A pain in the buttock can be exactly that – a pain in the butt. It can interfere with exercise, sleep and hobbies, and depending on what’s causing it, can be a bit tricky to manage. Let’s take a closer look at conditions that can cause buttock pain.

Gluteal tendinopathy

A gluteal tendinopathy is a condition that affects the tendon, the structure that attaches the muscles of the buttock to the bone. This condition usually affects women over 40 and is typically on one side. The pain is often felt on the side of the hip and can radiate into the buttock or down the leg to the knee. It will often hurt when you are lying in bed, either on that side or even on the opposite side when in certain positions. Standing up from sitting, climbing stairs and long periods of driving can aggravate this pain. This condition needs an accurate diagnosis, activity modification and strengthening exercises to resolve.

Sacroiliac joint (SIJ)

The SIJ is a joint that connects the pelvis to the tailbone, so you have one on either side, right at the base of your spine. This joint is a bit of a hot topic for debate, with some people believing it can be a source of instability and dysfunction and others believing that it can’t. A painful SIJ tends to produce buttock pain either over the SIJ or below it on the same side. It can be associated with clunking and is painful with single leg activities like lunging, kneeling on one leg and landing heavily on one leg – missing the bottom step is a common mechanism for stirring up this area. Pregnancy or post-partum can also contribute to pain around the SIJ. Management tends to include manual therapy techniques to mobilise and release around this joint, strapping or belts to offload the joint and strengthening to support and stabilise as you return to work, exercise and sport.

Referred pain from the lower back

The lumbar spine is the lower back and will often refer into the buttock or the leg. So much so that when someone reports buttock pain, it’s usually the first thing I like to rule out. When someone has buttock pain referred from their lower back, they will often describe dull, aching pain in the glute on the same side as their back pain. Sometimes they have no pain in the back, just in the buttock. Back movements may reproduce this pain, as well as long periods of sitting or standing up and sitting down. When we assess the lower back by compressing segments of it, our patients often tell us they can feel their buttock pain worsen. Management involves treating the lower back, as this is referred pain and treating the glute in isolation will not impact the pain in this instance.

Referred pain from the hip

The hip is a deep joint and as such, will often be felt all around the area. Although the most common place to feel hip pain is in the groin, it can also present as buttock pain. Any hip pain can refer to the glute so this may be the older osteoarthritic hip or the younger hip with a labral tear or impingement issue. It will also be a dull aching pain that is not reproduced with back movements or glute exercises. Your physio will rule this in or out by specifically assessing your hip joints to see if they bring on your pain. Management of this pain will be treating the hip joint for its diagnosed condition, which may involve imaging, physiotherapy, or orthopaedic input.

Special mentions

Other less common conditions that can cause buttock pain include muscle tears and strain, nerve entrapments, fractures, and red flag conditions.

If your pain in the butt is becoming a real pain in the butt, then come along to Healthzone Physio to chat to one of our experienced physios. They will assess you thoroughly and decide what is causing your pain, design a management plan and see you through it.

Contact HealthZone Physiotherapy today on: (09) 477 2098

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Rebecca graduated from AUT in 2008 with her Bachelor of Health Science in Physiotherapy and started working in a West Auckland private practice. She quickly gained an interest in sports physiotherapy including injury prevention and management. Rebecca worked for four years with premier and reserve club rugby teams including Waitemata and Kumeu / Helensville. She was the physio for the Western Pioneers team in 2012 when they won the North Harbour competition. Rebecca also practiced as a community physiotherapist administering the Otago Exercise Programme which focused on falls prevention for the independent elderly. Through these clients, she developed a curiosity in chronic pain conditions. While she has had plenty of experience in standard post surgical rehabilitation, she took a particular interest in Functional Reactivation Programmes, which work with people suffering persistent pain and complex recoveries post surgery or injury. Rebecca takes an interest in working with clients who have exhausted their channels within the health profession for the management of their pain and enjoys the challenge of helping these patients manage their conditions and return to activities of daily living. To aid in this work, she went on to get her Postgraduate Certificate in Rehabilitation from AUT. Rebecca’s passions include travel, yoga, food, comedy and film – don’t get her started on the topic of movies if you don’t have the time and energy to discuss them with her. She lives in central Auckland and is fiercely local – preferring to commute every day across the bridge than to live any distance away from friends and family!

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