Differential Diagnosis for Buttock Pain
Single Most Likely Diagnosis
- Piriformis syndrome: This condition is characterized by compression of the sciatic nerve by the piriformis muscle, leading to buttock pain that is relieved by standing and walking, as these activities help to stretch the piriformis muscle, but is aggravated by lying down, which can cause the muscle to compress the nerve further.
Other Likely Diagnoses
- Sciatica: This condition involves irritation of the sciatic nerve, which can cause buttock pain that may be relieved by standing and walking, but worsened by lying down, especially if the nerve is irritated by a herniated disk or other spinal abnormalities.
- Trochanteric bursitis: Inflammation of the bursa over the trochanteric area of the hip can cause buttock pain that may be relieved by standing and walking, but can be exacerbated by lying down, particularly on the affected side.
- Gluteal strain: A strain of the gluteal muscles can cause buttock pain that may be relieved by standing and walking, but can be worsened by lying down, especially if the strain is severe.
Do Not Miss Diagnoses
- Cauda equina syndrome: This is a serious condition that occurs when the nerves in the spinal canal are compressed, leading to severe buttock and leg pain, as well as other symptoms such as numbness, weakness, and bladder or bowel dysfunction. It is essential to consider this diagnosis, as prompt treatment is necessary to prevent long-term damage.
- Spinal infection or abscess: Infections such as osteomyelitis or discitis can cause buttock pain that may be relieved by standing and walking, but can be worsened by lying down. These conditions require prompt diagnosis and treatment to prevent serious complications.
- Tumor: A tumor in the spine or pelvis can cause buttock pain that may be relieved by standing and walking, but can be worsened by lying down. It is essential to consider this diagnosis, as prompt treatment is necessary to prevent further complications.
Rare Diagnoses
- Ischiogluteal bursitis: Inflammation of the bursa between the ischial tuberosity and the gluteus maximus muscle can cause buttock pain that may be relieved by standing and walking, but can be exacerbated by lying down.
- Hamstring strain: A strain of the hamstring muscles can cause buttock pain that may be relieved by standing and walking, but can be worsened by lying down, especially if the strain is severe.
- Osteitis pubis: Inflammation of the pubic bone and surrounding structures can cause buttock pain that may be relieved by standing and walking, but can be worsened by lying down.