Buttock pain can develop from many different conditions. Since the buttocks contain important muscles, nerves, and joints that are essential for movement and posture, even small problems can cause significant discomfort. Here are the most common causes:

Muscle-Related Causes

Muscle Strain (Gluteal Strain): The gluteal muscles include the gluteus maximus, gluteus medius, and gluteus minimus. These muscles are crucial for hip movement, balance, and maintaining good posture. A muscle strain happens when these muscles are stretched too far or torn due to sudden movements, heavy lifting, or overuse during exercise.

Myofascial Pain Syndrome: This chronic pain condition involves painful muscle knots called trigger points within muscles or the tissue surrounding them. When these trigger points develop in the gluteal region, they can cause buttock pain that may spread to the hips or lower back.

Nerve-Related Causes

Sciatica: This condition involves compression or irritation of the sciatic nerve, which is the largest nerve in your body. It runs from your lower back through your buttocks and down the back of your leg. Sciatica can cause shooting pain, tingling, numbness, and weakness in the buttock and leg.

Piriformis Syndrome: The piriformis muscle is a small, pear-shaped muscle located deep in your buttocks. When this muscle becomes too tight or goes into spasm, it can compress the sciatic nerve that runs nearby. This causes buttock pain that often travels down the leg and typically gets worse when sitting for long periods.

Deep Gluteal Syndrome: Similar to sciatica, this occurs when the sciatic nerve gets compressed by various structures in the gluteal region, including muscles, blood vessels, or connective tissues.

Disc and Spine Issues

Herniated Discs: The vertebrae in your spine are cushioned by disc-like structures filled with gel-like material. When the outer layer of a disc tears, the inner material can leak out and press on nearby nerves. A herniated disc in the lower back can cause pain that travels from the back through the buttock and into the leg.

Spinal Stenosis: This condition involves narrowing of the spaces within your spine, which puts pressure on the nerves. When it affects the lower back, it can cause pain, weakness, and numbness in the lower back, buttocks, and legs.

Joint and Bone Problems

Sacroiliac (SI) Joint Dysfunction: The sacroiliac joints connect the base of your spine to your pelvis. When these joints become stressed, misaligned, or inflamed, they can cause deep pain in the upper part of your buttocks.

Osteoarthritis (Hip Arthritis): This condition causes pain, stiffness, and inflammation due to cartilage breakdown in the hip joint. Osteoarthritis of the hip can cause a dull, aching pain in the groin, side of the hip, or back of the buttocks.

Coccydynia (Tailbone Pain): This refers to pain in the coccyx or tailbone, often resulting from a fall directly onto the tailbone or childbirth.

Inflammation and Infection

Bursitis: Small, fluid-filled sacs called bursae help reduce friction between tendons and bones. When these become inflamed, it causes bursitis. Two common types affect the hip and buttock area:

• Trochanteric bursitis occurs on the side of the hip
• Ischial bursitis affects the area between your sit bone and hamstring tendon

Hamstring Tendonitis: This involves inflammation of the hamstring tendons, usually from overuse. It’s common in athletes and causes pain at the sit bones and deep in the bottom of the buttocks.