Buttock pain when sitting can pose an annoying problem. Maybe you need to sit for work all day, or perhaps you’re simply just trying to relax. Whatever the case may be, it’s not ideal. You also aren’t quite sure why it’s happening in the first place.

The truth is that there are various reasons why you could be experiencing buttock pain when sitting. In this article, we’re going to look at the common causes, treatment, symptoms, pain relief, and preventative measures. What should you know?

 

Common Causes

The buttocks and hips are home to many nerves, muscles, tendons, and ligaments. Thus, there are many ways that pain can arise in this area. You also don’t necessarily have to be doing anything overly strenuous for pain to arise. In fact, sitting for too long can lead to some of the conditions listed in the next section.

Common causes of buttock pain when sitting include:

  • Repetitive bending
  • Sitting for long durations
  • Overstretching of the hamstring muscles
  • Incorrect lifting techniques
  • Overstriding when running

These actions (or inactions) can lead to tight, irritated muscles and structures in and around the buttocks area. These causes may also lead to the diagnosis of certain conditions, as discussed in more detail below.

 

Conditions That Cause Buttock Pain

Your buttock pain when sitting might happen due to different conditions, including proximal hamstring tendinopathy, ischial tuberosity bursitis, sciatica (lumbar nerve root impingement), piriformis syndrome, and gluteal tendinopathy. So, let’s examine these conditions in more detail and get to the bottom of your pain!

 

Proximal Hamstring Tendinopathy

Proximal hamstring tendinopathy is when the tendon (a piece of tissue that attaches muscle to bone) that attaches the hamstring muscles on the back of the thigh to the pelvis becomes inflamed and irritated due to overuse or misuse. It usually arises gradually. In some cases, it is also caused by doing too much too soon, such as amping up your training intensity or frequency too quickly.

 

Symptoms

Usually, individuals notice increased pain when sitting or shortly after, when running, when cycling, or when walking. In particular, repetitive activity tends to aggravate this tendon, leading to increased pain. Sometimes, this pain also radiates down the thigh and can be felt behind the knee. Additionally, an individual with proximal hamstring tendinopathy will usually experience muscle weakness.

Often the diagnosis of proximal hamstring tendinopathy can be made with a thorough examination by a physiotherapist without the need for imaging. In some cases, MRI or ultrasound can be helpful to aid diagnosis.

Treatment & Pain Relief

As with most musculoskeletal conditions, initially, ice is best. Ensure you apply an ice pack with a cloth between the ice and your skin to prevent skin damage. Apply the ice for 15-20 minutes at a time, leaving about 45 minutes in between each application.

Following initial pain relief measures, strengthening exercises that target the glutes, hamstrings, core, and lower back can help you bounce back after injury. Anti-inflammatories can also help reduce pain and other symptoms.

Your physiotherapist may also use lumbar mobilisation to improve the range of motion in your lower back, as well as soft tissue release to help alleviate muscular tightness.

 

Ischial Tuberosity Bursitis

Ischial tuberosity bursitis is a condition categorised by the inflammation of the bursa that sits between the ischial tuberosity (a bony part of the pelvis) and the gluteus maximus muscle. A bursa is a fluid-filled sac that helps reduce friction between structures at the joints throughout the body. This is another condition that is frequently caused by overuse, such as sitting for too long or due to injury to the hamstring tendon or muscle from running or cycling.

 

Symptoms

Generally, this condition is characterised by tenderness in the buttock, pain that gets worse when sitting down or performing repetitive activities, and, sometimes, muscle weakness. You might struggle to properly extend your hip and perform your regular activities.

In fact, this condition has been in the history books for thousands of years. Previously referred to as “weaver’s bottom,” professional weavers have complained about this exact issue for centuries.

Treatment & Pain Relief

Like many other conditions, ice application can help decrease pain and reduce inflammation. Along with icing, anti-inflammatories can also combat similar symptoms. Resting from whatever activity is assumed to have caused this condition is also encouraged.

Your physiotherapist may further recommend changes in sitting posture and strengthening exercises to help address any muscular imbalances and weaknesses. Your physio may also use lumbar mobilisation, along with soft tissue release to help improve your flexibility and pain-free range of motion.

 

Sciatica

Sciatica, also known as lumbar nerve root impingement, is pain that radiates from compression of the sciatic nerve. The sciatica nerve is one of the largest nerves in the body, innervating the thighs, legs, and feet. However, when these nerves become compressed, such as due to a slipped disc or a spastic and tight muscle, buttock pain when sitting may arise.

Typically, sciatica only affects one side of the body. It is a common condition, with studies reporting about 10-40% of individuals will experience sciatica during their lifetime.

 

Symptoms

Common sciatica symptoms include:

  • Radiating pain from the low back, through the buttocks, and down the leg
  • Pain ranging from a mild ache to a more sharp pain
  • Burning sensation
  • Numbness and tingling in the buttocks and down the leg
  • Pain aggravated by sitting for long durations
  • Leg muscle weakness

Treatment & Pain Relief

When it comes to sciatica, it can help to visit a physiotherapist so that they can thoroughly assess the cause of your condition and help guide you through proper exercises and treatment relevant to you and your situation. For sciatica, neural glides and stretching can help relieve pain and release pressure on the nerve.

Your physiotherapist will also recommend strengthening your core, glutes, hamstrings, and lower back, depending on your specific weaknesses. Anti-inflammatories can also be used initially to reduce pain and inflammation.

In terms of manual therapy provided by a physiotherapist during your visit, they will use soft tissue release and lumbar mobilisation to create space, improve flexibility, decrease pain, and help you regain function.

 

Piriformis Syndrome

Interestingly, piriformis syndrome can actually cause sciatica. The piriformis is a small muscle located deep in the buttocks that helps lift the thigh away from the body, as well as stabilises the hip. Despite being small, it can be a literal pain in the butt!

Generally, this condition happens when the piriformis muscle becomes tight or spasms, pressing on the sciatic nerve. This tightness can happen from direct trauma or overuse.

 

Symptoms

Unlike other conditions, piriformis syndrome won’t cause pain in the low back. This is because the issue arises further down within the buttocks.

Common signs and symptoms include:

  • Buttock pain
  • Leg pain
  • Pins and needles
  • Leg weakness

The pain may get worse when sitting for long durations, running, climbing stairs, or applying pressure directly to the piriformis muscle.

Treatment & Pain Relief

For piriformis syndrome, heat can help relax the muscle. Anti-inflammatories can further help combat inflammation and irritation.

Overall, stretching the piriformis muscle and addressing the factors contributing to tightness (E.g. training load, muscle imbalance, etc.) is key for making a proper and full recovery. In fact, various research shows the importance of stretching when it comes to addressing piriformis syndrome.

Similar to sciatica, neural glides, exercises that stretch irritated nerves, can also help relieve pressure on the sciatic nerve. Additionally, manual therapy performed by a physiotherapist, including lumbar mobilisation and soft tissue release, can help relieve the symptoms caused by this condition.

 

Gluteal Tendinopathy

Gluteal tendinopathy is inflammation and irritation of the tendons attached to the gluteal muscles that make up the buttocks. The three gluteal muscles, the gluteus maximus, the gluteus medius, and the gluteus minimus, help move the hip, as well as stabilise the pelvis, which helps you maintain your balance.

Muscle weakness is most often the common cause of gluteal tendinopathy, along with overuse due to running or walking. As a result, you might experience buttock pain when sitting, as well as pain when attempting to use your glute muscles.

 

Symptoms

Generally, gluteal tendinopathy tends to cause isolated pain within the buttocks. Your backside might feel tender and sore, especially when you sit down or move the hips. Pain often also gets worse when lying on the affected side, which may end up disrupting your sleep.

Treatment & Pain Relief

Ice can help reduce inflammation and swelling associated with this condition. Seeking out help from a physiotherapist can further help you determine what strengthening exercises you should focus on. Your physiotherapist can also perform manual therapy, such as soft tissue release, to help alleviate your pain.

During the initial onset of pain, anti-inflammatories might further help manage it, allowing you to go about your daily activities. When it comes to taking anti-inflammatories, it is important to consult your health care professional whether it is safe for you to take them and how long to take them for.

 

Preventative Measures

Ideally, if you can, prevention is always the best medicine. While you might be experiencing pain right now, it’s a good idea to think ahead and plan ways to prevent it from happening again.

Here are a few tips to help you prevent future buttock pain when sitting:

  • Stretch your hips, legs, and buttocks regularly.
  • Always warm up and cool down before any exercise.
  • Strengthen your core, glutes, legs, and lower back to prevent muscle weakness causing injury.
  • Take frequent breaks when working at a desk for long durations.
  • Learn load management and avoid overuse by gradually building up any workload or workout regime.
  • Work with a physiotherapist to determine any biomechanical issues contributing to the problem and how to fix it.
  • When running, walking, or cycling, only increase your duration, frequency, or pace by 10-15% each week.
  • Follow any advice given to you by your physiotherapist since they know you and your situation best.

Pain doesn’t have to be your new norm. In fact, it shouldn’t be. Proactively finding ways to reduce incidences of pain can significantly improve your quality of life, leading to greater fulfilment, happiness, and health.

However, chances are, you’ll face pain at some point or another. Yet, working with a physiotherapist can help you bounce back after injury and make a full recovery. That way, you can spend less time on the sidelines and more time taking an active part in your own life!

Todd Anderson

Todd Anderson

Physiotherapist

Todd graduated from Monash University in 2008 with a Bachelor of Physiotherapy and is a passionate and experienced musculoskeletal physiotherapist. Todd also completed an Advanced Diploma in Myotherapy & Health Science. Todd has more than a decade experience in a variety of private practice and elite sporting settings and has worked both in Australia and overseas.