The tailbone hurts when you sit and stand up: causes, symptoms and treatment

Pain in the buttock often appears as a result of pinching of the sciatic nerve by the piriformis muscle - a group of muscle fibers that begin in the sacrum area inside the pelvis and are attached by the lower tendon end to the femur. This muscle is responsible for external rotation of the hip and foot. Piriformis syndrome often accompanies degenerative changes in the discs of the lumbosacral region with the formation of a picture of radiculitis.

Doctors at the Osteomed Clinic in St. Petersburg almost daily observe manifestations of piriformis muscle syndrome, since lumbar osteochondrosis is the most common spinal problem in patients, regardless of their gender or age. And although pain in the buttock itself is not dangerous, it signals other disorders that need immediate correction. Experienced specialists conduct examinations and advise patients on this matter after making an appointment in advance.

Why does the tailbone hurt?

To understand why the tailbone begins to hurt when you sit and stand up, it is worth considering its function in the body. This is a rudimentary part of the spinal column, consisting of 3–6 vertebrae, to which muscles and ligaments from the pelvic organs are attached. Therefore, the coccygeal part of the spine is closely connected with these organs and reacts to any of their pathological conditions. The tailbone performs an important function - it partially distributes the load on the body and at the same time is its vulnerable part. If your tailbone hurts when you sit and stand up, a common cause is damage due to injury or disease.

Numbness of the buttocks due to lumbar hernia

Very often, numbness in the buttock is caused by a herniated disc in the lumbar spine. This is a complication of long-term untreated osteochondrosis. This degenerative disease of cartilage tissue gradually leads to the fact that the fibrous ring loses its elasticity and ability to receive fluid during diffuse exchange with surrounding muscles and endplates.

As a result, the fibrous ring becomes fragile and cannot withstand the shock-absorbing loads placed on it. It begins to take fluid from the nucleus pulposus located inside it. A protrusion is formed - a stage of osteochondrosis, in which the height of the disc decreases and the occupied area increases.

Under extreme stress, the annulus fibrosus ruptures. Through the resulting through crack, part of the nucleus pulposus emerges. This is a lumbar hernia. It can also be lumbosacral if it is located in the L5-S1 disc area,

Lower back numbness of the buttocks is provoked by the fact that the intervertebral hernia puts pressure on the radicular nerves and the nerve plexus. Thus, innervation is disrupted. In some cases, when a hernia prolapses, tension in the surrounding muscles occurs. They compress blood vessels and nerves. The innervation of certain parts of the body, including the gluteal region, is also disrupted.

Classification of pain sensations

Doctors divide pain into two types, which are determined by the location of its source:

For coccydynia

If the coccyx hurts, it hurts a person to sit and stand up; the cause of the discomfort may be the coccyx bone itself. Pain syndrome in this case appears for the following reasons:

joint problems;
accumulation of salts;
neuralgia.

Coccydynia requires modern diagnostic methods to accurately confirm the causes of pain.

Referred pain

These include pain syndrome, the cause of which is not the tailbone itself. In this case, the tailbone hurts when you sit and stand up, due to the reaction of the spine to problems in the organs associated with it:

Spinal diseases: osteochondrosis, displacement of intervertebral discs, etc. The spinal column is a single whole, so pain in any part of it can radiate to the tailbone when you sit and stand up.
Diseases of the rectum: in this case, the pain is called anorectal. Hemorrhoids, proctitis and other damage to the rectum in any part of it are accompanied by pain in the tailbone when sitting and straining.
Diseases of the genitourinary system: the coccyx is connected to them by nerve bundles, so it hurts when sitting and bending, accompanied by aching pain in the pelvic area. Such pain is typical for prostatitis, endometritis, cystitis and other common diseases of the pelvic organs.
Pregnancy: in this case, the tailbone hurts when you sit and stand up, in the last months of pregnancy due to the increased load and the natural deviation back under the pressure of the uterus.
The period after childbirth: the tailbone may tilt back during childbirth, which causes pain. If we are talking about referred pain in the coccyx, no less careful diagnosis is required than with coccydynia.

Causes of piriformis syndrome

Pain in the buttock occurs with sciatica - irritation of the sciatic nerve, which is most often observed with lumbosacral osteochondrosis and its consequences - disc protrusion, disc herniation or proliferation of osteophytes in the vertebral bodies, as well as with spondylosis and spondylolisthesis. Sudden pain causes a reflex spasm of the piriformis muscle, namely, in its thickness or under it passes the sciatic nerve, which is formed by the fibers of the spinal nerves emanating from the spinal canal.

Thus, pain in the buttock can have two sources - compression of the roots of the spinal nerves at the spine and compression of the trunk of the sciatic nerve by the piriformis muscle. Other causes of piriformis syndrome include:

Injury to the piriformis muscle - when falling on the buttocks, it is bruised, a hematoma is formed, a painful spasm - all this contributes to irritation of the sciatic nerve in its thickness;
Consequences of injury - the damage heals, but the muscle fibers in the area of the bruise are replaced by a connective tissue scar, which compresses the sciatic nerve - and a pain syndrome is formed again;
Inflammation - myositis of the piriformis muscle - can also cause pain in the buttock;
Neoplasms, bone tuberculosis, osteomyelitis, arthritis or arthrosis of the hip joint can cause reactive inflammation of the piriformis muscle and pain.

The pain is often unilateral, but sometimes both sides are affected. At the same time, it is quite pronounced, radiating to the back of the thigh, lower leg and foot. Skin sensitivity disorders on the leg are usually not detected; sometimes there may be a slight tingling sensation. But the patient tries to take care of his leg; it is uncomfortable for him to sit on the sore side - as a rule, the person holds his leg in an elevated position and is not able to sit straight.

Possible causes of pain in the tailbone

Pain characteristic of the coccygeal area when changing or taking a certain position has a very broad classification according to symptoms and causes. The patient should pay attention to exactly when pain in the tailbone appears and tell the neurologist

When getting up

Often the tailbone does not hurt when you sit, but when you stand up, it can make itself felt with lumbago, sharp or stabbing pain, as well as constant aching. Common causes of this reaction include the following conditions:

Consequences of surgical interventions on the pelvis: sutures, scars and adhesions can hurt. This is the most common cause of this symptom.
Pathologies of the upper spine: for example, with osteochondrosis or another similar disease, it often radiates to the tailbone when standing up.
Pelvic organ prolapse: observed as a postpartum process in some cases.
Injuries: due to a fall or blow to the tailbone area, cracks and soft tissue damage may occur.

When standing up, the tailbone hurts due to the change in load and the impact on the nerve associated with the problem organ or area.

When sitting

If your tailbone hurts when you sit or lie down, the reasons can be both serious and easily removable:

Trauma: sudden onset pain often indicates an old, many-year-old injury that the patient was unaware of - it makes itself felt after the formation of scars and other processes.
Previous operations: can cause changes in the intestines that lead to this unpleasant symptom.
The habit of sitting on a soft surface: it happens that the tailbone hurts when you sit, and goes away when you get up, if a person who is accustomed to a soft surface sat on a hard chair.
Sedentary lifestyle: when you sit for a long time, the tailbone often hurts from the load, which is why it is worth doing warm-ups periodically. This applies not only to office workers, but also to drivers, cyclists, and horseback riding enthusiasts.
Uncomfortable furniture: Furniture that does not fit the person or is of poor quality can cause this symptom.

In some cases, the patient is able to help the doctor make a diagnosis faster. Therefore, if your tailbone hurts when you sit or stand up, it is worth remembering the injuries you have suffered, surgical interventions and other points that could have caused the pain.

Causes of numbness in the buttocks

In order to understand what reasons can cause a feeling of numbness in the buttock area, you need to have an idea of the anatomy of this part of the body. To begin with, there are several large muscles running through the buttock area. One of them is pear-shaped. It is responsible for conducting the sciatic nerve from its exit from the lumbosacral plexus to the hip joint. There are also three gluteal muscles (minimum, major and medius), one of which is responsible for upright posture. In addition, there are the coccygeus, iliopsoas, and psoas minor muscles. All of them are responsible for performing one or another function. Innervated partly by fibers of the cauda equina, partly by the femoral nerve and the pudendal nerve.

The gluteal region is located next to the hip and iliosacral joints. These bone joints provide movable attachment of the lower limbs to the spinal column. They bear a large shock-absorbing load when walking, running and just standing. Therefore, unpleasant sensations are often associated with damage to the cartilage tissue inside these joints.

The innervation of the gluteal region begins in the spinal cord. The segment responsible for this is connected to the tissues using the radicular nerves. They arise from the spinal cord through the lateral foraminal openings in the vertebral bodies. They then branch and enter the lumbosacral nerve plexus. From it emerge large nerves responsible for the innervation of the buttock and lower limb. There is also a thermal filament of the spinal cord, which exits the spinal canal in the area of the coccyx. Together with the sacral radicular nerves, it forms the cauda equina nerve plexus.

Any damage to these structures provokes the appearance of neurological symptoms, such as numbness in the buttock area. Therefore, the following conditions and diseases may be potential causes of an unpleasant sensation:

lumbosacral osteochondrosis (degenerative dystrophic destruction of the cartilage tissue of the intervertebral discs);
protrusion, extrusion and prolapse of the intervertebral ridge, including its sequestration;
inflammation of the radicular nerve (radiculitis) against the background of its compression due to osteochondrosis and other pathologies;
displacement of vertebral bodies and cartilaginous discs due to instability of position;
destruction and deformation of intervertebral joints (spondyloarthrosis);
deforming osteoarthritis of the iliosacral and hip joints;
stretching and microscopic tears of ligament and tendon tissue in the lumbosacral spine;
stenosis of the spinal canal, including those caused by displacement of the vertebral bodies, compression of the dural sac, prolapse of the intervertebral hernia, etc.;
traumatic violation of the integrity of the bone tissue of the vertebral bodies and their processes (fractures and cracks, including against the background of osteomalacia and osteoporosis);
piriformis or cauda equina syndrome;
tumors and infections of the spinal cord and surrounding tissues.

A feeling of numbness in the buttock area can be caused by an unprofessionally administered intramuscular injection. Often this complication remains after an abscess of the gluteal muscle. Sensory impairment is also noted after hip replacement surgery.

There are risk factors, the presence of which together increases the likelihood of developing pathologies accompanied by the appearance of a similar symptom. These include the following aspects:

maintaining a sedentary lifestyle with predominantly sedentary work;
the presence of excess weight, which complicates metabolic processes in the body and entails numerous metabolic failures;
heavy physical labor associated with excessive functional loads on the lumbar spine and lower limbs;
incorrect organization of sleeping and working space from an ergonomic point of view;
numerous injections into the hip joint and iliosacral joint, including pain blockades;
wearing the wrong shoes;
incorrect placement of the foot in the form of flat feet and club feet;
curvature of the spine and poor posture;
domestic, industrial and sports injuries;
toxic effects on the body, including those caused by smoking, alcohol consumption, substance abuse, drug addiction, and the use of medications without a doctor’s prescription.

Before starting treatment, the doctor must make an accurate diagnosis and give the patient recommendations that will help reduce or eliminate the impact of adverse factors. It is important to promptly find the causes of numbness in the buttocks and eliminate them. Otherwise, there is a high probability of nerve fiber atrophy. At the same time, it will be very difficult to restore sensitivity in the future.

Diagnostic and treatment methods

If your tailbone hurts when you sit and stand up, a comprehensive examination is necessary. The following are used today as effective diagnostic methods:

X-ray
: allows you to identify pathologies and injuries of the coccygeal bone;
ultrasound examination: necessary to identify pathologies of organs and soft tissues of the pelvis;
examination of the intestines using endoscopic and non-endoscopic techniques: this is an effective way to confirm the diagnosis with a proctologist;
tomography: necessary for a detailed examination of already identified pathologies.

A patient with this symptom requires consultation with a number of specialists: proctologist, surgeon, neurologist, gynecologist
or
urologist
. How to treat the tailbone, which hurts when you stand up and sit, the doctor decides based on the diagnosis. The patient may be prescribed the following treatment methods:

Medication: in this case, painkillers and anti-inflammatory drugs are prescribed to relieve swelling and spasms.
Physiotherapy: gentle pressure on the muscles improves blood supply to the coccygeal area and speeds up recovery.
Massage: aimed at improving blood circulation, suitable for chronic pain.
Exercise therapy: helps not only to improve the patient’s condition, but also to prevent relapse of the disease.
Surgery: performed only in extreme cases, when other treatment methods have not brought the expected result over a long period of time.

It is worth knowing that if the tailbone hurts when you sit and stand up, especially severely, and the disease is in the acute phase, some treatment methods are contraindicated. Therefore, using them without the knowledge and consent of a doctor is strictly not recommended.

Treatment

Treatment of pain and numbness in the gluteal muscles directly depends on the cause of the unpleasant symptom. It is recommended to undergo a full examination first. The doctor will definitely find out why the muscles are numb and prescribe effective treatment. The most common methods include:

Conducting a course of physiotherapy;
Taking medications to help relieve pain and inflammation;
Using warming lotions and compresses;
Abscesses and ulcers can be treated by applying special ointments or removed surgically.

Prevention

To avoid numbness in your buttocks, try to move more and take daily walks. The joints of an overweight person experience constant heavy loads. This leads to their rapid wear. If your health is important to you, reconsider your diet.

If you do not pay attention to such an alarming symptom as numbness of the buttocks, the disease will begin to progress. Lack of timely treatment is a direct path to chronic pain and disability.