Is buttock pain relieved by walking related to Takayasu (Takayasu arteritis), piriformis syndrome, sacroiliac joint dysfunction, or lumbar spinal stenosis?

From the Guidelines

Buttock pain that improves with walking is most likely related to lumbar spinal stenosis, and the best course of action is to focus on flexion-based exercises that open the spinal canal, such as stationary biking or walking with slight forward lean, as recommended by the American College of Physicians and the American Pain Society 1.

Conditions to Consider

• Takayasu arteritis: immunosuppressants like prednisone (starting at 40-60mg daily) and methotrexate (15-25mg weekly) as a steroid-sparing agent
• Piriformis syndrome: piriformis stretches, NSAIDs like ibuprofen (400-600mg three times daily), and physical therapy focusing on hip mobility
• Sacroiliac joint dysfunction: core strengthening exercises, NSAIDs, and possibly corticosteroid injections if conservative measures fail
• Lumbar spinal stenosis: flexion-based exercises that open the spinal canal, such as stationary biking or walking with slight forward lean

Key Points to Keep in Mind

• The fact that walking relieves pain suggests possible vascular claudication (as in Takayasu's) or positional relief (as in stenosis)
• Heat therapy (15-20 minutes several times daily) may help muscle-related causes like piriformis syndrome
• Maintaining good posture, regular gentle movement, and avoiding prolonged sitting can prevent symptom worsening
• If pain persists beyond 2-3 weeks despite these measures, consult a healthcare provider for proper diagnosis and treatment, as recommended by the American College of Physicians and the American Pain Society 1

Recent Guidelines

• The American College of Radiology recommends considering lumbosacral plexopathy, including entrapment, inflammatory, autoimmune, hereditary, ischemic, and idiopathic etiologies, in the differential diagnosis of buttock pain 1
• The American College of Physicians and the American Pain Society recommend providing patients with evidence-based information on low back pain, advising patients to remain active, and providing information about effective self-care options 1

From the Research

Buttock Pain Relief by Walking

Buttock pain relieved by walking can be related to several conditions, including:

• Piriformis syndrome: a condition where the piriformis muscle compresses the sciatic nerve, causing pain in the buttock and leg 2, 3, 4, 5, 6
• Sacroiliac joint dysfunction: a condition where the sacroiliac joint is inflamed or irritated, causing pain in the buttock and leg 4
• Lumbar spinal stenosis: a condition where the spinal canal in the lower back is narrowed, causing pain in the buttock and leg 6

Conditions Not Directly Related to Buttock Pain Relief by Walking

There is no direct evidence to suggest that buttock pain relieved by walking is related to:

• Takayasu arteritis: a condition where the blood vessels become inflamed, causing pain and other symptoms 2, 3, 4, 5, 6 (no mention of Takayasu arteritis in the provided studies)

Key Findings

• Piriformis syndrome is a common cause of buttock and leg pain, and can be diagnosed through clinical evaluation, imaging studies, and targeted treatments 2, 3, 4, 5, 6
• The piriformis muscle cross-sectional area (PMCSA) is a key diagnostic parameter for piriformis syndrome, and can be measured using hip MRI 5
• Piriformis syndrome should be considered as a possible diagnosis when sciatica occurs without a clear spine pathology 6