Pain in the buttocks is often gradual onset and can include piriformis syndrome, myofascial pain or pain referred from the lower back or sacroiliac joint. A direct impact can cause a contusion or bruising.
Piriformis syndrome causes pain in the buttock which may radiate down the leg. It is due to the sciatic nerve being impinged by a tight piriformis muscle deep in the buttocks. Overuse and tight adductor muscles can cause the nerve to be impinged and make the buttock painful. Resting, icing and stretching can help ease the pain, with strengthening exercises helping once the pain has gone.
The Sacroiliac joint is located at the bottom and just to the side of the back. They can become inflamed and painful, causing either a sharp pain or an ache in the lower back which can spread to the buttocks. The pain can be caused by a trauatic impact, poor biomechanics, inflammatory disease or from hormonal changes, such as pregnancy. Read more on the causes, symptoms, and treatment of this joint pain.
Ischiogluteal bursitis is inflammation of the bursa that lies between the Ischial tuberosity and the tendon of a hamstring muscle. A bursa helps movement betweeen the tendon and the bone so when this becomes inflamed it can be painful. It can occur with a hamstring or tendon injury, which have similar symptoms to ischiogluteal bursitis.
Myofascial pain or trigger points in the Gluteus medius and 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.
Bruised buttocks or a contusion of the buttocks is bleeding in the muscles caused by a direct impact to the area. This can be from a fall or being hit in the area by a hard blunt object such as a hard ball. There will be pain and tenderness at the point of impact. Read more on the ways you can treat this injury.
A pelvic avulsion fracture is where the tendon comes away from the bone, often taking a piece of bone with it. This most commonly occurs at the ischial tuberosity where the hamstrings attach, or the anterior inferior iliac spine, AIIS, at the front where the Rectus Femoris attaches. Pain can be caused from explosive movements, and the location of the pain indicates what kind of avulsion fracture it is.