Sciatica is a common cause of pain in the buttocks. Many different conditions can cause sciatica. For example, piriformis syndrome or a herniated disc. Treatment depends on the underlying cause.
Though most causes of buttock pain do not lead to serious complications and may go away on their own, in some instances, there may be an underlying reason that needs treatment to relieve symptoms.
While many causes of buttock pain are not concerning, there are instances when an underlying condition may mean medical attention and treatment is advisable.
Fast facts on pain in the buttocks:
- There are many reasons why a person might feel pain in their buttocks.
- Buttocks can be prone to injury and disease, so buttock pain is common.
- Some people self-diagnose their pain if the cause is obvious, such as a fall or injury.
Sciatica is a common cause of pain in the buttocks. Sciatica is not a condition in itself, but rather a symptom of various conditions.
Sciatica can occur due to a condition that is known as piriformis syndrome.
The piriformis is a muscle that starts in a person’s lower back and runs down to their thigh.
When a person injures or overworks the piriformis muscle, it can press on the sciatic nerve. The sciatic nerve runs down from the lower spine through to the buttocks and the back of the thigh.
The pressure of the muscle on the sciatic nerve causes the pain known as sciatica.
Sciatic pain may be accompanied by numbness or tingling and may worsen if someone runs, sits, or goes upstairs.
A herniated disc can also cause sciatica. Similarly, sciatica occurs when parts of the spine narrow and begin to press on the sciatic nerve.
Sciatica happens more often in people in their 40s and 50s, as aging makes conditions such as piriformis syndrome more likely.
The most common causes of pain in someone’s buttocks are:
Bruising can occur if someone suffers an injury that causes the blood vessels to become damaged and blood to pool underneath the skin. This is why a bruise appears as a black or blue mark.
Injuries to the buttocks may occur, for example, if a person falls when engaged in sports, or if they slip while walking.
Initially, there may be a lump, swelling, and tenderness that should subside. Eventually, the area will heal, and the bruise will fade.
Muscle strain is another common cause of buttock pain. The muscles in the buttocks are known as gluteus maximus, gluteus medius, and gluteus minimus. If a person overstretches or pulls these muscle groups, pain may occur.
As well as pain, signs of a muscle strain can include:
- difficulty moving the muscle
A strain can occur if a person partakes in exercise without warming up first, or due to a sudden movement, which can pull the muscle.
Between the bones, a person has bursae. These fluid-filled sacs help to protect and cushion the bones. However, the bursae can become inflamed, leading to a condition known as bursitis.
The areas most frequently affected by bursitis are the knees, hips, shoulders, and elbows. Even so, bursitis can also occur in the buttocks when it is called ischial bursitis.
Symptoms of ischial bursitis may be:
- pain when sitting or lying down
- pain in the back of the thigh
- swelling and redness in the area
Sometimes bursitis in the ischial bursae incurs if a person sits on a hard surface for an extended period. An injury to the buttocks can also lead to this condition.
Discs in a person’s spine can become herniated if the outer layer of the disc tears, allowing some of the inner material to slip out.
When this happens, the disc presses on spinal nerves, which can be painful and also cause numbness, tingling, or weakness in the area.
Should a herniated disc occur in the lumbar spine or lower back, the pain can radiate to the buttocks and down the legs. Herniated discs are more likely to affect older people as the discs in the spine become weaker with age.
Pulling or lifting heavy objects and being obese are also risk factors.
Degenerative disc disease
In older people, the discs in the back can become weaker and worn down. As this happens, the cushioning that the discs provide becomes less effective, and spinal bones can begin to rub against one another.
This can cause pain in the buttocks and thighs, as well as numbness and tingling in the legs. Symptoms may worsen upon sitting, bending, or lifting.
A pilonidal cyst can be found in the cleft between a person’s buttocks. These cysts differ from other cysts, as they contain tiny bits of hair and skin.
Sometimes these cysts appear because of an ingrown hair that has grown into the skin.
A pilonidal cyst will appear as a lump and can be quite painful.
Other symptoms may include redness, swelling, blood, and pus seeping from the cyst, or a foul smell.
Pilonidal cysts often occur when a person sits for long periods or when there is lots of friction in the area, for example, on long bike rides.
A perirectal abscess, also known as a perianal abscess, is a cavity that forms in a gland near the anus. It is caused by a bacterial infection and is filled with pus.
It is also possible for an abscess to form when there is an abnormal connection between the inside of the anus and the skin, known as a fistula. Because of this opening, bacteria can become trapped, and so the abscess occurs.
Doctors may recommend surgery for people with this condition to remove the fistula.
Sacroiliac joint dysfunction
The sacroiliac joint can be found connecting the triangular bone known as the sacrum to the pelvic bone.
If the sacroiliac joint becomes inflamed, a person may experience pain in the lower back, buttocks, and upper legs.
Walking, running, and going upstairs can make the pain worse, and a doctor may recommend physical therapy to help keep the joint flexible and improve its strength.
Arthritis is a common disease that can affect the joints all over a person’s body. It is thought that more than 54 million Americans have a type of arthritis. Arthritis can occur due to the joints becoming worn down, as a person gets older.
Some types of arthritis occur because the immune system begins to attack the joints.
Arthritis causes joints to stiffen and can be very painful. If this occurs in the hip joints, pain can radiate to the buttocks, though keeping the joint moving, physical therapy, and medication can all help and improve the flexibility of the joint.
A person with vascular disease may experience pain in the buttocks due to blood vessels becoming blocked and not enough blood reaching the legs. The pain usually occurs when walking and stops if the person stops moving.
A person may also experience hair loss and weakness in the lower legs when they have vascular disease.
Making an appointment with a doctor can be helpful if there is no obvious cause for the pain, and it does not subside, intensifies, or there are other symptoms.
Additional symptoms can include:
- numbness or weakness in the legs
- sharp stabbing or shooting pain
- a sore that does not heal
- a temperature of 104°F (40°C) or above
- difficulty controlling the bowels or bladder
- pain that limits movement and only occurs when moving
Though not concerning normally, people should still monitor the pain, and if it does not go away or additional symptoms occur, it is a good idea to make an appointment to see a doctor.
Doctors are the best people to prescribe treatment after investigating the cause of the pain. They may refer the individual to a rheumatologist, orthopedic specialist, or physical therapist.
Other treatment can include:
- corticosteroid injections to reduce inflammation
- draining the cyst or abscess that is causing pain
- surgical repair of a damaged disc or replacement of a worn joint
It may be that rest and over-the-counter pain medication are enough to help a person manage their buttock pain.
Other home remedies include applying ice or heat to the area and gently stretching the legs, buttocks, and hips.