This is a real life case study from our clinic, involving a patient who for many years had experienced buttock pain when sitting for more than 45 minutes at a time. Buttock pain that occurs when sitting inevitably affects normal day-to-day activities such as work, travel, leisure, relaxation etc., and can have quite a negative impact on a person’s quality of life. Buttock pain is quite common but the good news is that it can be successfully treated with physiotherapy, as this case study demonstrates.
Introducing the patient
This 52 year old female patient had an anguished story to tell about her inability to sit down comfortably at work, or while relaxing for longer than 45 minutes, due to buttock pain. Much to her frustration, this woman had endured many years of discomfort when sitting and could not solve the issue with any posture work, chair modification or muscle exercise. She presented to Mid West Physiotherapy for help.
This lady was fit, healthy and worked at a desk much of the day, albeit in quite some pain. 9 years ago she had surgery on her lower back to address a disc issue which had been causing her severe pain. Following the surgery, she developed buttock pain when sitting for relatively short time. She figured that as she was much better than the original back pain of old she would put up with the issue. Nobody had explained to her what might be causing the pain, or if there was a way through it. It had interfered with her life so much that she had resigned all hope of being able to sit down for long to relax, ever.
The pain that was getting on her nerves, WAS her nerves
On examination with our physiotherapist, it was found that the raw materials of proper movement were for the most part working well in her spine and in her hips. Even though her MRI revealed wear and tear in her back, a less than perfect disc and some joint space narrowing, it was felt that structure in her joints and muscles was quite good. They moved, and moved in an ok fashion.
That is when we looked at them in isolation. So, each part in isolation – much like the MRI – did not show any significant signs to explain her problem. However, when we looked at her system from top to toe as a whole, we found that her stiffness as a whole was greater than the sum of the parts, particularly in relation to her nervous system and spinal tract. When we asked her nervous system, her spinal cord, nerve roots and branched nerves to move, the response highlighted the root cause of her problem; her nervous system tract was highly sensitive to being on any stretch, and it responded with pain in her buttock – a critical point when sitting, you might suspect.
We performed objective tests to get a measure of this problem and taught her how to desensitise this long tract on a daily basis with a home exercise nerve technique. We didn’t need to do anything to her joints or muscles as they were not implicated in her problem. She learned how to move all aspects of her nervous system – even those parts away from her pain – so that the sum of all the parts could begin to move again with more ease. After less than 4 weeks of treatment, this woman was able to sit for up to 2 hours without pain, for the first time in nearly a decade. On review a month later, she had maintained her improvements and was keeping up a home exercise routine for a few short minutes on a daily basis.
“The pain is gone and my quality of life has improved so much: I can go to the cinema again!”
If you have a pain or dysfunction in any part of your body, it helps to visit a Chartered Physiotherapist with a good knowledge of the whole interplay between joints, muscles and nerves in order to get a clear picture of what could be the root cause of your problem. It just might improve your quality of life.
To get buttock pain assessed
You don’t have to put up with buttock pain; help is just a click away. Click here to book an assessment with one of our expert Chartered Physiotherapists, or if you would prefer to speak with us in person first you can contact us on 061-201444 or email info@midwestphysio.ie.
