Dr. Hanif warmly welcomes you! Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can well realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns. First treatment option is reduction of weight, for that start physical activity, reduce input meals, leave taking junk food and beverages and alcohol. Change the chair where you sit mostly. It hurts sometimes due to a fault in the chair/seat. Pilonidal sinus formation is a disease where hair ingrow into the skin and make a bunch inside the skin leading to infection and pain on touching and sitting on it. It needs a check up by general surgeon and needs proper care and treatment. I feel sorry that you don t have an insurance but it s highly recommended to see a physician for getting a diet plan and to rule out pilonidal sinus. Hope I answered all of your questions. In future, if you need further, detailed and quick assistance on any health issue, feel free to ask me a question by writing my name as a reference in the start of your question. I will get back to you right away. Have a wonderful time ahead. Regards! DR. MUHAMMAD HANIF USA