Where is your pinched nerve: in the lower back or in the buttocks?

Nerve compression, or a pinched nerve, in the lower body can be an extremely painful and debilitating condition, leading to limited mobility and moderate to severe pain. These symptoms can get in the way of the most basic activities, from cooking to yard work.

One of the biggest obstacles in treatment for many patients is not being able to find the source of nerve compression. For example, a pinched nerve in the buttocks and a pinched nerve in the lumbar (lower) spine can produce almost identical symptoms. One of the nerves that is often pinched in either location is the long sciatic nerve, resulting in the group of symptoms called sciatica.

Sciatica and its causes

Sciatica is usually characterized by pain in the hips, buttocks, legs and down to the feet; it can occur on both sides but it is most commonly experienced on one side or the other. If the source of sciatic nerve compression is in the buttocks, a frequent cause is piriformis syndrome. The piriformis muscle is a small, pear-shaped muscle in the buttocks region that contributes to hip stability and leg rotation. This muscle can cause sciatica if it becomes inflamed and compresses the sciatic nerve, which is very close to the piriformis muscle. Piriformis syndrome is common in athletes, especially runners, because this muscle is critical to lower body movement.

The sciatic nerve can also be compressed by spine conditions in the lower back, including:

  • Bulging and herniated discs
  • Bone spurs
  • Inflamed spinal joints
  • Spinal stenosis

Since there can be so many causes of a pinched nerve with such similar symptoms, it is important to see your primary care physician for an accurate diagnosis and to develop a treatment plan.

Pinched nerve in the buttocks or spine: diagnosis and treatment

If you are unsure of the source of your painful symptoms, seeing your primary doctor can help determine whether you have a pinched nerve in the buttocks, the lower back or another location altogether. After a thorough examination, review of medical history and diagnostic imagery like an X-ray or MRI hopefully reveals the cause of your symptoms, you and your doctor can work together to make a treatment plan.

Piriformis syndrome is usually treated with methods such as rest, ice, heating pads and gentle stretching. Similar conservative treatments can also be effective for spinal nerve compression, with surgery being seen as a last-resort option. If surgery is necessary, there are alternatives to traditional procedures — including minimally invasive spine surgery — that can lead to shorter recovery times and a quicker return to normal activity for patients.

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