Pain in the literal Ass

[Painintheass]

Hi all, I've not used a forum before so be gentle, I'm tender ha Little pain joke for ya.

Anyways I've suffered with literal pain in both sides of my butt for years, roughly 4/5 years.

The pain, which haunts me for most the day affects me most when sitting. So relaxing is only really possible if laying on my front, which for a man isn't easy, balls, or in a swimming pool going for a swim as not pressure on any part of the body.

I practice meditation, transcendental meditation, that I went on a course for which can help but only gives momentary relieve.

I have been to two different physios, one hadn't a clue and the other thought it might have been piriformis syndrome, which closely matches my symptoms. I did the stretching and exercises for PS but it only got worse, maybe I didn't do enough exercise or too much, can't be certain.

I then went to pain management, they gave me Gabapebtin (300mg) which seemed good to start with but then they had to increase to triple that and it become inaffective after a short while.

So now I am waiting to see a consultant in Rheumatology as they may think this is related to inflammation in the smaller vessals. Is there anyone here that has had a similar journey with pain or is going through the same thing ?

My gf become frustrated a lot and it drives me mad when all she wants to do it lay in bed all day as that puts me into a week long episode and this occurs most weeks...

No one really understand what I'm going through and I rarely get the opportunity to relax, truly relax.

The only relieve I get is with ice and heat treatment to the area. I ice at night before bed and then apply gentle heat with a small electric heat cushion (mains powered) which helps me to get to sleep but I wake up multiple times a night, which leads to more pain of course.

I know this is a lot to take in a get ya head around but any advise on any of the above would be greatly.

I feel like I can't continue sometimes and the pain literally stops me from living a real life. When I fight the latter of course it flares the issue and the pain increases...

So yeah, any help would be appreciated.

[Madlegs1]

I thought Piriformis at first - but you say not. I would go to a good sports therapist who should be able to get to the bottom of your problem. There are many small muscles in that area - and you need a real expert to sort it out.

Dry needling may be an option.

Good luck.

[Painintheass in reply to Madlegs1]

Well when ever I do any type of exercise that involves the glutes, like lunges, the pain flares up and last for days, so I tend to avoid that nowadays. So I am thinking that there is some sort of muscle pinching in that area so I'll give the sports therapist a go. I have already tried accupunture, forgot to mention that, but that only gave me temporary relieve.

But thank you for the tip, much appreciated !

[saj01 in reply to Painintheass]

just wondering if it's ischial tuberocity bursitis. It's where your glutes etc join over the sit bones.... I've had that for 2 years. it can get extremely painful . I had scans done followed by guided steroid injections , but that last for about 2-3 months. Even simple things like walking up the stairs hurt! Was doing physio, but even gentle exercise aggravated it. So I had to limited myself to minimal exercise and stop any activity which made it worse... It's just starting to subside now and I can do a few squats and lunges a day... but I stop as soon as it starts hurting. It might be worth mentioning bursitis to your doctor and ask for an scan... in between time, don't do the squats etc as it has the same effect of 'picking a spot'.... all the exercise does is make it more sore. Gentle stretching is the most you should be doing... there's exercises for on the net.

[gg317]

i had what felt like i was sitting on an ice pick for a long time, it was awful...like i've been riding horse bareback for years...horrible, I could not sit at all. I figured that this severe tailbone pain was a result of being vit D def. so I swallowed a shotglass full. not literally but did take a few at a time...one day it was gone! Amen!!!

[Painintheass in reply to gg317]

Funny you mention vit d, I did give this a go but when I found out the body adsorbs around a bottle of the stuff in 15 mins or sun exposure I stopped buying it. Will have to give it another try though as anything is worth a try ATM. Thank you for the advice 🙂

[Mary-intussuception in reply to Painintheass]

It might be best to ask GP for a blood test to check Vitamin D levels first. Possibly other nutrients levels. When deficiency is found the treatment is dependant upon the severity. So, for example, severe Vitamin D deficiency is treated with initial Loading Doses of either 280,000 or 300,000 IU, taken in split daily doses over a period of several weeks. Then a daily maintenance dose is prescribed. You could look this up on NICE guidelines - Treatment of Vitamin D deficiency. Could also check symptoms of deficiencies of Vitamin D on NHS choices. Same with other nutrients.

Vitamin D is fat soluble and therefore stored. Caution would be needed if taking high doses regularly without knowing whether or not needed.

[tonyfiorese]

also been on Gabapentin 300 mg 3x a day but have now added .50 mg of Nabilone 3x a day I have very inflamed nerve pain, sciatic, calf, ankle, hip and groin area 24/7, and I'm now in a wheelchair because of muscle waisting so I can only lie on my back or sit, no quality of life anymore I'm only 52 and have been suffering for the last 5 yrs

CBD oil with some THC may also help u. I get too anxious and paranoid on it. Any Pain Clinics in your area? They can do glucose injections in the effected area, have not helped me, but maybe work for u.

[Painintheass in reply to tonyfiorese]

I did give cannabis a go once but like you it make me seriously paranoid and I got the munchies so bad, but I was smoking it and not using an oil. I live in the UK so hard to come by the oil in my experience. Sorry to hear about your circumstance, I hope you find a solution soon and thank you for the advice.

[mle121]

Hello, I can completely empathise with you on this as I have nearly the same. 2 years I started to have severe pain in right buttock over the sit bone, which I diagnosed myself as having ischeal bursitis. To help relieve the pain I bought many different cushions with cut outs but what worked best was a rolled up towel made into a horse shoe shape which I would put on a chair so when sat down painful area not in contact with chair. Unfortunately for me the pain then started to spread all down the back of my right leg. I can't tolerate anything touching my leg so only some very soft clothes I can wear and like you sitting is excruciating. I have been under pain management since and they think pain referring from back, had various treatments, epidural worked best for me, also on pregablin and noratriptyline. Pain is better than it was but sitting is a no no and now I've been told I need to accept my pain. Trying to live a life without sitting is miserable as unable to do so much stuff that I used to take for granted (meals out, cinema, travelling etc etc). Work have gotten me a stand up desk which is very helpful. I don't feel that people understand the impact this condition is having on me, the future looks so bleak. It will be very interesting to hear what your pain Dr says, when is your appt?

[bettyfl in reply to mle121]

I am sorry to hear you are going thru this too. Pain when sitting is excruciating fir me too. If you read my post in reply to paininass you can see some of my story. I had to quit my good paying job in Aug and am broke. Getting a divorce from a narcissistic man who had ruined my life. I think getting away from him eventually will help the pain. Stress makes pain worse. I am working on relaxing of mind and body with a special ot who does that. At almost 66 and having this the last 11 years yes I feel like my life is ruined. My faith is what gets me through and to keep going on. So hard some days I crawl in bed and stay there. On good hours I try to get something done. I wish you the best. Let me know if you have any other questions.

Blessings

[Painintheass in reply to mle121]

I can relate to life style change, used to love going to the cinema and eating our, which are both impossible now. With regards to your diagnosis I've read up on this and I'm currently doing most of which is described in the treatment of this and seeing good results so far. I'd advise the use of Zinc supplements, they help to heal by supporting testosterone, which is known to heal muscle. Gentle exercise for that area like stair climbing is good but only do this within pain fresh hold, it's known to take months to strengthen in this buttock area. After exercise it's best to stretch, then I apply ice and then heat afterwards. I also drink hot milk at night along with camomile to nod off.

I do all this every day, except the exercise, that's done every other day or once the area has healed. So far, the last week, it's been gradually working. I have always done exercise but have only recently been doing it whereby I am not making the pain worse, which is why you have to be gentle and only do what you feel you can do without being in a lot of pain, takes a while to figure that out.

It's easy to give up on doing all those things and simply taking a bunch of pain meds but give it a go. I read the below article which states what can be done to help reduce the pain.

physio-pedia.com/Ischial_Bu...

But seeing others writing about their issue in here has given me the motivation to keep going and to find the problem rather than solely relying on doctors who don't actually know the pain as well as I do.

Thanks for all the support and I'll update this thread with anything new I find that helps.

[bettyfl]

Hi painintheass,

What you are experiencing is real. I am a 65 year old lady and have had this and some other pelvic pain issues, and yes men have pelvic floors too. I am in no way giving you medical advice but you may want to research pudendal neuralgia. Sounds like it could be a possibility. I have had trigger point injections, Botox and physical therapy on and in my rectum. This has been going on now for 11 years. Please find a good pelvic floor therapist so you can be evaluated. They work on men with this problem too not just women. Perhaps you can search for Dr that deals with it. Don't give up even tho you feel like it. I've had some pretty rough years and had to go to ER for pain. Get to a good pain management place too. I can write more so please let me know any questions you have.

Blessings

[shortandround]

Hi,

I’d google SI joint.. is this anywhere near the pain ? Can you annotate a picture from google so we can see where exactly the pain is.

Presumably your GP has checked your blood results for inflammatory markers etc ?

[Painintheass in reply to shortandround]

I'll try and get a diagram of where the pain is but yes they have ran multiple blood tests for in inflammatory but they always come back in the normal range.. this is why they are so mythed as to what is causing the issue. I understand that I had some blood flow issues in one of my legs (right leg) but the pain is equal on both sides...

Nothing really adds up so far but I have a gp appointment tomorrow so will ask them about bursitis and a few other things.

[Painintheass in reply to shortandround]

So i've added a google picture in the original post.

The two circles at the top of the butt region is where I get tightness while sitting, which goes when standing. However when standing those two top circles is where I get pain.

The two bottom circles are where the pain is when sitting down, this is also true for when laying but the pain is fair less when lying.

I also get pain in the SI join area when i lay on my side which will radiate down the leg.

The two lines in the photo above is where the pain will tend to go down after about an hour of sitting.

I will try to show this thread to my GP tomorrow as I believe it might help the investigating a lot better, tbh never thought of doing it in the past.

Let me know what you think of the above photo and what I've tried to explain though.

[shortandround]

Don’t forget pain can be referred - I wonder if it’s from the sacroiliac joint but also secondly whether a Dr would do an injection as a way of testing it.

[Painintheass in reply to shortandround]

My GP told me this morning that if my appointment with rheumatology does not show anything then they can refer me to a specialist in muscles and skeletole to see if there is any issues there. Basically they are using a trial and error method on me at this point, seen most specialist but they can never find anything, probably not seeing the right ones..

Either way I'll get there.

The GP have given me naproxen for inflammation, which I've start as of today, so shall see if this helps. If it does then I can at least tell them that and that will give them a better idea as to where to look.

[Blondie503]

This sounds like high hamstring tendinopathy also known as proximal hamstring tendinopathy. Sitting makes the pain worse and lying on it.

[saj01]

Is the pain around the 'sit bones'... if so it's ischial tuberoscity pain, caused by inflammation of the tops of the ham strings. I've had it for 18 months now. Had a MRI scan followed guided cortisone injections which worked for about 2-3 months, all that does is mask the pain. I then had physio- again didn't do much as the moment you start to exercise so the pain starts... it's a vicious circle.. Have tried the heat/ice remedy, anti inflammatory meds to no avail. There are some stretching exercises on the net and there is a therapy called Prolotherapy which is supposed to work, but it's very expensive and not available on NHS.

Apart from that I have a foam cushion pad which I sit on... for my computer chair and dining chairs even though they are padded as I can't sit down for too long. It has gradually got better, but don't be tempted to do squats, lunges etc as they are the worse things you can do... which might have caused it in the first place

Sorry that's the most I can tell you.

[Painintheass in reply to saj01]

Yeah I've been doing my research and I believe that's it the core issue but I have also discovered a lot of muscle tightness in pretty much every butt muscle there is, aches all over after exercise. But I'm on naproxen ATM which has helped with the pain I get on the sitting bones but I still have very tight hamstrings, seems to be impossible to stretch then. Plus if you stretch then too often for too long it makes the pain worse... So no matter what I do I'm in pain...

I'll try the cortisol injection next as I think that's the most probably route sonic can strengthen the hamstrings which should stop them getting tight and then hopefully get rid of this shitty pain in the butt !!

[AuntieH in reply to saj01]

Are you cured now?

[AuntieH]

Hi Painintheass, did the steroid injections work? I too have had this problem for 9 months. Not fun!

[saj01]

Strangely enough it did ease off enough to be able to do a few and gradually increase the reps, and seemed to be okay for ages. But more recently it's come back again... nowhere as bad, but when doing squats/ lunges it gets sore quite quickly.

I've racked my brains try to think about why it stopped before and why it's started again???

I may be way out on this, but I'm wondering if it's because I changed my exercise workout and started doing an easy yoga routine purely for stretching and flexibility first, and then did the muscle toning- starting with just a few reps and then building up ...

but more recently, I've not been doing the yoga stretching as a warm up... could it be as simple as that ?

Note to self... go back to the beginning and start again... and see what happens!!

[AuntieH in reply to saj01]

Do you think it could be the pudendal nerve? I have the same thing.

[saj01]

Hi... that's a new one on me, so had to look it up. To be honest, I really don't know. There sseems to be quite a few nerves arouund that area... assuming your pain is in the same place as mine. Mine's nearer the 'sit bones'. Where exactly is your pain?

[AuntieH in reply to saj01]

Mine is at the inner side of the left sitz bone and radiates up thru the butt crack if sitting too long.

[saj01]

That's exactly where mine is!... When I went to physio, the guy told me squats and lunges were the worse thing for it and not to do them.??? (great help). I've got one of those balance cushions on my chair when i'm in front of a p.c. and sewing on my machine. It gets really sore sometimes. I can't sit down on a hard surfacr for too long... think I need more padding... I am a bit boney.

[AuntieH in reply to saj01]

Can you pm me? Maybe we can exchange numbers and chat.

[AuntieH in reply to saj01]

What do you take for pain?

[Painintheass]

Just as an update on this, if anyone cares, I never did the steroid injection, my doctor at the time and others along the way state that I was too young for it and it could potentially make it worse when the pain went and I went back to the gym.

In short, my issue was hamstring and glute weakness, I did physio based on those weaknesses and after 4 months and now do them daily. The weakness leads to tightness so I had to strengthen and also stretch all the time.

I do take Amitriptyline for pain, 10mg a day at night, to help with pain and chronic sleep problems (which makes the pain worse). But nothing other than that.

I did learn that there are a lot of different issues that could lead to this pain, but generally, there isn't much research into muscular pain and it's all generally attacked with strength programs and stretching, but what's important, is finding someone who actually knows there shit.