Buttock Pain

Buttock pain

Buttock pain causes include Piriformis syndrome, Sacroiliac joint pain, Tendonitis, Bursitis and referred pain from the spine.


Sacroiliac joint pain

The Sacroiliac joint is located at the bottom and just to the side of the back. It can become inflamed with the following symptoms:

  • Sudden sharp pain in the joint
  • An ache in the lower back which radiates causing buttock pain

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

Piriformis syndrome

Piriformis syndrome causes pain in the buttock which may radiate down the leg. The sciatic nerve becomes impinged by the Piriformis muscle, deep in the buttocks.

  • Buttock pain
  • Pain may radiate down into the back of the thigh and even into the calf muscles

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.

Ischiogluteal bursitis buttock pain

Ischiogluteal bursitis

Ischiogluteal bursitis is inflammation of the bursa that lies between the ischial tuberosity and the tendon of a hamstring muscle. A bursa helps movement between the tendon and the bone.

  • The bursa can become painful and inflamed with symptoms almost identical to Hamstring tendonitis.
  • Pain is located at the top of the back of your thigh, just below the crease of the buttock.
  • Stretching the hamstring muscles may be painful.
  • It can occur with a hamstring strain or tendon injury.

Prolapsed disc (slipped disc)

Prolapsed disc causes butock pain

A herniated disc, slipped disc or prolapsed disc occurs anywhere in the spine, although is most common in the lower back. Symptoms include:

  • Back pain.
  • Leg pain.
  • Neural (nerve) related symptoms.
  • Bowel and bladder problems.

Treatment may involve rest and exercises or surgery may be required in some cases.

Hamstring/Pelvic avulsion fracture

Buttock pain from hamstring avulsion

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.

Symptoms include:

  • Sudden pain, usually during a powerful, explosive movement.
  • Pain at the back of the pelvis in the crease of your buttock.
  • You will feel weakness and pain when doing certain movements such as sprinting, squatting, or jumping.
  • Bruising and swelling are likely.

Myofascial buttock 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.

Referred buttock pain (from the Lower back)

Pain in the buttocks may be referred from problems in the lower back, even if there is no obvious low back pain present. Many problems could cause this to happen including:

  • Prolapsed or ‘Slipped’ discs.
  • Nerve impingement from the joints in the spine.
  • Symptoms include a diffuse or deep aching in the buttock which can vary from mild to severe.
  • The slump test is used to identify if the sciatic nerve causing buttock pain.

Buttock pain from contusions

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.

Compartment syndrome

Chronic compartment syndrome occurs when a muscle swells up too big for the sheath that surrounds it.

  • Symptoms consist of pain in the muscle, especially during exercise when the muscles expand due to blood flow.
  • This is very rare but may happen in muscles at the back of the thigh and buttock, particularly following a muscle strain or previous injury.

Stress fracture of the sacrum

Stress fractures of the sacrum are rare and most likely to affect female long-distance runners. Symptoms include:

  • Vague low back or buttock pain on one side
  • Pain is worse with weight-bearing activities such as running
  • Tenderness on the bone itself

Treatment involves rest or non-weight-bearing exercise until paid goes, usually a couple of weeks. Then a gradual return to training is important rather than going straight back into full training.

Be aware of:

There are a number of conditions which although rare may be overlooked when diagnosing buttock pain. These include:

  • Spondyloarthropathies.
  • Tumours.
  • Infections of bone and joint.
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