What Is Causing Buttock Pain and How to Relieve It

Buttock pain can have several causes, including injuries, overuse conditions, and nerve compression. Because buttock pain can significantly impact your ability to sit, stand, or walk, it is important to determine the underlying cause, receive appropriate treatment, and prevent your condition from getting worse.

Causes of Buttock Pain

Different causes of buttock pain can produce varied symptoms, including shooting, burning, numbness, tingling, or aching sensations. Some causes of buttock pain will come on suddenly while others can develop gradually over time.

1. Osteoarthritis

Osteoarthritis, also called degenerative joint disease, is a condition that causes pain, stiffness, and inflammation of joints from the breakdown of cartilage. Osteoarthritis tends to develop slowly due to the wear and tear that accompanies aging, but can also develop quickly after an injury. 

Osteoarthritis can affect any joint, including the hip. Osteoarthritis of the hip can cause a dull, aching pain in the groin, side of the hip, or back of the buttocks that can make walking difficult. 

2. Sciatica

Sciatica is a general term that refers to compression of the sciatic nerve, the largest nerve in the body that runs from the lumbar spine of the lower back down the back of the leg. Compression of the sciatic nerve can cause pain, tingling, numbness, and weakness in the buttock, back of the thigh, and/or below the knee.

Sciatica nerve compression can result from a variety of different causes, including bulging or herniated discs, spinal stenosis, direct nerve injury, or muscle tightness.

3. Piriformis Syndrome

Piriformis syndrome is a condition characterized by an overly tight piriformis muscle in the back of the hip. Because the piriformis muscle most commonly overlays the sciatic nerve, tightness of the piriformis can cause compression of the sciatic nerve, resulting in buttock pain that radiates down the leg.

Symptoms of piriformis syndrome present or significantly worsen when sitting for extended periods due to constant pressure on the piriformis muscle.

4. Sacroiliac Joint Dysfunction

The sacroiliac joint is the joint that forms between your sacrum and both sides of your pelvis at the base of your spine. While very little movement occurs in the sacroiliac joints compared to other joints of the body, the sacroiliac joints can become stressed or shifted out of normal alignment from pregnancy and childbirth, injury to the spine or pelvis, muscle imbalances, or uneven leg lengths.

Sacroiliac joint dysfunction causes deep joint pain directly at the sacroiliac joint pain at the upper portion of the buttocks. Standing, walking, and climbing stairs all tend to worsen sacroiliac joint pain.

5. Hamstring Tendonitis

Tendonitis refers to inflammation of a tendon, connective tissue that attaches muscles to bones, from overuse of the associated muscle without proper rest. Hamstring tendonitis can occur from overuse of the hamstring muscles in the back of the thigh, which commonly occurs with long-distance running, repetitive weight lifting, and field-based sports. 

The hamstring tendons attach to the ischial tuberosities of the pelvis, the hard bony prominences that you can feel at the bottom of your buttocks when you sit. With hamstring tendonitis, pain can develop at these bony areas and deep at the bottom of your buttocks.

6. Trochanteric Bursitis

Bursae are small, fluid-filled sacs that lay in between tendons and bones to decrease friction and irritation at tendons from rubbing over bones. With repeated contraction or overuse of the muscles associated with the tendons, the underlying bursae can become inflamed and irritated, resulting in bursitis.

Trochanteric bursitis occurs at the side of the hip where the femur (thigh bone) joins with the hip. Symptoms of trochanteric bursitis include pain, tenderness, swelling, and muscle weakness at the side of the hip and/or buttocks.

7. Ischial Bursitis

Ischial bursitis occurs between the ischial tuberosity (a bone in the lower pelvis) and the tendon that attaches the hamstring muscle to the bone. This condition is associated with prolonged sitting and repetitive movements of the gluteus maximus muscle. Symptoms may include pain in the upper thigh or buttocks.

8. Coccydynia

Coccydynia, or coccyx (tailbone) pain, often results from a fall on your buttocks and landing directly on your tailbone. Injuring your tailbone can cause a tailbone fracture or bruise to the connective tissue around your tailbone, causing significant pain and discomfort, especially when sitting.

9. Hemorrhoids

Hemorrhoids result from swollen and inflamed blood vessels around the rectum, causing pain, burning, itchiness, and sometimes bleeding during bowel movements. Hemorrhoids are often caused by straining during bowel movements, chronic constipation or diarrhea, or pregnancy.

10. Myofascial Pain Syndrome

Myofascial pain syndrome is a chronic pain condition characterized by the presence of trigger points within muscles or fascia. When these trigger points (or muscle knots) occur in the gluteal region, it can result in buttock pain.

11. Other Causes

Some other conditions can also lead to pain in the buttocks, including:

• Pilonidal cyst
• Muscle strain
• Degenerative disc disease
• Ischiofemoral impingement

How Buttock Pain Is Diagnosed

To diagnose the cause of your buttock pain, a healthcare provider may:

• Take your medical history: This will include going over any medical conditions you have and discussing how and when your buttock pain began. 
• Perform a physical examination: After reviewing your symptoms and medical history, your healthcare provider will perform a physical exam to look at your buttocks and surrounding areas, including your hips and spine. Your healthcare provider will inspect and touch your buttock and thigh muscles and move your hips and legs to see if your motion is restricted and/or painful. 
• Recommend imaging: Imaging methods may be used to examine the structures in and around your spine, hip, and sacroiliac joints to check for damage. X-rays are typically performed first to check for signs of arthritis or broken bones. An MRI (magnetic resonance imaging) may be performed to check for a sprain, tear, tendinitis, spinal stenosis, nerve root compression, and more.
• Recommend a nerve conduction test: A nerve conduction test may be performed to examine the functioning of your nerves if your healthcare provider suspects nerve compression or damage is causing your buttock pain. This test will measure how fast your nerves transmit signals to assess abnormal nerve functioning.

What Is the Best Treatment for Buttock Pain?

Treatment options for buttock pain will vary depending on the underlying cause and severity of your symptoms. They may include:

• Lifestyle treatment options: Simple at-home methods can be used to help manage buttock pain. These include ice or heat for pain relief, topical pain-relieving creams or gels, stretching, using a specialized seat cushion, and resting from aggravating activities.
• Medications: If needed, medications can be used to help reduce your pain levels. Pain medication can be taken by mouth, such as over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) or stronger prescription-strength opioids, or delivered through a steroid injection into your hip or spine.
• Physical therapy: Physical therapy can help you stretch overly tight muscles and improve your strength to help correct muscle imbalances. A physical therapist may also perform manual treatments and administer therapy that includes heat, ice, or electrical stimulation to help reduce your pain intensity. 
• Surgery: Surgery may be an option for significant causes of buttock pain due to spinal problems such as spinal stenosis or herniated discs that cause ongoing pain and limit the ability to stand and walk comfortably. However, surgery may only be considered after trying other treatment methods for several weeks or months. 

Preventing Buttock Pain

Most causes of buttock pain are due to physical issues resulting from overuse, muscle imbalances, or joint problems that develop over time. Exercising regularly and strengthening muscle groups around your buttocks such as your glutes, hamstrings, and abdominals can help decrease the risk of injury. 

Whenever starting a new exercise program or an increase in physical activity, start slowly to allow your body to adjust to the increase in physical demand. But first, check with your doctor to make sure that you are healthy enough to exercise. 

When to See a Healthcare Provider

If you have persistent, unexplained buttock pain (not due to a hip or leg injury) that travels into the leg, contact your healthcare provider.

The presence of certain signs and symptoms should also prompt you to schedule a visit to a healthcare provider, such as:

• Your pain significantly impacts your ability to walk, stand, or sit for extended periods.
• You cannot move your hip without causing pain.
• You experience burning, numbness, tingling, or weakness in your hip or leg.
• You have pain and/or difficulty passing bowel movements.
• You have unusual symptoms such as fever, fatigue, or unexplained weight loss. 

Summary

Buttock pain can result from a variety of different causes, including osteoarthritis, sciatica, piriformis syndrome, sacroiliac joint dysfunction, hamstring tendonitis, trochanteric bursitis, coccydynia, and hemorrhoids. 

Most causes of buttock pain can be addressed with at-home treatments, physical therapy, and medication if needed. Some severe or ongoing causes of buttock pain resulting from spinal problems like spinal stenosis or herniated discs may require surgery if symptoms fail to improve with conservative treatment options. 

Limiting repetitive strain to your hips, correcting muscle imbalances, and resting from aggravating activities, especially if your buttocks are already hurting, can help prevent symptoms from developing or worsening.