Buttock Pain

What is Buttock pain?

Buttock pain is one of the most common complaints that we see but it can be a real ‘pain in the bum’ to accurately diagnose and successfully treat. One reason for this is that there are many different conditions that can cause buttock pain and an accurate diagnosis is critical to tailoring appropriate treatment.

What causes buttock pain?

Buttock pain can be caused by;

• An injury (either sudden or degenerative) to the tendon that attaches the hamstring to the sit bone
• Inflammation of the hamstring attachment (enthesitis or bursitis)
• Inflammation of the sacroiliac joint (the joint where the pelvis joins the spine)
• Stress fractures of the pelvis or sacrum
• Irritation of a nerve in the buttock
• Irritation of a nerve in the spine (referred pain)
• Pyriformis syndrome (commonly over-diagnosed but actually quite uncommon)
• Ischiofemoral Entrapment Syndrome (A condition where a narrow gap between the thigh bone and the pelvis results in entrapment of soft tissues) – click here for our blog article on that condition
• Hip joint pathology including arthritis and cartilage tears
• Gluteal muscle injuries.

How is buttock pain diagnosed?

As there are many different potential causes of buttock pain, making an exact diagnosis can be tricky but it is extremely important for successful treatment. The most important step is an expert assessment with an experienced Sport and Exercise Physician who can perform clinical tests to narrow down the possible causes. Sometimes a scan is required to further investigate but it is very important that the correct scan is selected and interpreted by an expert as an incidental finding on the wrong scan can lead to the wrong diagnosis and treatmen. For example, many runners have signs of painless degeneration of their hamstring tendon on an MRI scan and most adults have some damage of their lumbar discs. If the diagnosis is wrong, the treatment can’t be effective.

How is buttock pain treated?

Treatment must always be targeted to the exact cause of pain and individualised to the person and their physical demands. This may involve stretches, strength work, medications and injection therapies. Your specialist Sport and Exercise Physician will explain guide you through the treatment options appropriate for you.