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.
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.
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 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.
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.
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.
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 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 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.
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