with bilateral femoro-acetabular impingement (FAI). I had surgery this month to fix the right labral tear. I'll try to keep you updated to let you know if this helps. To everyone else, thanks for the info. I need a few months to rehab from my surgery and hopefully the pain goes away. If it doesn't I will have to try some of the other things mentioned here.
Have you requested your records so you can read your radiology report? See if it says anything about any "incidental findings" of Tarlov cysts. They are also called perineural cysts. I've been a "chronic pain patient" for 15 years (since my accident) and am finally finding out that I've had these cysts the whole time. There seem to be a lot of "incidental findings"! Anyway, these cysts basically bulge from the nerve root sleeves that exit the vertebrae and cause a multitude of symptoms. Rarely does a doctor even acknowledge them because they are "incidental findings" and they weren't taught any more than that about Tarlov cysts in medical school. You will need to mention them to your doctor or even have him/her pull your pelvic MRI up to see if you have them. Radiologist may or may not even document them, I guess it's their choice.
I have the same "pain in the butt" that others have described on here. I know exactly the kind of pain you're talking about because I have it in both. I can't even put any pressure on my right butt cheek. It feels like there are hard balls of muscle/nerves in there and the pain is crazy. That nerve pain then spreads down my leg and into my feet. I now have peripheral neuropathy because of this. These cysts, when big enough, push on your sacral nerves causing cauda equina syndrome. For more info. look up Tarlov Cyst Foundation.
I have spinal stenosis.Foot drop dead nerve L5. Can't sit, read standing. Have to travel by plane. How will I sit??
@12251948 you can buy a vive inflatable tailbone cushion on amazon if getting the tuberosities off the chair helps. You can conveniently carry it in a grocery store bag (I bought some black poly bags on amazon) so it looks like any carryon bag. The vive is adjustable since it is inflatable. I used to use that when my pain was worse. I had several posts above where I described what I did that helped me over time to get rid of /lessen my sit pain.
@qball2019 yes. I had the exact same thing. I’m going to be highly speculative, below. Briefly, this sit pain is a weird intersection of nerve compression, aging metabolism and poor wound healing I think.
One can’t know for sure but the sit pain is probably one of three things: 1. bursitis from tension. With bursitis comes intense pain that is 100% contact pain. Standing good. No pain. Sitting = excruciating pain. 2. It can also possibly be abnormal scar tissue /adhesions. Slow trigger point massage /myofascial release like @jenniferhunter mentions might help this. 3. There is also the possibility that bursa fluid has crystallized. I had the feeling like I had an ice pack under my skin. Again, slow trigger point massage (rolling on balls/Rollga , etc., Myofascial release) can help. The irony is that involves contact and pressure which can cause some pain. However, you might want to work the adjacent areas as they are referring the pain and tension to the ischeal tyberosities. Going back to #2, the hard tissue in those adhesions can be fibrin deposits (as in what is in you cloys). As we get old wounds don’t necessarily heal the same. I think citrus bioflavonoids with vitamin c especially and other plant supplements might help actually dissolve those fibrin deposits. Also , I take turmeric, rutin (low dose!) quercetin, resveratrol) and supplements that help mobilize fat rather than sugar (ie citrulline maleate and carnitine) might help (burn sugar = lactic acid buildup). To some extent the Myofascial tension might be a metabolic issue associated with aging, too.
My blood pressure went down and my triglycerides went from high to normal levels with those supplements and I think they mostly cut some of my nerve pain (except citrus bioflavonoids slightly increase my nerve pain but I think they help me heal the abnormal tissue). It has softened up considerably since I started them. It could take several months. Discontinue those when the scar tissue remodels. Keep the other supplements. Monitor blood pressure while taking supplements or natural pain supplements, too. Some raise it, most lower it.
Cure the root cause though which is the Myofascial tension. Stretching, rolling, exercise I mentioned in earlier posts and the supplements above really did it for me. I also use a wall hugger model of lazy boy. Easier on the back and bottom and you can get to zero gravity and sit comfortably.
My sit pain is almost all gone. I had chains of trigger points and tension all up and down my legs (quads, IT band, hamstrings and glutes) which can cause pain as well as bursitis. It took me two years of hard work and a lot of experimentation. Again, see my several prior posts in this thread.
I would guess those are not Tarkov cysts at you tuberosities. Either scar tissue or bursa. However, nerve compression causes the tension which may drive bursitis or scar tissue formation. For me it is DDD and tight Myofascial tissue near the sciatic nerve that drove the tension and pain I think. Get rid of the tension, the other issues should get better. Also, no one can count on therapists to do it all for you. You need to do whatever you can for yourself every day to get better. Good luck.
Hamstrings which have been even slightly injured can cause a "pain in the butt". That is exactly how medical literature describes it. Not sure if your images were from x-Ray, which would not show ti, or from an mri, which would show it. These are quad muscles that insert high up in the back of your thighs, right by your butt. Hope this helps.
I slipped and come crashing down on my sacrum/coccyx 5 months ago. no fracture but pain when I sit for any time is excruciating. Fine standing or lying. But sitting upright on a chair at church or concert, pain becomes excruciating, radiating out in all directions. So little improvement over 5 months. Only had an exray. Did I briuse my sacrum? Crushed some nerves? What could it be? what can be done ? What should I request be tested and how next?