One cause of pain in the buttocks and hip region may be misdiagnosed as a problem of the lumbar spine, as it causes pressure on the sciatic nerve, which is a large nerve that provides motor and sensory function to the buttocks and back.
Any pain caused by peripheral nerve problems is known as a radiculopathy or a peripheral neuritis. The sciatic nerve can be affected by problems of the lumbar vertebrae. If the wrong diagnosis is made, then treatment will be ineffective.
The piriformis muscle helps with postural stability while moving and standing. It is attached to the hip joint and also at the sacrum, usually near the 2nd through 4th sacral vertebrae. The nerves known as S1, S2 and L5, designating their position as they exit the spinal column, supply the piriformis muscle. In most people, the piriformis muscle lies above the sciatic nerve, which sometimes travels through the piriformis muscle. In others, the sciatic nerve may branch into two branches. Uncommonly, the sciatic nerve runs on top of the piriformis.
Piriformis syndrome is caused by inflammation and compression by the muscles and small nerves and blood vessels. Piriformis syndrome may be the result of the path of the sciatic nerve, or may be the result of an injury. The most common symptom of the syndrome is increased pain after sitting for 15 to 20 minutes or longer. Pain occurs over the buttocks, and results from spasm of the muscle or compression of the sciatic nerve by the muscle. The problems resulting from piriformis syndrome include compensatory changes in the spine, low back pain and decreased range of motion.
When you see a pain specialist, you will undergo a variety of physical examination maneuvers and neuromuscular testing that will reveal the true cause of your pain. If you are experiencing any of the signs or symptoms mentioned above, you should consult a pain specialist to rule out piriformis syndrome, or to begin treatment in order to avoid ongoing pain and potential complications.