It might seem silly to be Googling “butt pain,” but when you’re suffering from it in real life, it’s not all that funny. Buttock pain can range from a dull ache to sharp, shooting sensations that interfere with sitting, walking, and even sleeping.
Rest assured that if you’re experiencing pain in your buttocks, you’re not alone. This type of discomfort is surprisingly common and can affect people of all ages and activity levels. The good news? Most causes of buttock pain are treatable with the right approach and professional guidance.
Understanding what’s causing your buttock pain is the first step toward finding relief and getting back to your normal activities.
Causes of pain in the butt
Several conditions and injuries can trigger pain in the buttocks and surrounding areas. The discomfort you’re feeling could stem from issues with the gluteus muscles, piriformis muscle, or nearby structures like the sciatic nerve.
- Muscle strain or overuse often occurs after intense physical activity or sudden movements. This type of buttock pain usually feels like a deep ache in the gluteal muscles.
- Bursitis happens when the fluid-filled sacs that cushion your hip joint become inflamed. This condition typically causes pain on the outer side of the buttock that may worsen with movement.
- Herniated discs in the lower spine can compress nearby nerves, causing referred pain that radiates into the buttock area.
- Arthritis in the hip or sacroiliac joint can create stiffness and aching sensations in the buttocks, especially after periods of inactivity.
However, two of the most frequently misunderstood causes of buttock pain are piriformis syndrome and sciatica. While these conditions share similar symptoms, each one has distinct treatments depending on the underlying cause.
What is piriformis syndrome?
Piriformis syndrome occurs when the piriformis muscle—a small, flat muscle located deep in the buttock—becomes tight, inflamed, or spasms. This muscle plays a crucial role in hip rotation and stability, running from the lower spine to the top of the thigh bone.
The piriformis muscle becomes a problem when it compresses or irritates the nearby sciatic nerve, which passes close to or right against this muscle. This compression creates the characteristic symptoms of piriformis syndrome.
Common triggers for piriformis syndrome include:
- Prolonged sitting, especially on hard surfaces
- Overuse from running, cycling, or other repetitive activities
- Direct trauma to the buttock area from a fall or accident
- Muscle imbalances or weakness in the hip and core muscles
- Poor posture or biomechanics during movement
Piriformis syndrome typically feels like:
- Deep, aching pain in the buttock that may be difficult to pinpoint
- Pain that worsens with sitting, especially for extended periods
- Discomfort when climbing stairs or walking uphill
- Pain that may radiate down the back of the thigh
- Stiffness in the hip area, particularly in the morning
- Tenderness when pressing on the buttock muscle
The pain from piriformis syndrome often develops gradually and may come and go depending on your activities and posture throughout the day.
Difference between piriformis syndrome and sciatica
It can be difficult to guess whether the pain, numbness, or shooting sensations you’re experiencing are caused by sciatica or piriformis symptoms. Both conditions can cause buttock pain and discomfort that travels down the leg. However, understanding the differences between these conditions is important for proper treatment.
Sciatica usually refers to pain that originates from compression or irritation of the sciatic nerve at the spine level due to conditions like herniated discs or spinal stenosis, rather than an inflamed or injured piriformis muscle.
Similarities between piriformis syndrome and sciatica
Both conditions can cause:
- Pain in the buttock area
- Discomfort that may radiate down the leg
- Numbness or tingling sensations
- Pain that worsens with certain positions or activities
- Muscle weakness in severe cases
Key differences
| Piriformis Syndrome | Sciatica Pain | |
| Location: | typically affects the buttock and posterior thigh | originates in the lower back and travels down the leg |
| Pain type: | deep, aching pain centered on the buttocks/hips | shooting pain that can travel all the way to the foot |
| Triggers: | worsens with prolonged sitting | worsens with coughing, sneezing, or bending down |
| Response to movement: | may improve with gentle movement and stretching | symptoms can vary widely with different movements |
Getting an accurate diagnosis is crucial because treatment strategies differ significantly between these conditions. While piriformis syndrome often responds well to targeted muscle therapy and stretching, sciatica may require different interventions depending on the underlying issue.
Treating leg pain and numbness with physical therapy
Whether you’re dealing with piriformis syndrome, sciatica, or another cause of buttock pain, physical therapy offers effective, non-invasive treatment options that address the root cause of your discomfort.
Physical therapy for buttock pain typically includes:
- Manual therapy techniques to reduce muscle tension and improve mobility in the affected area. These hands-on treatments can help release tight muscles and improve blood flow to promote healing.
- Targeted stretching programs designed to address muscle imbalances and reduce pressure on irritated nerves. For piriformis syndrome, specific stretches can help lengthen the tight piriformis muscle.
- Strengthening exercises to improve stability and support in the hip, core, and gluteal muscles. Stronger muscles provide better support for your spine and reduce the likelihood of future episodes.
- Postural education to help you identify and correct movement patterns or positions that may be contributing to your pain. This is especially important for people who spend long hours sitting.
- Activity modification strategies to help you return to your normal activities while avoiding movements that aggravate your symptoms.
- Pain management techniques including ice, heat, and other modalities to provide immediate relief while your body heals.
The key to successful treatment lies in getting an accurate diagnosis and developing a personalized treatment plan that addresses your specific condition and lifestyle factors.
Take the first step toward pain relief
Whether you’re dealing with piriformis syndrome, sciatica, or another condition causing hip or butt pain, an Armor Physical Therapy clinic is here to help. Our team specializes in diagnosing and treating hip pain, sciatica, and related conditions and promise there’s nothing embarrassing or awkward about being in pain.
Start finding relief by calling one of our Southwest Michigan clinics or by requesting an appointment online today!