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Burning sensation in buttocks and back thigh 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 mins. So I have to be 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 be neuropathy. Everything is ok, lab test and nerve tests. I have always have problems with veins in the legs; having them inyectes several times and 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 applied, 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 applied to the area; sit anywhere for 15 mins or more and only in the area which touches (butt & thighs) or laying, even in a chase lounge or massage table in the feet soles. No other moments of pain, nor standing or exercising. Only when pressure is applied and only in those areas, not 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. If 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 possibilities. That is not my problem. My burning sensation is very specific and allocated in the butt, thighs and soles. Doesn't get better with rest or exercise or stretching. I can't avoid sitting, have to drive, travel in airplane (live in PR, an island), work in the office or go to movies.

Few times in my life because of exercise or tension, have experienced sciatica pains. Its very different and goes away with aspirin or Tylenol. My burning (like fire) does not run from hips to feet like sciatica and there's no electricity feeling.

Its burning! The only way to alleviate is with ice (no more heat!) or with freezing creams with menthol like Biofreeze or cool-gel Bengay. Eventually 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 reliving the pressure is the only thing that gives relief to the burn.

I went to the neurologist because my symptoms. Seems more like to be neuropathy even tough I'm not diabetic, nor have any vitamin deficiency, illness on injury.

Because it only happens when pressure is applied, I think it has something to do with circulation, since always have problems with leg circulation, that is why I told you about my veins.

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

Expert:  Dr. Thomas, MD replied 4 years ago.

Have you had an MRI of the lower spine?

Customer: replied 4 years ago.

No. Once, about 5 years ago, got a bone scan. After I quit smoking, started to have lots of pain in different parts like feet, back shoulders, legs, hips. A family practitioner thinks I may have fybromialgia or some kind of arthritis, referred me to a reumathologist. I have a lot of tests done, everything ok. He has no explanation, so told me to take aspirin for pain and go back if it continues after 6 months. Eventually the pains disappears without doing nothing. Strange!

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

It has been a while since I am looking for an answer, and in some blogs and sites like this, noticed there are a lot of people with my exactly same symptoms 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.

OK. 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. It 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.......

Customer: replied 4 years ago.

I'm approaching menopause and I noticed that the burning worsens during my menstrual period, but its present in some degree 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 supplements?

I would like to know some other possible causes for my burning butt, thighs and feet soles. If it's a problem with spine, how come the burning only happens when these specific areas are under pressure like sitting on my butt and have my soles touching the mattress when laying? I have't been in any accidents, I exercise regularly all my life and my back never hurts. The pain only appears under pressure, any other way, there's no burning. But I have to drive, work with papers and a computer sitting down in my office and lay down to bed every night to rest. Right now, I'm standing and sitting down every five minutes and put some cooling gel in my butt and thighs trying to find an answer from you...

Expert:  Dr. Phil, MD replied 4 years ago.

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 event that this isn't a lumbar spine issue, the EMG will help elucidate the problem.

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