10 Causes Of Buttock Pain

Want to know the causes of buttock pain?  We’ve probably all had buttock pain at some time, from a numb bum because you’ve been sitting too long, to the sharp shooting pain of sciatica. Buttock related pain or hip pain as some people describe it because they feel it around the big hip or pelvic bone can range from mild to severe. In some cases, it can significantly affect a person’s quality of life and their ability to perform activities of daily living. The causes of  buttock pain can be many and varied. The causes can  be local buttock structures, or they can be referred from other areas of the body, such as the lower back or even thigh muscles.

Sciatica:

Sciatica is not a diagnosis, it’s really a description of pain in the distribution of the sciatic nerve. The sciatic nerve is the longest nerve in your body. It starts in your low back, then runs from the back of your pelvis, through your buttocks, and all the way down both legs, ultimately parts of it end at your feet. When something compresses or irritates the sciatic nerve, it can cause a pain that radiates out from your lower back into your buttock and can travel down your leg to your calf. Sciatic pain can range from being mild to very painful.

Sacroiliac Joint:

The Sciatic Joint is sometimes shortened to SI joint, S/I joint or occasionally SIJ. This is the joint between the triangular sacral bone at the base of the spine and the iliac or pelvic bone. Pain here can be caused by too much or too little movement. Some people term these as Sacroiliac joint dysfunction. Certain types of Arthritis can also cause inflammation and pain at this joint. Weight changes and ligamentous laxity during pregnancy can also lead to pain at this joint.

Osteoarthritis:

Osteoarthritis is another commonly used diagnosis for one of the causes of buttock pain.

Osteoarthritis is often called arthritis or OA for short. OA is really ‘just’ wear and tear of one of the body’s joints. OA in the low back, S/I joint and possibly in the hip could cause buttock pain. The pain, when spreading from an arthritic joint, is often non-specific, by this I mean there may be an ache in the area. This ache can become more centred when the joint is inflamed in which case it’s the inflammation causing the pain rather than the joint. The muscles can also become involved, this is then a muscle pain rather than arthritic or joint pain. It is worth remembering that OA is normal and doesn’t have to cause pain if treated properly

Bursitis:

A bursa is a fatty sack. Its purpose is to reduce friction where muscles pass across other muscles, ligaments or bones. Muscles that are overused or are too tight can rub and inflame a bursa which then causes pain. Another explanation for bursitis is that compression, or squashing the bursa, by certain exercises or shoes is to blame for bursitis.

The two main bursa in the buttock area are the trochanteric bursa and the ischial bursa. One can hurt on sitting the other pain when laying on your side.

Coccydynia:

Sometimes written as coccyx/coccygeal pain. The coccyx is often described as the tailbone. If affected people complain of pain at the very base of the spine, just above their anus. The pain can sometimes be felt in the ligaments that help the coccyx maintain it’s position as these ligaments become strained The sensation can vary from mild discomfort to extremely painful.

Iliolumbar ligament:

This is a really strong little ligament that holds the lumbar spine to the Ilium (part of the big “hip” bone). The iliolumbar ligament can be felt just around the dimples in the very low back. This can get strained and stretched leading to inflammation. A common way of stretching this ligament is by sitting with your low back unsupported in a slumped position. Pain can vary from a mild ache to a strong throb. Some sources say that a sciatic type pain can be caused by this ligament.

Piriformis muscle:

Piriformis is a small muscle that is located deep in the buttock region. The sciatic nerve runs through this muscle. This muscle can become tense enough for it to squeeze the Sciatic nerve, producing symptoms including pain and numbness, that travel down the leg from the buttock region. When the nerve is trapped this way, it is called Piriformis Syndrome. Additionally, trigger points in the muscle may refer pain to other parts of the buttock and the hip joint region.

Trigger points:

Trigger points are described as “a highly irritable localised spot of exquisite tenderness in a nodule in a nodule in a palpable taut band of muscle.” Another attribute of trigger points is they when the nodule is pressed or irritated it can trigger pain distant to the nodule. Trigger points in quadratus lumborum a back muscle and soleus a calf muscle can and do refer pain to the buttock. Trigger point therapy helps stop pain caused by these painful, tight knots

Buttock Muscles:

The Gluteus maximus, medius and minimus are the three main buttock muscles. Gluteus maximus is the biggest muscle in the body, and some sources say it’s the strongest. All of these muscles may get tendon problems causing pain in the buttock. There are also a number of trigger points within these muscles that may give pain within the buttock. There are three trigger points commonly encountered in Gluteus max, another three in medius and 7 minimus.

High Hamstring Tendinopathy:

This gives you pain most noticeably when you sit and also a tight, painful sensation in the hamstring. It’s also known as proximal hamstring tendinopathy or high hamstring tendonitis and refers to inflammation of the common origin (ischial tuberosity) of the hamstring muscles. This gives you pain in the lower buttock on the part of the pelvic bone you should be sitting on. The pain in the buttock has been described as very sharp or like toothache all the time. More about High Hamstring Tendinopathy

PLEASE NOTE: No diagnosis or treatment plan specific to you and your buttock pain  can be given without a full case history and examination. If you wish to book an appointment in Glasgow please click the appointment button

This Post Has 63 Comments

  1. Hey there..i experience buttock pain like some sort of muscle pain in the my left buttock..i feel the pain when i sit and when laying up after bending… Its like i experience difficulties in doing…this thing has happened for two months now..i’ve never been to a doctor though..please help

    1. Hi Nifty
      I obviously can’t give you a full answer tailored to you because I don’t know enough about you and because of that your condition (and here isn’t the right place), but gentle movement and exercise often helps. I realise that most of the world isn’t as lucky as Scotland with Our fee health service, but if you are worried, it maybe worthwhile trying to see someone medically qualified.

  2. I have serious pain on both sides of my buttock, especially when I wake up in the morning.It hurts real bad, sometimes I can hardly walk.Its mostly in the uppper part of my bottock.Need some help.thanks John

    1. Hi John.
      I can’t give you definite answers or solutions on here, but from my understanding of what you’ve described, I would also be looking at your low back for an answer.

  3. Since squatting at the gym i have developed a dull ache in my left buttock which is more pronounced when i am walking. The pain seems to be in my hip and in my buttock.
    Could it be Piriformis syndrome and would stretching help?

    1. Hi Kenny. I obviously can’t give a definitive diagnosis from the information above. The name or diagnosis of piriformis syndrome is gradually changing to deep gluteal syndrome. This change is to reflect, that the problems in the area are probably coming from more that one structure. If the problem is in a tendon in the area stretching can make it worse. The answer, really on here, is I can’t answer. However if the pain is from muscle, or tendon, then reducing the weight to desensitize the area and then using appropriate sets/reps/resistance combo to rehabilitate. The soft tissue therapy and taping are often used to try and help settle it quicker. Hope that helps.

  4. Hi, I’m Hanah. A few years ago, I felt like something was moving from my back to my right buttocks, afterwards I felt like there was a painless mass there. It gets uncomfortable when I sit on it. Yesterday, after a stressful day, I laid on that particular buttocks and I felt pain. I’m always aware that there’s a mass in that buttocks, what can this be?

    1. The Obvious first thing to do is to get it properly checked by a health professional who can, if needed perform a biopsy. If that proves to be clear then it way be a better time to think about what else it could be

  5. For a few years now I’ve found if I sit too long on a hard surface it gets really uncomfortable and painful on my bum. First time it happened I think it was a long flight from uk to mexico… Yesterday for example I was sitting on a picnic bench for hours and it hurt…Today when i touch my bum it feels bruised but no bruise visible..today hurts if I sit on the bed…happens quite often when it’s a hard surface…sitting on couch is fine…any idea?…never been to doc… I do get lower back pain but again not been to docs so no diagnosis

    1. Hi Amy

      A hard one to answer without a full case history and a chance to examine you. I would be considering something that doesn’t like compression. This could include tendons and bursa in the area. The treatment would vary as to the tendon and/or bursa involved if any.

  6. I tore my hamstring (grade II tear) two summers ago and it has never healed proper’y. I have pain in my right buttocks and back of leg. This has also cause problems with my shin and foot. I get a lot of shin splints. I can no longer run as i cannot extend my leg fully. I tried physiotherapy but I never fully healed. Any suggestions or ideas are welcome!!!

    1. Hi Kelleen. While I can’t answer the question for you specifically this is generally what I’d be thinking of. Strengthen and lengthen the hamstrings. This may take the form of “Nordic Hamstrings” exercises. These can be regressed and progressed to find the appropriate level for the person doing them. Hamstring curls also may be useful. As the Active management
      (the stuff the patient does) progresses, I would also be thinking about what I’d do. Some soft tissue/massage techniques as well as active/PNF style stretching to the glutes and hamstrings may be used. This is all conjecture as I don’t know your full history and haven’t examined you. If I did this may all change to make it specific to you. So as always this shouldn’t be considered medical advice…

  7. Tammie
    I have had buttock pain for 3 to 6 months been having therapy no luck, It hurts just when I sit. So I stand at work all day. Please help.

    1. Hi Tammie Because I don’t know your history, diagnosis or what treatment is and has been done it is impossible for me to answer this. I hope to publish some future posts on this area that you may find appropriate, but they will, of course, be general advice rather than specific to you.

  8. Hi Pat. Let me have a little think about this before I reply.

  9. Hello

    I have been told previously by specialist at hospital that I have soft tissue wear and tear in my lower back and no structural probs with my spine. Caused by years of running. My back flares up from time to time pain in buttock and occasionally pins and needles. Two years ago I had very bad pain in lower back, right buttock which travelled down my leg. I struggled to sit down, walking was painful and it took approx 8 months to settle. Last July I climbed Ben lomond and have had pain/discomfort in my left butt cheek (general area of Piriformis) ever since. I walk my dogs every day for approx 10 days and exercise 5/6 days a week. I have tried not exercising st all for a couple of weeks which didn’t help. So I have been avoiding high impact exercise, squats, deadlifts etc. It has been constant and varies in pain level – at the moment it is really sore again with the pain wrapping round to the front of my hip and radiating slightly down the back of my leg. I’ve had orthotics fitted but no improvement. I have tried stretching the area, foam rolling etc but can’t seen to get it to settle. Any advice would be appreciated

    1. This is quite a hard one. In some respects, it sounds like a hamstring tendon problem, and they don’t generally respond well to stretching. The pain wrapping into the groin opens up other possibilities though,

      Often these “things” are about load management. Decrease the load or work that you’re doing to allow it to settle and become less sensitive. Then you can start rehab exercises. (I’m intending to do something on this soon).

      The main problem is starting the exercises at an appropriate level to make sure that any exercises are effective but not at too high a level. I believe that treatment can help increase the window that exercise is effective in..

      This is a general answer as I’m sure you’ll appreciate that a specific to you can’t be given unless I’ve taken a full case history and examined you.

  10. I have had buttock pain off and on for several years. I never know when it will happen mostly when it pops up I’m lying in bed. Sometimes it last for a few minutes other times 20 minutes or so, sometimes more intense. It’s like a dull pressure, sometimes I compare it to labor. Walking seems to help it most of the time it goes as quick as it comes. Sometimes it just in one side sometimes it spreads the entire area and into the low front. I may go months without it happening. Any thoughts would be appreciated

    1. Hi Kimberly. Intermittent pain, particularly intermittent buttock and groin can be particularly hard to diagnose, particularly online. I guess that from your name and the pain being described as labour like your a woman. This may be significant as it could be an internal problem rather than purely muscular related. I really can’t tell one way or another. Have you been to any medical professionals with this, as this would be the best place to start, to begin ruling out problems

  11. I have a pain in my left hip which is aggravated by, either sitting or laying on the side. I can feel the exact spot that hurts when I press on it. When I sit, then stand, I have to stand slowly, for the hip movement causes a lot of pain. Once up, though, I can move about without pain. I try Ibuprofen and aspirin, but without affects. I don’t go to the doctor, because I think that all he’ll tell me is to go to physical therapy. Will stretching hurt, or help, the pain?

    1. The hip means different things to different things to different people. Some people refer to the hip as the big bit of bone at the top of the leg, this is the greater trocanter. Other people refer to the pelvic bones (the bones your trousers hang off) as the hip. The real hip joint is best described as being deep in your groin. Is that where your pain is?

  12. I have severe pain in a fairly small area of the lower right buttock. I walk for over an hour with my dogs every day and it is the only time I have no pain. There is terrible throbbing when I sit for a short period or when I am driving. I find if I raise my leg it relieves the pain or if I press the area. Would pain killers taken regularly help? I’m worried it is something more serious. I do have a history of back problems after the birth of my son, but these are not causing me any problems at the moment. Any advice would be appreciated.

    1. A couple of things. First one. Pain killers may help, but as an osteopath I’m not in a position to advise. They do also have side effects so in my opinion they should be avoided for long term use unless it’s under the guidance of a properly registered medical practitioner.

      The second thing is a question. When you say raise your leg, do you mean lifting your buttock from the seat or bringing your leg up as if you were going to touch your knee to your chest?

  13. Hi Daniel,
    I have pain in my right side buttocks area, particularly when driving. It is not constant pain. While driving for about 60 – 90 minutes, I will have to release pressure from my buttocks 8 – 10 times. But when I ride my motorcycle, I do not experience this pain.
    In my history, I have degenerative disease in my lower back by which I have lower back pain in morning and it reduces as the day goes on. Secondly, about 18 months ago, I fell off a ladder and landed on the edge of the ladder on my right side buttock. It hurt for few days and then then the pain went away. I have had this pain for about one year now. Recently I tried Physiotherapy and it worsened so I just stopped it. I have not tried anything else after that.
    Do you have any advice regarding this buttock pain? What kind of medical approach should I take for this issue?
    I thank you in advance for your help.
    Mahendra

    1. I think I’d like to know more about the fall. How high was it? Were x-rays taken? Did the physio suggest a diagnosis and what treatment was given? Remember that this info may appear in the comments section, unless you ask for it to remain confidential.

  14. Replying to some comments on the website. Only 2 more to do on causes of buttock pain. Feel like a proctologist. http://t.co/53WH4G7Pui

  15. Hi Daniel
    My pain started 3 weeks ago and is at the lower right part of my back, the the pain is worse when siting, I also have pain in my lower right leg and a light numbness with pins and needles in my right foot. Trying to stand up after sitting or lying down is painful to the back,buttock and down the right leg, and is a struggle to walk at first, any advice would be great.

  16. Hello Daniel

    I first had pain at night lying on my side in bed. Soon after soreness when sitting became a daily problem. I am 71 and take moderate exercise.
    Radiographs show some curvature of the spine with degeneration of a disc. Nothing unusual for my age. The diagnosis is referred pain to the hips and buttocks from the spine. I’m rather sceptical.
    My feeling is that bursitis is the problem. Could that be right, and can it be treated anyway?

  17. Hi Daniel
    I was reading your comments.
    I too have buttock pain and just above buttock and hip pain which radiates down my legs quite often, but also affects the bottom of my feet. The soles feel like they are on fire. This happens especially if I spend too long sitting. Walking helps. but I can not walk around all day. Does this sound like the condition you are talking about

  18. I Have a constant pain in my left buttock right near to the anus, I have had this for about 12 months and sometimes suffer lower back pain and pain down m left leg. Any suggestion as to what it could be i have not yet visited my gp.

  19. Thank you for your article, was much more helpful than the NHS site I’ve just been on. Have had pain in right buttock for over a week, it is localized, unable to detect exactly where even when I have applied pressure I am unable to locate the exact point. Also, developed pain behind my right knee too. No back pain. Not been to GP as yet. No pain in sitting and is OK when first get up in morning. However, after sitting, sometimes as little as 15 minutes, I find the pain extreme when first walking, but after I have taken a few steps it eases and I am fine? Any ideas?

    1. Is that the buttock pain that’s extreme after sitting then walking?

  20. hi, i get pain in the lower buttocks, both sides and then need the toilet urgently with diarrhoea. I,ve been to my gp ,he advised me to do pelvic floor exercise every day. it did help a bit , but it seems to be getting worse.pain killers don’t help.what can i do ?..

  21. following an X Ray I have been told that I have degeneration of my hip.Some days I find walking difficult and suffer some considerable pain. Is there anything you could do to help me get some relief

    1. I think that the degeneration or wear and tear of the hip doesn’t improve but from clinical experience patients often say that the level and nature of the pain often does change. This makes me think that in some cases something other than the degeneration is to blame. The maybe muscular or inflammatory in nature and this is where osteopathy can help.

      By working on the muscles and loosening them I can potentially increase the range of movement that is pain free. This increased movement can also help with the inflammation giving you a better quality of life with less pain and discomfort.

      1. Hello there Daniel
        Many thanks for your helpful comment
        Hope to be in touch with your practice soon
        Regards
        Ian

  22. Hi Daniel,

    Interesting read, mine sound like the High Hamstring Tendinopathy although not sure, the pain description is the same and its usually in my left buttock near my anus, it normally starts at night time and its not regular, then for no apparent reason it starts during the day for no reason, i have found a way of easing it but this only works at home as wont be able to do this during the day, is to clench your hand into fist and lay on your fist where the pain is and press down, this actually causes more pain but for some reason it seems to work as it clears up a lot quicker otherwise it could last for hour or more.

  23. I suffer from an ache in my lower back and my buttocks. Although I am fit and active and have regularly walked, I now find walking just a few hundred yards gives me an aching in both thighs, at the sides and front, and is sufficient to stop me from walking further. I have to rest a while before I can continue.

    Your notes on sciatica seem to describe my condition. If this is sciatica, will osteopathic treatment help?

  24. Hi Daniel

    Very informative article indeed. I am working here in Jeddah,KSA as a radiologic technologist.My symptoms match with Buttock Muscles pain. Sometime i pick up right side buttock pain and sometime left.I feel severe pain while walking. After taking Diclofenac potassium one or two time I feel ok. But there is a recurrence of this pain after a few weeks or month I have no OA problem and i walk almost 2km daily. Can you help me?

  25. Hi Daniel,
    Nice article. I have had pain in my tailbone for the past 2 months.It started few days after I fell on the ground on my back while playing soccer. Do you think this can be a reason for the pain? My buttock usually pains when i sit on the floor for a while (it hurts badly) or while laying straight. What should i do in this case?

  26. Hi Daniel,
    Interesting to read your 10 reasons for buttock pain, I have had such pain for the last 6/12, when I first get up in the morning, I can hardly put my weight on my legs, shooting pains down the path of the sciatic nerve, I take painkillers and gradually the shooting pain is replaced by waves of pins and needles down the front of my legs, and into my feet, this is more severe on the right. later in the day I get a nagging ache in both buttocks, and the pins and needles recur at intervals. I have seen a physio, an osteopath, had acupuncture and massage, most treatments give relief that lasts 24hrs. I am now waiting to see a rheumatologist, but I am beginning to despair! Any suggestions ?

    1. Hi Wendy. sorry to hear about your problems. Two thoughts. 1st this isn’t an exhaustive list, there are other less common reasons that I chose to leave out, so picking a condition from here isn’t the best way of “diagnosing” you

      The 2nd Giving a suggestion when I haven’t seen you is really hard to do. The other therapists you’ve seen, did they give you a tissue that was causing the problem (ie a disc or a muscle?), or did they just use the catch all sciatica diagnosis? If I were to have that information I could perhaps offer some advise tailored to you.

  27. Hi Daniel

    Iam certain that i have been suffering with piriformis syndrome for 10 years, often unable to walk even after sitting or lying down, all the symptoms match how i suffer ( some days nearly in tears with pain) i work full time and iam on my feet 10 hours of my 12 hour shifts, my doctor only offers more painkillers and refuses to acknowledge piriformis syndrome, i have had an mri scan that showed up only minor wear in my spine, my doctor sent me to physio that left me off work for 3 weeks in horrific pain, i cant go to another doctor as all three at my surgery just offer painkillers,, any advice ?

    1. Hi Nygel, It’s often hard to give specific advice without having seen and examined a patient, (in this case you)

      Let me have a little think about it, and I’ll get back to you with something you can use hopefully by this time tomorrow.

      Is that OK?

  28. Hi there Daniel
    thanks for a really good articel which helped me remember the causes and highlighted what to ask the [patient when I see him

    1. Glad you enjoyed reading it. Writing posts like this acts as good revision of possible differential diagnosis. I did leave out a few, only because they would hopefully present as more than musculoskeletal symptoms.

  29. Good article on buttock pain from @GlasgowOsteo that will stop you taking them for granted. http://t.co/WfIPfBLw”

  30. RT @GlasgowOsteo: Are you sitting comfortably? 10 reasons why you might not be. New post http://t.co/LntmU2Fs

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