Butt Pain and Sciatica: How Do I Tell if This Pain is Sciatica?

Transcript Below Of: Butt Pain and Sciatica: How Do I Know if This Pain is Sciatica?

Alright everybody! Welcome to this month’s question of the month. As you know I answer a question submitted by somebody who has dropped onto the website and has a question for me to answer. Of course, your very personal questions that are really long, I have a hard time answering those and sometimes they seem like emergencies, so I don’t mess with those.

But, this one is from Mort.

The Question:

“Hi David,
My name is Mort and I am writing from Saudi Arabia. My question to you is related to butt pain and sciatica. [David’s note: In this case maybe it is butt pain and not sit bone pain.] I have been experiencing butt pain (left butt) since over a year now. The pain is kind of seasonal, comes and goes away completely and then again comes back the moment I start bodybuilding.

At first I thought it was sciatica related pain that is radiating from my lower back to butt, but as I did more research, I found out that sciatica normally radiates through the entire leg not only the butt, which tells me mine is not sciatica-related because the pain is ONLY in the left butt. [David’s note: Just pause the question there for a moment. Self-diagnosis is always dubious. You might be right. You might be wrong. When I read the rest of it, I’m going to agree with you. That is, not seeing you, meeting you, and not being able to diagnose anybody…anyway…] Sometimes the pain stays for a week sometimes two, but now it has been over a month and the pain hasn’t gotten better.

For example, when I stand still or walk, I hardly feel any pain, if at all. But the moment I sit on a chair or car, it starts aching and makes it more painful to stand up for at least 2 minutes until it goes away as long as I am standing still. The pain also is very little if I lay especially if the left butt isn’t touching the mattress in bed.

I am not really sure what caused this pain over a year ago but my best guess is bodybuilding. [David’s note: I’ll trust your intuition on that one! It’s a very specific intuition it seems.] I remember doing 12 sets of squats with 130 lbs without any warm up. [David’s note: Mort, I’m not sure why you would do that, but you probably haven’t done it again!] When I do even light weight dead-lifts, the next day the butt pain comes back. So I am not really sure what caused this problem from the beginning, but most likely from squatting.”

The Answer:

Alright, so, as I read these questions, you know, I often try to sift through the stories that are built up around it. Maybe the bodybuilding has something to do with it. Maybe it’s sciatica, maybe it’s not. I really don’t know, but the parts that kind of stand out to me are, and this is what I usually go after when I talk to people, who are dealing with stuff, whether it’s butt pain or some other type of pain, is typically what it feels like, what seems to make it worse or what seems to make it better. And, to me, those are the best clues into figuring things like this out.

So, in this case, squats, glutes, sitting, glutes, doing dead-lifts, glutes. My best guess, is what’s going on for you… Oh, the other part, sorry. One more piece that’s important here is basically what you’re describing here is, as you move around your body warms up and as a result of that, the pain kind of diminishes. You cool off, you sit down, things start to relax and the pain comes back. My best guess is you have a trigger point in your gluteus medius. That’s my best guess, once again, not seeing you, not being able to touch, palpate, do anything. Maybe I’ll drop an image at the bottom of this page, that is, on my website, not necessarily on YouTube, I don’t think I can drop images there.

Read more on trigger points in this article: What are Trigger Points?

That muscle is going to be in a contracted position when you sit for periods of time. It would totally be active when squatting, doing dead-lifts, all that kind of stuff. I’m not sure about when you lay down and your butt is touching the ground, but either way, it seems like everything is pointing toward the gluteals and I don’t mean gluteus maximus, I mean gluteus medius. So that would be the first step, the first place to check. If that doesn’t pan out, then you need to look into other things, like possibly, maybe it is sciatica. It doesn’t sound like it to me, but it could be.

Alright, I hope I’ve pointed you in a good direction Mort. And if anybody else has a question, once again go to https://www.yoganatomy.com/myquestion and I’ll answer a question for you.