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  • Writer's pictureLorenzo Basso

Buttock Pain: How to Diagnose It Correctly

Updated: Aug 24, 2023

Pain in the buttocks can be caused by a variety of conditions. Sometimes, it is the result of an injury in the hip region, while in some cases, it can be a referred pain from another part of the body. Getting the right diagnosis is vital in order to optimize recovery. In this blog post, we will address the most common reasons of buttock pain.

Buttock pain

Following are some of the most common conditions that cause pain in gluteal area:

  1. Piriformis syndrome. The piriformis muscle is located in the posterior hip region. Its action is to laterally rotate the hip joint. When this muscle is overworked, it can irritate the sciatic nerve that runs underneath, causing pain in the buttock. Piriformis pain can also be exacerbated by prolonged sitting on hard surfaces. In order to treat this condition, it is usually advisable to take a period of rest from the physical activity that is causing the pain, perform gentle stretching and massage to alleviate the tension, use a soft cushion when sitting, and gradually strengthening the gluteal muscles with a rehabilitation program.

  2. Hip osteoarthritis. Osteoarthritis is a condition that causes wear and tear in the joints, and is more common in people above 50 year old. Hip osteoarthritis is characterized by a deep pain in the hip area, worsened by prolonged standing and walking. People with this condition might find difficult to perform daily activities such as squatting and climbing stairs because of stiffness in the hip joint. Sometimes, hip osteoarthritis can be successfully managed with exercise therapy, while more severe cases might need surgery to replace the joint.

  3. Sciatica. The sciatic nerve originate in the lumbar region, and runs in the posterior hip, all the way down to the calf and foot. The sciatic nerve can get compressed by a disc herniation in the lumbar spine, causing referred pain in the hip area. Sciatic pain can take several months to subside, so a correct diagnosis can help to manage patient expectations. Treatment usually involves manual therapy to desensitize the pain, and gentle exercises to improve mobility and blood flow. It is also important to refrain from aggravating activities such as repetitive bending forward and intense stretching.

  4. Hamstring tendinopathy. Hamstring tendinopathy refers to inflammation in the proximal attachment of this muscle. It is usually caused by repetitive hip extension, such as during ballet dance. This condition can be easily diagnosed by palpating the hamstrings tendon near the ischial tuberosity. The healing time for hamstring tendinopathy can be quite lengthy, ranging from 3 months up to 12 months. In the initial phase, soft tissue release can help to improve circulation and promote healing. Once the pain subsides, it is advisable to follow a rehabilitation program to strengthen the tendon before returning to the previous level of physical activities.


Buttocks pain can have several different sources, and each condition is managed very differently. For this reason, it is vital to get a precise diagnosis in order to optimize the recovery process.

Lorenzo Basso, Physiotherapist

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