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Thread: Alot of pain on my right butt cheek, no redness, no fractures, but still worried

  1. #1
    Senior Member mr_coffee's Avatar
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    Question Alot of pain on my right butt cheek, no redness, no fractures, but still worried

    Hi everyone,

    Its been awhile! I'm running into a big issue. My right butt cheek is super painful. I have chronic pain and have dealt with it for 10 or so without any medication. But this pain surpasses even my pain threshold.

    I fell last christmas on a toilet seat which cracked the seat and caused similar pain to what I'm experiencing now but went away after a few months. I got it checked out and they said there is no fracture. But just recently it started again just as it did the first time I hurt it. This is really an issue because I'm working 8-10 hour days and although I can often its getting to the point where I can't focus.

    The only thing I'm worried about is causing a pressure sore but if there is no redness nor a dot I can't figure out what this could be or if I should just deal with the pain. If its just pain I can probably go on but if I'm ignoring something more serious I don't want to cause any more damage.

    Any ideas what this could be?

    Also I noticed when I sit on a very soft removable cushion its much better. Currently I'm using a varalite evolution as I have been ever since I had a wheelchair but perhaps its time for me to move to a more forgiving surface. Adjusting the airpressure doesn't help.

    Can anyone recommend any softer foam cushions I should purchase? My size of seat is 14x14, should I increase the size to something longer perhaps that may put more pressure on my lower legs rather than my butt? Also after going to the doctors it seems like they say nothing is wrong but my body is telling me something different.

    Any advice would be great, I hope all is well in CC!

    -Cory
    Injured:10-16-04
    C7/C8, T1 incomplete;


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  2. #2
    Have you had a PT seating eval? I would encourage you to do that prior to changing cushions because you may be switching the problem from one place to another - literally. That goes for size and type. Do you do weight shifts - that might help to ease the pain if you are not putting any prssure on the area for a minute every few minutes.

    If there is no sign of a pressure ulcer, it is unlikely that is the cause of your pain. And since you have had it since December, it is more than likely that you would have seen it by now. However, you could have a deep tissue injury that is aggrevated by the sitting. Do you have pain when you lie on it?

    Am not sure if this is what you are looking for, but hope it helps.

    CKF

  3. #3
    Super Moderator Sue Pendleton's Avatar
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    If it goes away when you lie down and take weight off it you may have sciatica. With me it was always in the same place on my left cheek for months on end. I finally decided I'd rather be doped up then in that much pain and saw my physiatrist. Amazingly an Army MD suggested accupuncture which I was rather leery of. But it really helped. Within 6 sessions it was gone. No narcotics just the coiled needles for about 30 minutes each time. First find out what it is then look at your treatment options. But if it is where you have little padding and especially if it starts heading down the back of your leg or bottom of that foot it's probably sciatica.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  4. #4
    Cory, my situation isn't quite the same as yours and so these observations might not apply to you - but I have had something similar to the delayed-onset pain you describe, in the identical location, and decided to chime in just in case.

    I fell several years ago and landed on my left sitting bone. It was quite sore for awhile, but gradually the pain disappeared. A good bit later, though, I developed intense sciatic nerve pain that went all the way from the left buttock, down the back of my leg and into my foot. I could bear weight on the leg, but lying down was excruciating and it even kept me awake at night. At that point I went to the ortho, thinking I'd cracked my hip or something, but no bones were broken and the ortho said that in all likelihood the fall had slammed my sacroiliac joint to such a degree that it had become arthritic, with chronic bursitis of the hip joint (worse at night) and sciatic/peroneal nerve inflammation to boot. There was no redness, swelling, or even a bruise after the original fall, the damage was invisible but ongoing and it hurts a lot if I put pressure on the left hip area; even lying down on the right side hurts, because it pushes upward against the left side. And I mean hurts - a deep, grinding, eye-popping pain. Like you, I find that sitting on a soft cushion helps (also sleeping on a memory foam topper).

    You had a terribly hard fall, enough to crack the toilet seat - so it wouldn't surprise me if you, too, have arthritic changes causing delayed-onset pain and/or bursitis (with referred pain to the buttock). You might also have a damaged lumbar spine disc causing sciatic nerve pain.

    Your pain is severe during work hours, interfering with your ability to concentrate, and I wonder if you also have pain lying down - postural information can tell the doctor a good many things. Perhaps something medical can be done to help you, or treatment of some kind with a PT or OT - so you might want to have new X-ray and MRI studies done. Even if the tests prove inconclusive, you'll have a baseline for comparison in the future. I wish you all the best, going forward.
    Last edited by Bonnette; 04-01-2014 at 10:19 PM. Reason: grammar
    MS with cervical and thoracic cord lesions

  5. #5
    Senior Member lynnifer's Avatar
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    My first thought was deep tissue injury. What's the quality/density of your bone where your hurt it? It's been - what at least 10yrs for you now? I know you walk around as much as you can but it can't be the amount an AB does. Just wondering about arthritis.
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  6. #6
    I'd concur with the moderator that a seating consult would be a good first idea. 14 years post, I'm on my 5th cushion (J-Jel, Roho, combo foam / air, 2nd Ride ) in an attempt to alleviate acute ischia bursitis (pain's on one side only). The Ride isolates both 'sit' bones and coccyx the best of the lot, but (butt?!) the pain is still overwhelming and interferes with my focus on work, and everything else for that matter. No evidence of pressure redness. Massage, hamstring stretching, electrotherapy, pressure relieving, acupuncture, cortisone, various meds, er, um, Jack Daniel's, and other distractions help a bit. I'm looking into surgical intervention or draining the bursa, and am on 'Care Cure' now to see if other members have had it done.
    'Ischiogluteal bursitis' most commonly occurs due to repetitive or prolonged activities such as sitting, but can develop suddenly following a direct blow such as a fall onto a hard surface.

  7. #7
    Senior Member mr_coffee's Avatar
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    Hi everyone!

    Thanks for the great advice. It really does sound like I have Ischiogluteal bursitis. I'm working on getting a new seat now and next time I go to the docs i'll ask them about ischiogluteal bursitis and how I may treat it better.

    Thanks,
    Cory
    Injured:10-16-04
    C7/C8, T1 incomplete;


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  8. #8
    Super Moderator Sue Pendleton's Avatar
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    Quote Originally Posted by mr_coffee View Post
    Hi everyone!

    Thanks for the great advice. It really does sound like I have Ischiogluteal bursitis. I'm working on getting a new seat now and next time I go to the docs i'll ask them about ischiogluteal bursitis and how I may treat it better.

    Thanks,
    Cory
    Ditto, here! Reading a Korean paper in the NLM about this may have just given me the reason behind the last 12 years of butt pain my Dad has had. If this can be set off by radiation treatments that may not have been perfect...well, I'll be mentioning this to his doc. Thanks!
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  9. #9
    Senior Member PC720's Avatar
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    I see somebody else already pointed it out but, if the pain radiates all the way down your leg and a little on your back you're probably hitting the sciatic nerve. I just discovered this problem the other day shortly after discovering the cushion in my chair was in any good anymore. The pain was so intense I thought I broke my hip or at least fractured it or something. That sciatic nerve is no joke. we had to call an ambulance take me to the hospital where they did xrays and CT scan.I've been in bed last few days trying to calm the nerves down.

  10. #10
    I too have had this sit bone pain on both sides for a couple of years now...The pain goes away the second I get the pressure off my butt as when I do a push up or when I lie on my side or my tummy..I am a c6/7 incomplete...I got an orthopaedist's opinion and he said I had ischial bursitis and suggested I use a cushion with holes where the ischium sit and that it should get better in a couple of months..

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