Pain in Buttocks

A great deal of muscle and bone is located in the buttocks which help the body maintain balance and movement. Pain in buttocks may be localized or could originate elsewhere and felt in this region. In most cases pain in buttocks is mechanical in nature and may be managed with consecutive treatments. Any pain in buttocks that is not resolved in a few days or becomes progressively worse may be a sign that something more serious is impacting the area which should be evaluated by a doctor.

If the pain in your buttock region is very intense, is accompanied by sudden swelling, causes an inability to bear weight on the affected leg, causes an inability to move the hip or leg or the joint appears to be deformed, seek medical attention immediately.

Causes of Pain in Buttocks

  1. Sciatica. Sciatica is pain that affects the lower back, spreading down the back into the buttocks, legs and feet due to compression or irritation of the large sciatic nerve. In most cases this discomfort is caused by a herniated disk in the lumbar spine, caused by the center portion of a spinal disk pushing out of its confines and putting stress on the sciatic nerve. This condition may also include pain in one hip or leg, muscle weakness or a loss of sensation in the affected area.
  2. Piriformis Syndrome. The piriformis is a small muscle that is located in the center of the buttocks. This muscle is very active during movements such as walking or running which makes it easy to overstress the muscle. If this muscle becomes overstressed it will become tight, causing inflammation and pain in the buttocks and hip. A tightened piriformis may also spasm, putting pressure on the sciatic nerve, causing symptoms similar to those of a herniated disk.
  3. Sacroiliac Joint Dysfunction. The sacroiliac joint is formed in the sacrum beneath the pelvis and spinal column. This is a common location for pain felt in the buttocks to originate. Those that frequently sit for long periods of time can experience fixated pain in this area as the ligaments and muscles become tight. Inflammation in the sacroiliac joint may cause extreme pain with even the slightest movement.
  4. Ankylosing Spondylitis. This inflammatory condition will initially impact the sacroiliac joint or spine, though it may progress to other joints throughout the body. This inflammation and pain is typically managed with therapy or anti-inflammatory medications.
  5. Osteoarthritis. Osteoarthritis is caused by "wear and tear" on the joints. The sacroiliac joint and hip are susceptible to this condition which may cause pain in the buttocks. The pain may become more centralized when the joint is suffering from inflammation. This may also lead to muscle stress and pain.
  6. Bursitis. The bursa is a fatty sac used to reduce friction when muscles cross other muscles, bones or ligaments. Muscles that have been overused can become tight, rubbing on and inflaming the bursa. The trochanteric bursa and ischial bursa in the bursa lie on either side of the buttocks, causing pain in this area when they become inflamed.
  7. Coccydynia. The coccyx or tailbone is located at the base of the spine below the anus. The ligaments that allow the coccyx to maintain its position can become strained, leading to pain felt in the buttocks.
  8. Iliolumbar Ligament. This ligament is responsible for holding the Ilium or hip bone to the lumbar spine. It is located in the dimples in the lower back. It can be strained if the lower back is unsupported through long periods of sitting. Straining this ligament can lead to inflammation and pain similar to sciatic pain.
  9. Trigger Points. Any localized point that is highly irritable spot that exhibits exquisite tenderness in a nodule or palpable band of muscle. Trigger points are caused when a nodule presses against or irritates a trigger, causing pain in the quadratus lumborum muscles or calf muscles, leading to pain in the buttocks.
  10. Buttock Muscle Damage. The gluteus medius, maximus and minimus make up the main muscles of the buttocks. The gluteus maxamus is the largest of these muscles, perhaps one of the strongest in the body. Trigger points within these muscles can be irritated, causing pain throughout the buttocks.
  11. High Hamstring Tendinopathy. If the pain in the buttocks is more noticeable when sitting it may be caused by tightness in the hamstring. Proximal hamstring tendonopathy and high hamstring tendonitis is defined as inflammation originating in the hamstring, causing pain in the lower buttocks, or pelvic bone region. This pain is often described as being similar to a toothache.

Remedies for Pain in Buttocks

  1. Rest and Sleep. If the sciatic nerve has been irritated, continued movement can increase your discomfort and prolong healing time. If the piriformis or other muscles are irritated avoid activities such as tennis, running soccer, basketball, running and others. Getting plenty of sleep will allow your body to better address any illness or damage to this area. Applying a topical analgestic in the affected area can help to minimize spasms of the sciatica that can inhibit your ability to rest or sleep.
  2. Stretch Yourself. Stretching the muscles in the buttocks, upper legs and lower back can help to relax them, relieving strain on the joints and nerves in this area. Stress gently to avoid excessive strain and stop stretching immediately if it causes a sharp pain or additional aggravation. Lying on your back and pulling a knee up toward the opposite shoulder, holding this position for 5-30 seconds is an ideal way to stretch muscles near the sciatic nerve.
  3. Use Ice Compress. Placing a cold pack or ice on the tailbone or lower spine for 20 minute intervals 2-3 times each day can reduce swelling in this area to provide relief. Alternating cold applications with a heating pack can help to reduce inflammation. If this has not been effective after 4-5 days, limit your use of heat to 20 minutes each day as it may begin to dry out the tissue and cause more damage.
  4. Keep Straight. Standing or sitting in a straight position can help to prevent irriation to the nerves, both helping to prevent further damage and decrease haling time for pain. Invest in chairs and couches that provide adequate support and invest in a support condition to ensure that you are able to sit up straight.
  5. Get Moving. Avoid sitting for longer than 15-20 minutes at a time without a break. Remaining still for long periods of time will cause muscle strain, damage and stiffness around the spine. Stretch or take a short walk to maintain circulation to shorten recovery time. Avoid pushing yourself too hard as this can cause further irrigation.
  6. Watch for Your Wallet. Men that carry a large wallet in their back pocket will often sit unevenly, causing strain or damage to the sciatica.
  7. Drink Plenty of Water. If the body is not properly hydrated the tissues will become tacking and form adhesions that will slow your ability to heal. If adhesions form between the sciatic nerve and surrounding tissue it increases your risk of developing further damage or pain in the buttock region.
  8. Massage the Affected Area. A deep tissue massage in the lower back, hamstring or piriformis area can help to relieve tension and take stress off the nearby nerves. Combining a massage with pain relievers can help to relax these muscles to promote healing.
  9. Get Help From Professionals. Your doctor or chiropractor can help to diagnose what is causing frequent pain in the legs or lower back. If a condition of the nerves is contributing to your discomfort you may need permission from your doctor to take time off work so you can heal properly.

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