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Having pain in buttocks, back and legs. Feeling nauseous. Difficulty in stretching. Cure?

Feb 2014
User rating for this question
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5930 Questions
Dear Doctor,

I'm writing to you on behalf of my female friend. She's suffering from pain coming from her hip/buttock and back. It all started three months ago when she took a normal 40 min walk. When she got home she started experiencing pain in her right hip. The pain could be described as burning and the hip felt very stiff. She says that it feels like the pain is either coming from the muscles in the hip/buttock or the joint.

One week later, she was walking down some stairs and after that, she started experiencing problems with her back. The back pain feels like nerve pain. After this, her hip got so stiff that it actually feels like one leg i shorter than the other when she walks. The pain feels very intensed in two places in the buttock/hip (please see the attached picture with the red dots) but it also feels like it burns over the whole hip and leg.

The right hip feels a little bit better in the morning when she wakes up and then gradually gets worse during the day. The back is bad during the morning but gets a little bit better during the day when she walks around.

She tried to stretch the hip and buttock but that only made the pain worse. Right leg feels week. She feels nauseous from time to time.

Because of these problems she has started taking:

Paracetamol 2x500mg/day
Ibuprofen 1x400mg/day

That didnt really help at all.

Please give us your oppinion on this. What could be the cause of the pain in the hip/buttock and how could it be treated?
Thu, 13 Jun 2013 in Bones, Muscles and Joints
Answered by Dr. Saurabh Gupta 1 hour later
Thanks for posting your query.

Cause of burning pain in her buttock seems to be due to pyriformis syndrome. It occurs when the pyriformis muscle, which is present at the top of buttock/hip presses the sciatic nerve which goes down the back of leg.

I suggest her to consult an orthopaedician for clinical evaluation and if required then MRI to rule out other cause of sciatic nerve compression such as disc herniation at back.

I also suggest her-

Try to avoid position that triggers pain.
Apply heat therapy to relax the muscle.
Do pyriformis stretching and strengthening exercises under supervision of physcial therapist or doctor.
Take antiinflammatory drug and muscle relaxants after prescription of doctor.

Hope this will helps you. Let me know if you have any more concern.

Wishing her speedy recovery.

Warm regards
Dr Saurabh Gupta
Orthopaedic Surgeon.
Above answer was peer-reviewed by
Follow-up: Having pain in buttocks, back and legs. Feeling nauseous. Difficulty in stretching. Cure? 2 days later

Thank you for the answer.

Stretching only made the pain worse, should we continue anyway with stretching and hope it helps in the long run?

Weve tried antiinflammatory drugs such as ibuprofen but also stronger drugs such as Etoricoxib and none of them seem to help. Muscle relaxants seem a bit XXXXXXX to start with.

What is in your oppinion the best treatment for pyriformis syndrome? Do you know of any alternative treatment for this such as for instance using a TENS machine or other alternatives?
Answered by Dr. Saurabh Gupta 15 hours later
Thanks for writing again.

If stretching hurts more, stop doing it at present. Muscle relaxants if taken under supervision of doctor are not XXXXXXX to start with.

Physical therapy is best option for pyriformis syndrome.
Transcutaneous electrical nerve stimulation (TENS) is good for pyriformis syndrome and it is part of physical therapy.

Hope this will helps you.

Best wishes

Warm regards
Dr Saurabh Gupta
Above answer was peer-reviewed by
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