What causes lower back pain in the buttocks area?

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Differential Diagnosis for Sore Lower Spine and Butt

  • Single most likely diagnosis
    • Musculoskeletal strain: This is the most likely diagnosis due to the common occurrence of strain in the lower back and buttock area, often caused by overuse, poor posture, or sudden injury.
  • Other Likely diagnoses
    • Piriformis syndrome: This condition occurs when the piriformis muscle, located in the buttock region, irritates or compresses the sciatic nerve, leading to pain in the lower spine and buttock.
    • Sciatica: Sciatica is a common condition characterized by pain radiating along the path of the sciatic nerve, which runs from the lower back down to the legs, often caused by a herniated disk or bone spur.
    • Coccydynia: This condition refers to pain in the tailbone area, which can be caused by a fall, injury, or repetitive strain, and may radiate to the lower spine and buttock.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Cauda equina syndrome: A rare but serious condition that occurs when the nerves in the spinal canal are compressed, leading to severe pain, numbness, and weakness in the lower back and legs.
    • Spinal infection (e.g., osteomyelitis, discitis): Infections in the spine can cause severe pain, fever, and other systemic symptoms, and require prompt medical attention to prevent serious complications.
    • Fracture: A fracture in the lower spine or pelvis can cause severe pain and may be a sign of osteoporosis or other underlying conditions.
  • Rare diagnoses
    • Sacroiliitis: Inflammation of the sacroiliac joint, which can be caused by various conditions, including inflammatory arthritis, infection, or trauma.
    • Ischiogluteal bursitis: Inflammation of the bursa located between the ischial tuberosity and the gluteus maximus muscle, which can cause pain in the buttock and lower spine.
    • Tarlov cyst: A rare condition characterized by the formation of cysts in the nerve roots of the spine, which can cause pain, numbness, and weakness in the lower back and legs.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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