Sharp Pain in the Top in the Middle of my Bum

This post is a response by a doctor to a question one of our community members asked.

Jason Asks:

I have sharp pain in the top in the middle of my bum. Its very sore to sit on. On left bum cheek I feel like a hard muscle or lump there more likely a muscle. I fell and hit my head and a week later I got pain in my upper but. I went for crays doctors say it just sore muscle. I had this pain for over 1and half weeks. When I went to hospital for stronger pain tablets they gave me tramadal 50mg and it did work still pain. They also gave me a vatarine injection. Day later I had a boil and it popes with blood in the middle left side. What could it be its continuous pain. And the boil just has unlimited pust. Plz help

Dr Edin’s reply:

It is hard to tell for sure without an examination, but based on your description and history of a recent fall, there is a high chance that the lump you are feeling is caused by hematoma or fat necrosis. Under the skin in buttocks region, there is a layer of fat followed by a layer of muscles. In case of blunt trauma (fall on buttocks), all tissues suffer a trauma.

If there is an injury of small blood vessels, the blood will come out of them into the surrounding tissues (muscles, fat) and cause a hematoma. The patient will notice a lump on the impact site which can be painful. Later it becomes firm. The similar mechanism occurs in case of fat necrosis, only this time fat cells suffer a direct impact which causes their death and creation of lump. After a few days, that lump can become soft to touch and even puss-like substance can be drained out of the lump. I would suggest you to consult your doctor to be sure. You might need a drainage of your lump.

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