Buttocks Pain: 12 Possible Causes

Written by Jamie Page
Physiotherapist, Salford University
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on June 28, 2022

Woman with buttocks pain sitting on the couch

Pain in the buttocks or gluteal pain usually happens because of overuse injuries.[1] This could lead to inflammation of the gluteal muscles resulting in irritation of the sciatic nerve causing pain in the buttocks extending to the back of the leg.

What other symptoms can accompany pain in the buttocks?

Other symptoms that come with gluteal pain depend on the underlying condition. Damage or irritation to the surrounding nerves in the butt may lead to numbness and weakness in the legs.

Strains and injuries to other soft tissues of the butt can cause difficulty walking or negotiating stairs. Some medical conditions can cause gluteal pain and present with loss of bowel and bladder control.

What are the causes of pain in the buttocks?

Various conditions may cause pain in the buttocks. Most of them are minor concerns like muscle strains, but others may require additional medical attention, such as infections..

1. Bruising

Direct injury such as falling and landing on your buttocks or getting hit while playing contact sports can cause bruising. Bruising is typically characterised by black-and-blue discolouration in the skin surface of your buttocks due to the damaged blood vessels underneath the skin.

2. Muscle Strain

Strong muscles of your buttocks control the movement of your hips and pelvis. However, like any other muscle, they are also prone to tears if overstretched. In addition, gluteal strains can lead to swelling and tenderness of your butt, causing difficulty moving around.

Improper training, overuse and sudden awkward hip or leg movements during high-intensity activities can cause muscle strains.

3. Sciatica

Sciatica is a symptom rather than a condition. Irritation or damage to the sciatic nerve located beneath the muscles of your buttocks can cause sharp or burning pain extending from your back down to your leg.[2]

4. Bursitis

Bursitis is an inflammation of the bursa, a fluid-filled sac that reduces the friction between the moving parts of your joints. The ischial bursa in your buttocks can also be injured from sitting for a long time on a hard surface.

Ischial bursitis causes swelling and pain when sitting or lying down. Pain can also radiate down to the back of the thigh.

5. Bulging Disc

The spinal disc in between your vertebrae can become inflamed and create pressure on the surronding nerves. This impingement of the surrounding nerves causes pain, numbness and weakness. A bulging disc is a common injury amongst the sporting population.

6. Degenerative disc disease (DDD)

As we get older, the discs in your spine wear down and lose their cushioning function that keeps your vertebra from rubbing against each other. Degenerative Disc Disease of the lumbar and sacral spine can cause pain in the buttocks and thighs.

7. Piriformis syndrome

Overuse injuries can irritate the piriformis muscles, causing pressure on the sciatic nerve. This may lead to sciatica or sharp pain that extends from your back down to your leg. Numbness and tingling sensation are also common symptoms of piriformis syndrome.

Physiotherapy and compliance to exercise programs is the best way to treat this condition.

8. Pilonidal cyst

A pilonidal cyst can form at the bottom of your tailbone or coccyx. It contains tiny pieces of hair and skin debris. It usually occurs when a hair punctures the skin and becomes embedded. The pilonidal cyst can get infected in some cases, resulting in pain and an abscess with a foul smell.

It is common among people who sit for long periods, or sitting on a surface with a lot of friction, such as riding a bike.

9. Perirectal abscess

Bacteria can get trapped in the connection between the inside of the anus and skin, causing a perirectal abscess formation.

This is common among adults with diarrhoea, constipation and other bowel problems. Doctors can perform surgery to remove the fistula and perirectal abscess.

10. Sacroiliac joint dysfunction

The sacroiliac joint connects the hip bones to the sacrum, the bone between the lumbar spine and the tailbone. Dysfunction in the biomechanics of the sacroiliac joint can cause pain in the lower back that may radiate to the buttocks.

Sacroiliac joint pain can easily be misdiagnosed. That’s why it is vital to consult a professional for treatment. Physiotherapy can help improve joint mechanics and strengthen key muscle groups to help you manage the pain and improve your daily activities.

11. Arthritis

Arthritis of the hip joint can cause pain in the buttocks. Pain and stiffness of the hip joint can get worse during the morning and gradually improve throughout the day. A combination of physiotherapy and pain medication can help you manage the symptoms of arthritis.

12. Vascular Disease

Blockage to the vital blood vessels supplying blood to your legs can cause leg pain and other medical symptoms. Walking for a certain distance can cause an aching pain on the buttocks and legs when you have blocked arteries.

Weakness and hair loss in the legs are also common signs of arterial problems. It is best to consult a medical doctor if you have these signs and symptoms.


Treatment of buttock pain requires a tailored treatment from a qualified medical professional such as a physiotherapist, rheumatologist or orthopaedic specialist.

Treatment should focus on addressing the root cause of your pain rather than the pain itself. However, your doctor may also give you pain medications to control the pain.

Consult a physiotherapist

Physiotherapists can create a tailored treatment plan for you to strengthen your muscles and correct impairments in your biomechanics. In addition, they will give you therapeutic exercises to improve your range of motion and help you manage your symptoms.

Written by Jamie Page
Physiotherapist, Salford University
Published on June 28, 2022
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on June 28, 2022
Medical reviewers
Last medically reviewed on June 28, 2022
BookPhysio.com has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
  • 1.

    Zügel M, Maganaris C, Wilke J, Jurkat-Rott K, Klingler W, Wearing S, Findley T. Barbe M, Steinacker J, Vleeming A, Bloch W, Schleip R & Hodges P. Fascial tissue research in sports medicine: from molecules to tissue adaptation, injury and diagnostics: consensus statement. Brit J Sprts Med 2018 [cited 2022 June 20]; 52(23): 1497-1497.

  • 2.

    Koes BW, van Tulder MW & Peul WC. Diagnosis and treatment of sciatica. BMJ (Clinical research ed.) 2007 [cited 2022 Mar 4]; 334(7607):1313–1317.

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