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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
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Experience:  Medical Doctor Trained at a Top Academic Institution
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strong burning sensation on buttocks and back of thighs when sitting

Customer Question

Hi! I am a woman, 47, 5'6". 150 lbs. Lately, 6-12 months, been having a strong burning sensation on buttocks and back of thighs when sitting for as little as 15 min. so I have to br standing or laying, in my face to stop the pain. Driving the car or working in the computer is a challange, using Biofreeze to deal with every day shores. Also if laying in bed or anywhere I have the same burning sensation in my feet soles and have to keep them without any pressure with a pillow under the calfs. Went to the neurologist thinking it will br neuropathy, everything is ok, lab test and nerve tests. I have always have problems with veins in the legs; having them inyectes several times an being operated twice to remove varicose and also some treatments of laser. The veins never really hurt but I don't like the look, even have some darker areas in the calf, but not spider veins, just darker/blueish areas. Since the burning sensation always happen when preasure is apply, I think the burn could be related to poor circulation.
Please, give me possibilities and which tests and kind of doctor to consult.
Thank you
Submitted: 4 years ago.
Category: Medical
Expert:  khagihara replied 4 years ago.
Sitting, standing for a long time, and movements that cause the spine to flex (such as knee-to-chest exercises) make symptoms worse?
Walking, lying down, and movements that extend the spine (such as shoulder lifts) relieve symptoms?
Customer: replied 4 years ago.
I have no back problems, so far. The pain only occurs when pressure is apply to the area; sit anywhere for 15 min or more and only in the touching area (butt & thighs) or laying, even in a chaselounge or massage table in the feet soles. No other moments in pain, nor standing or excercesing, only when preassure applied and only in those areas, nor arms or back, or head.
Expert:  khagihara replied 4 years ago.
You could have piriformis syndrome. IPiriformis syndrome is an uncommon neuromuscular disorder that is caused when the piriformis muscle compresses the sciatic nerve. The piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. This muscle is important in lower body movement because it stabilizes the hip joint and lifts and rotates the thigh away from the body. This enables us to walk, shift our weight from one foot to another, and maintain balance. It is also used in sports that involve lifting and rotating the thighs -- in short, in almost every motion of the hips and legs.

The sciatic nerve is a thick and long nerve in the body. It passes alongside or goes through the piriformis muscle, goes down the back of the leg, and eventually branches off into smaller nerves that end in the feet. Nerve compression can be caused by spasm of the piriformis muscle.
Piriformis syndrome usually starts with pain, tingling, or numbness in the buttocks. Pain can be severe and extend down the length of the sciatic nerve (called sciatica). The pain is due to the piriformis muscle compressing the sciatic nerve, such as while sitting on a car seat or running. Pain may also be triggered while climbing stairs, applying firm pressure directly over the piriformis muscle, or sitting for long periods of time.

Approximately 50% of patients with piriformis syndrome have a history of trauma, with either a direct buttock contusion or a hip/lower back torsional injury. The remaining 50% of cases are of spontaneous onset,

There is no definitive test for piriformis syndrome. In many cases, there is a history of trauma to the area, repetitive, vigorous activity such as long-distance running, or prolonged sitting. Diagnosis of piriformis syndrome is made by the patient’s report of symptoms and by physical exam using a variety of movements to elicit pain to the piriformis muscle. In some cases, a contracted piriformis muscle can be found on physical exam. The doctor can often detect tenderness of the piriformis muscle during a rectal examination.

f pain is caused by sitting or certain activities, try to avoid positions that trigger pain. Rest, ice, and heat may help relieve symptoms. A doctor or physical therapist can suggest a program of exercises and stretches to help reduce sciatic nerve compression. Some health care providers may recommend anti-inflammatory medications, muscle relaxants, or injections with a corticosteroid or anesthetic. Other therapies such as iontophoresis, which uses a mild electric current, and injection with botulinum toxin may be used. Surgery may be recommended as a last resort.

Any questions?
Customer: replied 4 years ago.

I have already read a lot about piriformis syndrome because I know it is one of the posibilities. Thats not my problem. My burning sensation is very specific and allocated in the butt, thights and soles. Dosen' get better with rest or excercise or stretching. I can't avoid sitting, have drive, travell in airplane (live in PR, an island), work in the office or go to movies.

Few times in my life because of excercise or tension have experince sciatica pains. I'ts very diferent and go away with aspirin or Tylenol. My burning,(like fire) do not runs from hips to feet like sciatica and there's no electricity feeling.

I'st burnning! The only way to aliviate is with ice (no more heat!) or with freezing creams with menthol like Biofreeze or cool-gel Bengay. Eventualy have to take off the pressure by turning myself face down in bed or take my feet off the bed or chaise, for soles. Standing up or seat on ice or move from one butt to the other realiving the pressure is the only thing that relief the burn.

I went to the neurologist because my simptoms seem more like to be neuropathy eventough I'm no diabetic, nor have any vitamin diffeciency , illness on injury.

Because it only happen when preassure is aplied, I think have something to do with circulation, since always have problems with leg circulation, thats why I told you about my veins.

Please take some more time to study some other posibilities...

Expert:  khagihara replied 4 years ago.
Problems in the veins and arteries don't cause your problem. You should see an orthpediatrician to have your problem evaluated.
Customer: replied 4 years ago.
Relist: Inaccurate answer.
Expert:  Dr. Thomas, MD replied 4 years ago.
I would be glad to help you
let me ask you
have you had an MRI of the lower spine?
Customer: replied 4 years ago.

No. Once, about 5 year ago, get a bonescan. After I quit smoking, started to have lots of pains in diferent parts like feet, back shoulders, legs, hips. A family practioner thinks I may have fybromialgia or some kind of artrhitis, refer me to a reumathologist. I have a lot of test done, everything ok, he has no explanation, so told me to take aspirin for pain and go back if continues after 6 months. Eventually the pains disapear without doing nothing. Extrange!

Now, for few months try to ignore the burning and just move when it burns. but its getting wosrt, sometime can't sleep and being in heavy traffic is really a fire on my butt!

I'ts have been a while since looking for an answer, and in some blogs and sites like this, noticed there are a lot of people with my excaxtly same symtoms and lot of more test with no answer. Hope you can help me and with me many people.

Expert:  Dr. Thomas, MD replied 4 years ago.
I disagree with the doctors.
You need an MRI of the lower spine.
This is first and foremost
When the pain is burning, comes and goes, and also occurs in the feet, lower spine compression from degeneration is typical, does not show up on x ray, and can be aggravated by movement, without giving neurological findings for the neurologist.
See a physical medicine and rehabilitation doctor, another type of MD and they will confirm this possibility rapidly.

Circulation is not common for this, but ultrasound studies [dopplers ] of the legs would rule this out quickly.

good luck

Let me know if you have further questions, details or need clarification, just use reply.......

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Customer: replied 4 years ago.
Relist: Answer quality.
I'm aproaching menopause and I noticed that the burning worsten during my mestrual period, but its present in some dregee the whole month. Now my periods are heavier in flow and closer (every 21 days).
Sorry to be such a pain. But I'm really desperate. What do you think about alternative medicine, problem in coxix, some suplements?
Expert:  Dr. Phil, MD replied 4 years ago.

Hello. I would like to help you find an answer.


I noticed the relist. What else would you like to know?

Customer: replied 4 years ago.
I' like to know some other posible causes for my burning butt, thights and feet soles. If it's a problem with spine, how come the burning only happens when these especific areas are under preasure like sitting on my butt and have my soles touching the mattress when laying? I have't been in any accidents, I excercise regurally all my life and my back never hurts. The pain only apears under preasure, any other way, there's no burning. But Ihave to drive, work with papers and a computer sitting down in my office and lay down to bed every nigth to rest. Right now, I'm standing and sittin down every five minutes and put some cooling gel in my but and thighs trying to find and answer from you...
Expert:  Dr. Phil, MD replied 4 years ago.

I agree with the other expert. Sometimes these problems with the spine (discs, stenosis, etc) can come out of the blue and don't necessarily have to have a specific injury.


An MRI of the spine is indicated.


I would like to elaborate on his point a little. You should also get an EMG/nerve conduction study of the legs. In the even that this isn't a lumbar spine issue, the EMG will help elucidate the problem.

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