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Buttock muscle pain can arise from the gluteal area, the lower back, the pelvic area, or the hip. Buttock pain is commonly associated with stiffness in the lower back and/or hips, making daily tasks difficult. Putting on shoes, sitting, standing up from a seated posture, walking, and/or driving are all common actions that are affected.

Buttock pain conditions can affect the nerves in the gluteal region, causing symptoms similar to sciatica in the hip, thigh, and/or leg. Buttock pain is typically treated with rest, self-care, and medical intervention.

This blog explores the different causes of buttock discomfort as well as effective treatments.

Buttock pain originating in the gluteal region

Buttock pain that originates in the gluteal region might be caused by buttock muscle abnormalities or problems with the pelvic and hip bones and joints. Lower back and pelvic discomfort, deep pelvic muscle pain, lumbar spinal nerve pain, and sciatic nerve pain are examples of these diseases.

Myofascial Pain Syndrome. Myofascial pain syndrome, which affects the buttock’s massive gluteus maximus and gluteus medius muscles, is a common cause of buttock muscular soreness. Myofascial pain syndrome is characterised by the formation of painful muscle knots known as trigger points, which elicit acute pain when compressed or lightly touched. These trigger points may cause pain to spread throughout the buttocks.

    Trigger points develop as a result of muscular fatigue produced by persistent stress or frequent microtrauma to the buttock, such as severe physical activity. 

Piriformis syndrome. Piriformis syndrome is a condition in which the piriformis muscle, located deep in the buttock, spasms and produces pain. The piriformis muscle can also irritate the nearby sciatic nerve, causing pain, numbness, and tingling along the back of the thigh and leg, as well as sciatica-like pain in the buttock.

    Spasms, tightness, or an increase in volume or mass (muscle hypertrophy) as a result of trauma, overuse, or poor posture are the most prevalent causes of piriformis syndrome.

Bursitis of the ischium. Ischial bursitis is an inflammation of the ischial bursa, a fluid-filled sac that serves as a cushion between the hamstring muscles and the ischial tuberosity, a prominent component of the bottom border of the pelvic bone. Because they make contact with the sitting surface and absorb the body’s weight while sitting, the ischial tuberosities are also known as sit bones. Buttock soreness after sitting for an extended period of time is a frequent symptom of ischial bursitis. When pressing the bony prominence of the lower pelvic rim, pain is also felt. 

    Hamstring tendon damage causes ischial bursitis. 

Ischiopubic ramus – The ischium impinging on the femur. When the outside rim of the pelvic bone (ischium) makes inappropriate contact with the top of the thigh bone (femur), it causes ischofemoral impingement. This type of touch, which is more common in females, may cause buttock pain. 

Stress fractures of the ischiopubic ramus (the lowest segment of the pelvic bone) can cause buttock pain. Other signs of an ischiopubic ramus fracture include increased symptoms when standing or standing on one foot (on the afflicted side). If you suspect an ischiopubic ramus fracture, seek immediate medical attention and treatment from an expert.

Buttock pain stemming from the pelvic region

The pelvic area is made up of the pelvic floor, sacrum, and coccyx. The following disorders have an impact on these structures:

    Coccydynia. The medical term for the tailbone, which is located at the very bottom of the spine, is the coccyx. Coccydynia is a condition that causes moderate to severe pain in the coccyx, which is frequently perceived as localised pain along the midline of the buttock. When sitting, reclining, rising from a seated position, or engaging in any activity that puts pressure on the bottom of the spine, symptoms of coccydynia worsen. 

    A pelvic floor dysfunction. The pelvic floor muscles support vital organs and regulate hip, sacroiliac (SI) joint, lower back, and trunk mobility. If these muscles become overly active without adequate rest, they can cause pain in the buttock, lower abdomen, tailbone area (coccyx), and back of the leg. Pelvic floor dysfunction is a condition that affects more bikers and women after pregnancy. Buttock and thigh pain caused by pelvic floor dysfunction may be misdiagnosed as sciatica. 

    Endometriosis. Endometriosis is a female-only gynaecological disease. The syndrome results in the development of uterine tissues outside of the womb. The illness usually causes moderate to severe lower back pain, pelvic pain, and lower stomach pain during menstruation.  Some women may experience hip and buttock discomfort during endometriosis if the sciatic nerve is damaged. 

In rare circumstances, buttock pain may be caused by tumours or severe nerve illnesses in the sacrum and coccygeal spine, in addition to severe lower back or leg pain, severe numbness and weakness in the buttock/thigh area, nocturnal anguish, growing weight loss, and/or lack of appetite. These symptoms indicate a medical emergency and should be addressed by a doctor as soon as possible.

Sciatica –

Sciatica is a collection of symptoms that start in the lower back when the spinal nerves become inflamed, irritated, pinched, or crushed. Sciatica is characterised by mild to severe pain, numbness, altered sensation, and weakness on one side of the lower back, thigh, leg, and foot. Sciatica pain in the buttocks can be caused by a pulled lower back muscle, sacroiliac joint dysfunction, or spinal nerve compression at the L4-L5 and L5-S1 spinal segments. 

Sciatica-like buttock pain can be caused by piriformis syndrome, which occurs when an inflamed or spasming piriformis muscle pushes on the sciatic nerve, causing symptoms similar to sciatica.

How to Treat Buttock Muscle Pain

Buttock muscle soreness can be treated with over-the-counter (OTC) medications, heat and/or cold therapy, and simple stretching exercises that target the buttock, hip, and lower back muscles. Massage the gluteal region gently with a foam roller or tennis ball to assist release trigger points in the superficial and deep gluteal muscles and relieve buttock soreness.

Using a supported sitting posture and avoiding sitting on hard or uneven surfaces are two lifestyle modifications that can help reduce tension in the buttock and pelvic regions. If these self-care approaches do not reduce buttock pain within a few days or weeks, or if the pain worsens, a medical evaluation is necessary.

Buttock muscle pain treatment is reliant on the underlying cause, which can be accurately diagnosed by a specialist in musculoskeletal disorders of the spine. Nonsurgical treatments are normally tried first before considering more intrusive treatments like injections and surgery, unless there is a medical urgency, such as cauda equina syndrome or a spinal tumour.

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