Pelvic Pain Support Network
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Butt pain and spasms. Piriformis/pelvic

For two years now I've been getting constant dull ache in my glutes or in that general region. It came on one day when I number 2'd and my "poopin muscles" spasmed hard causing me to feel like I was dying. Ever since I've had a dull ache and spasm in that area in my gluteal area moving down into the out portion of my legs. Also my left hip is extremely tight. I think its my hip.

I've been told pelvic disorder as I've experienced burning penis as well but PT is yielding minimal results. I'm actually thinking piriformis syndrome but I'm not sure.

Can anyone help? I'm at my wits end. Living like this is not quality

8 Replies

I would guess that your levator ani (pelvic floor) muscles are tight or have trigger points, and they may be impinging on one or more nerves in the area such as the pudendal or femoral nerve. Your PT should be doing internal muscle release through the rectum. Sometimes it takes trying more than one pelvic PT before you find one who works out well.

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so I've tried this but with minimal benefit. all MRIs are negative on my back and pelvis.

with the minimal benefit to the pelvic pt, Im wondering if its more of a piriformis thing


Im sure the pelvic therapist also checked and treated the piriformis, if needed. She should have been able to tell you what the problem is. If not, you need to see a different one.


There are still mysterys unfortunately. She said the pelvic muscles were right. Bi had a massage therapist say my muscles waist down were all tight. Piriformis and some other butt muslce (obli something) wa suspect tight ...

I'm tight. Lol


I think it could be several things i.e. Piriformis Syndrome, pudendal neuralgia or possibly a hip condition. Your GP can refer you to a hip specialist. Your GP can also refer you to a pain management specialist who will take your history i.e. if you remember any fall or incident that happened to cause these symptoms. Usually then arrange for you to have cortisone and lignocaine injections under CT guidence into the piriformis muscle and in the area of the pudendal nerve.

You will have to wait to see if your problem is due to the hip and if the pain management treatment helped or not and take it from there. All the best.


I have had similar problems. I have had two bilateral Pudental nerve blocks, been seen by PT for trigger point release, had two MRIs which showed no problem, been to chiropractor, etc.

I am now seeing a pain management specialist who says I show some of the symptoms of Pudental neuralgia. I don't have any problem with hip but do experience low back pain. I have been on Gabapentin, Valium suppositories and Baclofen. None of these helped. Only drug which has helped with burning, spasms and tightness is Lyrica. Since you have a hip problem I think it's possibly the perifotmus muscle. I have heard there has been success with Botox injections. I have accepted the fact there is not a cure and only management of symptoms. Good luck. Rocky68


Try regular stretching of the Piriformis muscle and don't give up. Allow for a month or two to see if the physio and stretching helps.

Other than that you could also try applying heat to the area when you are resting at night.


Thank you. Stretching is the only thing that's helps manage it


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