It sometimes has a sharp, lighting bolt-type of pain sensation.
Trigger Point Therapy for Buttock or Gluteal Pain
It can be difficult sometimes to clinically distinguish pain in the buttocks from low back pain. Generally we say that pain experienced along the belt-line or above is low back pain, and anything below the belt-line in the buttock, sacroiliac joint, or sacral regions is termed gluteal pain.
The gluteus maximus trigger points are the only to refer pain exclusively to the gluteal region.
Trigger points in the quadratus lumborum and gluteus medius muscles refer pain to gluteal region, but also to the low back region. While trigger points in the gluteus minimus, quadrates lumborum, and piriformis muscles refer pain to gluteal and hip regions.
Because of this overlap in pain patterns, I typically treat low back pain and gluteal pain as one disorder in my practice, especially in chronic pain situations. I've found this comprehensive treatment approach to be the most effective as trigger point activity will spread to different muscle groups over time. Often I see a client that initially experienced a low back pain complaint come to me with a gluteal pain complaint.
The Quadratus Lumborum Trigger Points that Cause Gluteal Pain
The Quadratus Lumborum muscle group is composed of several small muscles that are located deep within the lower back muscle mass. It attaches to the lowest rib, at several spots along the lower (lumbar) spine, and along the pelvic rim.
The Quadratus Lumborum contracts to help stabilize the spine, and to flex the trunk to either side. This muscle group can contain up to four trigger points that refer pain to the low back, groin, hip, and gluteal regions.
Trigger points in the middle of this muscle group seem the most responsible for the gluteal pain projection.
A person with active Quadratus Lumborum trigger points will typically experience severe pain when their trunk is in an upright position. Often they will instinctively brace and support their upper body with their arms to avoid this severe pain.
Referred pain from Quadratus Lumborum trigger points may also activate other trigger points in muscle groups that function to move the hip joint, causing hip joint dysfunction.