Buttock, outer thigh pain

[Dave79]

I am a 40 year old male that went from trying to stay fit by either working out in my home gym or travelling for work and working out in hotel/private gyms for a few years. Then, my wife and I started having babies and I stopped travelling (management/desk job) and very little working out.

I have some pain in the upper right side of my buttocks. Also, pain (sore to the touch) in the entire outside of my rt thigh. That pain starts around the tuberosity of the femur and goes down to just above the knee. I thought that pain was a sore IT band but my doctor keeps telling me that if I had an IT band issue then the pain would be at the outer knee joint. I did have an MRI of the lumbar area which shows a bulging disc at L5. Xrays of the area were negative. Recently, an MRI was done on the pelvis which showed mild tendonitis of the rt hamstring but did not show any issue with the IT band (I don't think the MRI captured that area). No signs of bursitis or arthritis with that MRI either. I do not have ANY pain in my low back. I do not have any tingling, numbness.

I have tried many stretches of the low back...hamstrings are so tight I have my 5 year old pushing lightly on my back to stretch further. I have been trying the IT band stretch where my legs are crossed while bending over. That has showed some relief for a short while.

I have tried all kinds of oral NSAIDS, including specifics for arthritis but no relief. I did have 2 steroid injections in my lower spine without major relief. I recently started using Voltaren topical cream on my outer thigh with great success however the pain returns.

I drive a company vehicle (Pickup truck) and the spot on the seat where the seat cushion bends upward around my outer buttocks and outer thigh is so uncomfortable on the right side. I have tried gel seat cushions for folks in wheel chairs, small pillows or even a cushion from a dining room chair - again no major relief.

My doctor first believed that my problems were directly caused by the bulging disc. But when I explained to him the pain in the outer thigh, he became unsure. Obviously, that has left me unsure. I am just puzzled by the outer thigh pain and how sore it is just by running my finger down the out edge of my thigh. I am not convinced that my bulging disc is causing my pain.

Any thoughts are greatly appreciated.

[Heidi]

Hi
The disc may or may not be contributing to the pain. It may be that where the disc is protruding onto the nerve this is sending pain into the buttock and outer thigh.

However, like you said it could be caused by something else. The best thing I think is to visit a sports injury specialist who specialises in exercise rehabilitation and sports massage. They could assess you for muscle imbalances and postural problems which may be causing the pain. A common combination is tight hamstrings and weak buttocks (especially gluteus medius). Trigger points in the buttocks could also be a problem which can radiate pain into the legs. This can be eased with massage:

http://www.sportsinjuryclinic.net/cybertherapist/back/buttocks/myofascial_pain_trigger_points.htm

I would recommend sports massage to the hamstrings, buttocks and thigh including ITB, as well as correction of any muscle imbalances using stretching and strengthening exercises.

[Dave79]

Thanks for the direction Heidi. I have been thinking about massage. I will probably give it a try along with the stretching, etc.

[Dave79]

Heidi: Just curious...but do you know what tests would show if my pain stems from the sciatic nerve/disc issue??

[Heidi]

Hi

Do you know where the disc prolapse is? For example they usually describe it by the vertebrae above and below, e.g. L3/4, L4/5 or L5/S1 (these are the most common).

The higher the prolapse the more likely the pain is coming from the back. L3/4 in particular radiates pain on the outside of the hip and thigh.

Usually if the disc is the problem there would be back pain, although this does not occur in 100% of cases.
If the back is involved, pain is most frequent on bending forwards, coughing, sneezing and sitting, whereas laying down usually eases pain.
You can find some more symptoms of this here:

http://www.sportsinjuryclinic.net/cybertherapist/back/buttocks/sciatica.htm