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Buttock Pain What You Should Know

Buttock Pain What You Should Know

If you work in an office, you likely remain seated for up to eight hours a day, sometimes more. That constant pressure on your back and tailbone that comes from sitting for long periods of time can cause pain to radiate throughout your lower body, causing damage over a long period of time and leading to serious lower back and butt pain. Buttock pain can affect your muscles and lower back and hip joints resulting in a constant pain that is further aggravated by activities such as running and even just by sitting down.

This pain may be an offshoot of another injury or condition. For example a lower back injury may cause a spasm or discomfort in the buttock muscles or inflamed ligaments at hip joints may result in the pain.

Often buttock pain is related to or as a result of an injury elsewhere such as the lower back. Pain usually develops gradually over time, but can also occur suddenly in the case of muscle strains or sciatic nerve-related injuries.

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.

You might not have paid much attention to your buttocks, given that they’re behind you. But you will notice if they start to hurt. Your buttocks are mainly composed of fat and gluteal muscle, but they can be prone to injury and disease.

Having a literal pain in the butt is not a fun experience; it can make walking, sitting and sleeping difficult and uncomfortable. It is certainly something that one would want gone as soon as possible, yet sometimes we unknowingly exacerbate the issue by trying to stretch the injured area.

There is a special name for these types of practices: anga bangha. It basically means that you want to do something good but end up hurting yourself. Today we will explore three types of the pain in the butt and how you can avoid making your practice anga bangha.

A number of conditions can cause pain in the buttocks, from minor muscle strains to infections. Most of these conditions aren’t serious, but some warrant a visit to your doctor.

3 Types of Pain in the Butt

Lower Butt Pain

Many years ago I was preparing for a fitness competition and my routine included a split. One day, being young and silly, I plopped into the split right off the bat and heard “Crrkkhh” at the bottom of my right buttock. “Hmm,” I thought, “that didn’t sound too good.” I did manage to get out of the split, but ended up limping for couple of weeks and then dealing with butt cramps for months afterwards.

Location: This is the pain that you experience right in the crease of the buttock at the back of the thigh. It might give you trouble when you walk, but becomes especially pronounced when you bend forward with legs straight.

Offender: Hamstring tendon(s)

Reason: This type of pain is usually a sign of an injury to the tendon(s) that attach your hamstrings to the pelvis. It is usually a result of pulling on the hamstrings too enthusiastically, An anatomical diagram of a lower butt crampespecially if they haven’t been warmed up properly. When yoga practitioners insist on keeping the legs straight in forward bends and then force themselves into a pose, they may end up injuring the tendon. Yoga teachers who demonstrate a lot in their classes are also at risk, since they are more likely to go into a difficult posture without proper preparation.

Common remedy: Here is the paradox: When the tendon becomes injured, the hamstring muscles naturally contract, trying to prevent further damage to the tendon. And we think, my hamstrings feel tight and painful; if I only stretch them the pain will go away. So instead of allowing the tendon to heal, we keep reinjuring it by actively stretching the hamstrings. This cycle can go on for a very long time.

Better solution: Give your tendon(s) a chance to heal. This means contracting the hamstrings to increase circulation to the area, bending the knees generously in the forward bends and only very mild stretching, if any. Once the acute phase has passed, you can begin to add gradual stretching.

Outer/Upper Butt Pain.

I have a client who came to me complaining about the pain in the hip that interfered with her walking and sleeping. She has been to a physical therapist who suggested core strengthening, an orthopedic surgeon who diagnosed her with piriformis syndrome, and a licensed massage therapist who treated her for a tight iliotibial band.

After careful exploration we have determined that the location and symptoms of her pain were pointing toward the weakened abductor muscles (the muscles on the outside of the thigh), which caused a displacement of the pelvis and a host of muscle compensation patterns. We began to work on strengthening her abductors and shortly after her butt cramps were gone.

Location: This type of pain usually shows up in the upper or outer buttock area and can resonate down on the side of the leg. It usually gets worse during walking and while lying on the affected side at night.

Offender: Weak abductor(s), tight ilioitibial band can be a contributing factor

Reason: This pain is often due to some sort of an asymmetrical movement pattern that goes on for an extended period of time.An anatomical diagram of outer/upper butt pain that resonates down the leg

Common remedy: This pain is often perceived as an IT band issue and remedied by stretching the IT band or using the roller to apply pressure to it. This can be very useful, but it does not address the root of the problem – weak abductors. Until those are strengthened, the issue will continue to pop up.

Better solution. You need to strengthen the abductors by using them in the stabilizing role (standing on one leg) and moving role (moving the leg out to the side, preferably against gravity).

Central Butt Pain

When the Body Worlds exhibit came to town, one of the reasons I went was to check out the structure of the hip, since I do not have ready access to cadavers. Yes, it was creepy at times, but also fascinating. For example, I was amazed at how big the sciatic nerve is – yes, it’s the longest nerve in your body, extending from the lower spine all the way down into the foot, but it’s also very thick – about the thickness of your pinky finger – between your spine and hip area.

Since the nerve is so big and long, it can get pinched at various locations causing all-too-familiar sciatic pain. Two common sites of impingement are the lower back (between the lumbar vertebrae) and underneath the tight piriformis muscle.

Piriformis is a small muscle that can cause a lot of trouble if it gets tight. It sits deep within the hip and its job is to rotate the hip externally and to abduct the leg when the hip is flexed. Tight piriformis by itself can An anatomical diagram of cramps in the center of the left buttockcause the pain in the butt, but the situation becomes worse if it presses on the sciatic nerve that passes underneath (and for some people right through) the piriformis muscle.

Location: The pain can show up in the middle of the buttock, in the lower back or anywhere along the pathway of the nerve. It can also manifest as numbness or weakness in the leg.

Offender: Herniated disks, bone spurs on the vertebrae or tight piriformis muscle

Reason: Sitting or driving a lot, degenerative changes in the spine with age

Common remedy: If the sciatic pain is due to a herniated disk, it is a much bigger issue and is beyond the scope of this post. Core strengthening under the guidance of a physical therapist would be the best solution. If the pain is due to the tight piriformis muscle, we can work on releasing the muscle tension. The most commonly recommended pose for the tight piriformis is Pigeon Pose.

Unfortunately, for many people with this type of pain Pigeon Pose is too much, too soon. Pigeon Pose places the piriformis in the maximum stretched position and pulls strongly on the sciatic nerve as well. This means that if the pain is acute, Pigeon Pose can make it feel worse.

Better solution: It makes much more sense to utilize our usual Contract-Relax-Stretch principle.

Step 1. We begin by contracting the surrounding muscles (particularly gluteus maximus) to increase the blood flow into the general area.

Step 2. Then we can gently contract the piriformis muscle itself, asking it to relieve the chronic contraction (only if it doesn’t cause pain) in combination with gentle stretching. Poses like Virabhadrasana 2, Utthita Parsvakonasana and versions of clam shell (lying on your side with your knees bent and lifting top knee off the bottom knee) will contract the piriformis. A simple standing twist with a chair and Ardha Matsyendrasana (Half Lord of the Fishes Pose) would be good options for stretching it since they place your leg into flexed/adducted position without the external rotation element, which is milder for piriformis.

Step 3. When you are ready to add the external rotation element to your stretching, it’s better to choose Thread-the-Needle Pose (Supine Half Lotus) Pose instead of Pigeon, or Gomukasana. Or you can practice Gomukhasana on your back instead of in a seated position, which will apply less leverage against your piriformis. Only after practicing those will you be ready for Pigeon or Gomukasana (and some students won’t be ready for a long time if ever).

Symptoms Of Buttocks Pain

  • Pain, tingling or numbness in the buttocks and down the leg
  • Pain in one side of your lower back and buttock
  • Pain that begins in the buttock and radiates to the lower hip, groin or upper thigh
  • Pain that worsens when sitting, standing, sleeping, walking or climbing stairs
  • Tenderness or aching in the buttock
  • Difficulty sitting
  • Pain that worsens the longer you sit
  • Pain that only happens when walking or doing physical activities

Because of the involvement of the buttocks in almost everything you do, getting to the source of pain and eliminating it is paramount.

Causes Of Buttock Pain


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.

Deep Gluteal Syndrome

Sitting can compress muscles, skin and blood vessels and place pressure on nerves, sending severe pain signals to your brain. Deep gluteal syndrome shares symptoms similar to other types of buttocks pain, and it is often non-responsive to rest and home remedies.

Piriformis Syndrome

This painful syndrome often occurs in runners and athletes, and involves a small muscle near the sciatic nerve. Symptoms are similar to those of sciatic nerve pain, including pain, tingling and numbness in the buttock and down the leg. Consequently, the condition is often misdiagnosed, delaying healing and recovery.


Bruising is a common cause of buttock pain. The black-and-blue color of a bruise is caused by blood from damaged blood vessels pooling under the skin. Wondering how much longer the bruise will last? The color will tell you.

You can get a bruise if you’re injured in the buttocks — for example, if you fall while rollerblading or get hit while playing a contact sport like football. Often, you’ll notice a swollen lump and tenderness in the bruised area. Here’s how to relieve your symptoms and speed along the healing process.

Piriformis Syndrome

The piriformis muscle is in the buttocks. It extends outwards from the base of the spine to the top of the thigh. When the muscle is irritated or compresses on the sciatic nerve, piriformis syndrome occurs, causing pain in the buttocks, down the back of the legs, and thighs. You can also experience this kind of pain if you’re dealing with tight piriformis muscles. This medical condition is particularly common for athletes and runners.

Sacroiliac Joint Pain

The Sacroiliac joint is located at the bottom and just to the side of the back.

  • The joint can become inflamed and painful.
  • Pain may be a sudden sharp pain.
  • Or maybe more of an ache in the lower back which radiates into the buttocks.

Sacroiliac joint pain may have a number of causes including traumatic impact, poor biomechanics, inflammatory disease, or pregnancy.


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

SI Joint Dysfunction

Because your sacroiliac joints attach your spine to your pelvis, they can easily become damaged during vigorous physical activity. SI joint pain usually begins in the low back and buttock, sometimes radiating to the hip, groin or upper thigh. Pain is usually one-sided, but it can affect both sides. SI pain often gets worse when sitting, standing, sleeping, walking or climbing stairs.

Muscle Strain

Your buttocks are made up of three muscles: the gluteus maximus, gluteus medius, and gluteus minimus. You can strain one of these muscles if you stretch it so much that it tears.

This can cause:

  • swelling
  • tenderness
  • stiffness and trouble moving the affected muscle

Common causes of muscle strains are exercising too much, not warming up before you exercise, or moving suddenly or in an awkward way. If you think a strain may be the source of your pain, here are a few things you can do to find relief.


When the tailbone (also known as the coccyx) is injured or strained, it’s called coccydynia. Coccydynia can be caused by poor posture or prolonged strain on the coccyx, both of which can occur because of an uncomfortable or unsupportive office chair.

Hamstring Tendonitis

Hamstring tendinitis is inflammation or degeneration of one of the hamstring tendons at the point it attaches to the pelvis.

It may follow a tear of the hamstring tendon which hasn’t properly healed or simply develop through overuse.
Pain may come on gradually, especially after activity.
Stretching the hamstrings is likely to be painful. In particularly chronic cases the sciatic nerve becomes irritated causing sciatic pain.


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.

Herniated Disk

Each of the bones in your spine is separated and cushioned by small pads filled with a jelly-like material. These are called disks. A disk can become herniated if its outer layer tears, letting some of the inner material slip out. A herniated disk can press on nearby nerves, causing pain, numbness, and weakness.

If the affected disk is in your lower back (lumbar spine), you’ll likely feel the pain in your buttocks. The pain can also radiate down your leg. Other symptoms include:

  • numbness
  • tingling
  • weakness

You’re more likely to get a herniated disk as you get older, because disks degenerate with age. Other risks include obesity and working in a job where you lift or pull heavy objects.

Myofascial Pain

Myofascial pain or trigger points in the Gluteus medius and/or Piriformis muscles can cause pain in the buttock area.

A trigger point is a tiny localized knot in the muscle.
It will cause pain in the buttock or lower back which may spread to other areas.
Movement around the hip will be difficult, but this can be helped by stretching and massage.

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.

Pilonidal Cyst

A cyst is a hollow sac that can form in different parts of your body. Cysts often contain fluid, but a pilonidal cyst contains tiny pieces of hair and skin. These cysts form at the cleft between the buttocks. You can get one of these cysts if a hair grows into your skin (ingrown hair).

Along with the pain, you may notice:

  • reddened skin
  • pus or blood draining from the opening
  • a foul smell

Pilonidal cysts are more common in men than women, and in people who sit for long periods of time. You can also get them from friction — for example, while riding a bike.


A contusion of the buttocks is bleeding in the muscles caused by a direct impact or trauma. This can be from a fall, or being hit in the area by a hard blunt object such as a ball or even an opponent. Symptoms include:

  • Pain in the buttock at the time of impact.
  • Obvious tenderness when pressing into the muscles or sitting down.
  • Bruising may appear and pain and stiffness may be felt when stretching and contracting the buttock muscles during exercise.

Treatment involves rest and applying the PRICE principles.

  • Apply ice or cold therapy products regularly for 15 minutes to ease the pain, bleeding, and swelling.
  • Once comfortable to do so, start gently stretching the glute muscles.
  • Sports massage can help to relax the muscles and disperse waste products, but should not be performed within 72 hours of injury due to possibly increasing blood flow.

Diagnosis Of Buttocks Pain

  • A detailed review of your health history
  • A clinical exam that includes testing for mobility and range of motion
  • A gait analysis to identify harmful patterns of walking and running
  • Ultrasound imaging to view the structures of the pelvic region in motion

Use of pain medication and anti-inflammatories may mask your symptoms, but in most cases, buttocks pain will not go away on its own. It is important to see a specialist who can accurately diagnose your pain and develop a treatment plan to eliminate the underlying cause of pain.

Relief Options For Buttocks Pain

Avoid Prolonged Sitting When Possible

The best way to prevent buttocks pain or provide relief to existing pain is to cut down the amount of time you sit down every day. If you work in an office, this may be hard to do. You can’t exactly stop sitting down. In these cases, you might want to consider switching to a standing desk.

Standing desks are great because they allow you to choose between sitting and standing. If you start to feel like your back or butt is hurting, you can simply switch to a standing position to give yourself a break from sitting.

Of course, standing desks can be expensive, and not all workplaces allow them, so this isn’t a viable option for most people.

Stay Active Throughout the Day

Experts suggest getting up and remaining active throughout your workday is a great way to cut down your risk of chronic pain associated with sitting down for too long. You should get up, walk around, stretch, and generally move frequently throughout the day.

Every half hour to every hour, stand up from your desk and stretch out your body. Take a few minutes to walk around the office. Use this opportunity to check in with people on your team or grab a glass of water.

If you work at home, stand up, stretch, and walk around your house or apartment for a few minutes before getting back to work. Take a longer break in the middle of the day and take a walk outside if you can.

Apply Hot and Cold Packs

Using hot and cold packs to relieve pain is a tradition that’s as old as time. To use the hot and cold method, you need to have both a heating pack and a cold pack. Heating packs that plug into the wall are a great idea, as they heat up quickly, and you don’t have to worry about microwaving them.

Heat opens up your blood vessels, helping to assist in the healing process and alleviating some of your pain. Heat also increases blood flow, which can help with stiff joints. You should use heat for 15-20 minutes before switching to a cold pack.

Ice and cold packs help to relieve swelling, pain, and inflammation. You should use an ice pack or other icing method for about 10-15 minutes. You should ice the sore area about three times a day. You should leave a few hours in between icing and heating your skin, don’t switch back and forth rapidly.

Try Over-The-Counter Medications

Over-the-counter medications like Acetaminophen, Ibuprofen, and Naproxen can help with pain associated with sore buttocks, thighs, and hips. You can also take something to tone down the inflammation at the same time.

If you can’t take over-the-counter medications, there are plenty of natural methods for relieving inflammation, such as spices, herbs, and essential oils. Installing an essential oil diffuser in your office is a great way to incorporate anti-inflammatory scents into your daily routine.

Yoga and Stretching Techniques

There are so many different stretching techniques you can try to relieve the pain you’re experiencing in your lower body by working to combat muscle tightness. Exercises such as yoga and stretching will help to strengthen the muscles in your buttocks as well as help to relieve any pain you’re experiencing. To relieve pain, try the following stretches:

  • Knee to chest
  • Piriformis stretch – with your back on the floor and your knees bent, cross one leg over the other so that one ankle is on top of the opposite knee, and then pull your knees towards you.
  • Hamstring stretch
  • Bird dog stretch
  • Sitting rotation stretch

There are also many different yoga routines and videos you can follow, including some specifically made to help relieve pain associated with sitting at a desk. If your pain is serious and you want to take these stretches to the next level, you could also speak to your doctor about whether physical therapy is right for you.

Use a Seat Cushion

The best way to make your desk more comfortable is to add a seat cushion. It can be costly to upgrade your chair to something ergonomic, but seat cushions are surprisingly affordable.

You can choose from flat cushions, cushions with coccyx cutouts, and wedge cushions to help with your buttocks pain. They will help reduce the pressure you’re feeling, preventing you from developing any new pain while providing relief to your current pain.

Wedge cushions lift your hips to provide relief from tense hips, while coccyx cushions relieve the pressure that’s put on your coccyx. A standard cushion is an excellent option if you’re looking to relieve overall buttocks tension and pain.

Cushions made of memory foam and gel infusions will provide support that’s contoured to your body while also keeping you cool throughout the day.

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