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. Pain in the buttock area can be caused by buttock structures, or it can be referred  from other areas of the body, such as the lower back or thigh muscles.

Sciatica:

This 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:

This 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 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 centered when the joint is inflamed in which case it’s the inflamation 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.

Bursitis:

A bursa is a fatty sack. It’s 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. The two main bursa in the buttock area are the trocanteric bursa and the ischial bursa. One can can give you pain 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 have been described as “a highly irritable localized 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.

Buttock Muscles:

The Gluteus maximus, medius and minimus are the three main buttock muscles. Gluteus maximus is 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 tendonopathy 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 tooth ache all the time. More about High Hamstring Tendinopathy

 

44 Responses to 10 Causes Of Buttock Pain

  1. @stinkyrich says:

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

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

  3. @macdog73 says:

    RT @GlasgowOsteo: A pain in the butt. What’s causing yours? http://t.co/LntmU2Fs

  4. Dr Kenneth Landers says:

    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

    • Daniel Gerber says:

      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.

  5. nygel says:

    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 ?

    • Daniel Gerber says:

      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?

  6. wendy wallace says:

    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 ?

    • Daniel Gerber says:

      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.

  7. Sid says:

    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?

  8. A. Qayyum Khan says:

    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?

    • Daniel Gerber says:

      While I don’t have a diagnosis it would be hard to help, and as I’m sure you can appreciate it would be impossible to examine you while you’re in Jeddah. Any advice given would have to be general in nature and may not be correct for your condition as no diagnosis has been made.

  9. Kathleen says:

    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?

    • Daniel Gerber says:

      Osteopathy can often help with sciatic pain. It would depend on the cause. The best course of action is to speak to your local osteopath. I offer a free consultation to allow me (and the patient) find out more about treatment options best suited. Many other osteopaths also offer a free consult.It could be worth trying that route

  10. Keith Jones says:

    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.

    • Daniel Gerber says:

      I’d possibly question that. Near your anus doesn’t sound right for High Hamstring Tendinopathy. Along the crease of where your buttock joins your thigh would probably be a better description of the location. It sounds more like a trigger point you’re treating with that approach. It works well and I use that treatment method a lot, but I don’t find it helps with High Hamstring Tendinopathy. Have you read my post on High Hamstring Tendinopathy for more information?

  11. Ian Wood says:

    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

    • Daniel Gerber says:

      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.

      • Ian Wood says:

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

  12. carole says:

    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 ?..

    • Daniel Gerber says:

      Without examining you it’s impossible to say. I’d also want to know if there is numbness anywhere and pain into your legs at all. There is also the possibility that your painkillers are causing the diarrhoea.

  13. Elaine says:

    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?

    • Daniel Gerber says:

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

  14. Stacey Hemingway says:

    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.

    • Daniel Gerber says:

      Coccydynia was my initial thought. This can be quite common after childbirth or falls, but the leg pain makes me doubt my initial thought. Best get it checked by an osteopath or a good musculoskeletal specialist.

  15. Stephanie Vincent says:

    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

  16. John says:

    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?

    • Daniel Gerber says:

      Sorry John you didn’t tell me where the pain was (unless you meant the referred pain to the hips and buttocks). The trouble with that is that hips mean different things to different people. “Real” hip joint pain in often felt in the groin. Some people mean the bone on the outside of their leg (the femur). Other people refefer to the big pelvic crest as their hip- (the thing trousers sometimes hang off). So as you can see it can be hard for me to give further info without knowing exactly where you mean.

      • John says:

        Hi, The pains are in the outer area of the hip, and caused by my weight lying on my side. As if I was lying on a hard floor rather than a mattress.
        The buttock pain is soon after sitting down, and as if I had been sat for many hours rather than a few minutes.

        • Daniel Gerber says:

          Thanks for getting back to me. It sounds like there may be two problems, although they may be connected.

          Without examining you it is hard to be sure, but I’m not happy with the diagnosis. Compression of “something” local seems to be causing the problem, rather than a referred pain. I probably would start with treatment of the gluteal muscles and see what changes you notice.

          I personally have treated people with similar symptoms and they have had good results. As is at the moment I don’t see why I can’t get the same with you, but I’m sure you’ll understand that I can’t give a definite answer until I have a proper diagnosis and this can only be given after a proper case history and examination.

  17. Chris says:

    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.

    • Daniel Gerber says:

      Hi Chris on first read it sounds like it may be a disc problem, but the “struggle to walk at first” makes it sound like walking improves it. Does it? because this would change the diagnosis. Best thing to do is get it checked out to be sure.

  18. 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

  19. Mahendra Damania says:

    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

    • Daniel Gerber says:

      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.

      • Mahendra Damania says:

        Hi Daniel,
        I had seen doctor who suggested to go for bone scan. Bone scan revealed no damage to bone, so I was suggested to go for Physio. I am not too sure about his diagnosis but after going through couple sittings it was more painful and I stopped. Treatment included hot pad and then massaging.
        Regarding fall, it must be approx 4 feet of fall.
        Thanks,
        Mahendra

  20. Hil says:

    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.

    • Daniel Gerber says:

      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?

  21. Steve Thorpe says:

    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?

    • Daniel Gerber says:

      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?


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