Pain in the buttocks


Pain caused by the buttocks area is mistaken for most of those affected as pain lower back perceived.

The main reason for this is that pain in the buttocks usually extends to other parts of the body radiate.

In this way, the original focus is often localized very late and the underlying disease is treated at a correspondingly advanced stage.

Buttocks pain can vary in both intensity and quality (stabbing, dull, pulling, burning) vary greatly from one another.

In most cases, the complaints are mainly felt by the affected patient while running, stooping or standing.

In addition, the majority of causal diseases cause pain, which initially only occurs when burden occur.
The patients are completely symptom-free during the early stages of the disease.
Only arise as the underlying change progresses Resting pain.
Many patients who suffer from pain in the buttocks compare the intensity of the complaints with the typical Sciatica pain.

This fact can be explained by the fact that in many cases the sciatic nerve is indirectly involved in the development of pain in the buttocks.
In case of inflammation of the Gluteal muscles (Gluteal muscles) there is often an enlargement of the Muscle belly.
This can lead to direct irritation of the sciatic nerve and typical symptoms.

Buttocks pain occurs in principle any age on.
The gender distribution between the affected patients is almost the same.
Nevertheless, older people can often experience pain in their buttocks.
The reason for this is the fact that there is often a significant decrease in the gluteal muscles as we age.
In this way, the nerve running under the muscles becomes straight at long periods of sitting strongly irritated.

In addition, it can be observed that mainly people who work in the office or a Misalignment of the physiological body axis particularly often suffer from pain in the buttocks.

However, pain in the buttocks doesn't always need to be treated.
In many cases there is a complete regression of symptoms even without medical intervention.
People who suffer from chronic and / or frequent pain in the buttocks should urgently consult a doctor and clarify the cause of the symptoms.


Most of the affected patients experience severe pain in the buttocks area, especially when walking, sitting and / or bending over.

The quality of the pain perceived by those affected ranges from stabbing to boring or burning.
Buttocks pain can be centered on a single point or across the whole Buttocks occur.

In addition, diseases that trigger pain in the buttocks tend in most cases to also cause complaints in the area of ​​the Back and the Thigh to cause.

Depending on the cause, the pain perceived by the patient can either be already in peace or only after a longer one Stress phase occur.

In addition, some of those affected describe the feeling of being distinct Fatigue of the Gluteus and thigh muscles.

The appearance of general symptoms (for example fever) is possible with some of the underlying medical conditions.

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In order to be able to treat successfully in orthopedics, a thorough examination, diagnosis and a medical history are required.
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For more information about myself, see Lumedis - Orthopedists.

Figure pain in the buttocks: view of the back, buttocks, thighs and causes of pain (A-D)

Buttock pain

  1. Lumbar spine (lumbar spine)
  2. Iliac crest - Iliac crest
  3. Lumbar sacrum nerve plexus
    Lumbosacral plexus
  4. Iliac scoop - Ala ossis ilii
  5. Pear-shaped muscle -
    Piriformis muscle
  6. Great Rolling Hill -
    Greater trochanter
  7. Femoral head (= femoral head) -
    Head femoris
  8. Ischium - Os ischii
  9. Sciatic nerve - Sciatic nerve
  10. Femoral shaft -
    Corpus femoris
  11. Lumbar and sacrum kink -
  12. Gluteus Middle - Gluteus medius muscle
  13. Sacrum - Sacrum
  14. Gluteus Muscle -
    Gluteus maximus muscle
  15. Bursa (large rolling mound) -
    Trochanteric bursa
  16. Iliac-tibial tendon -
    Iliotibial band
  17. Cam impingement
  18. Pincer impingement
    A - Piriformis Syndrome -
    Irritation of the sciatic nerve
    Piriformis muscle
    B - Lumboischialgia -
    Pain in the lumbar spine and
    Leg pain over the sciatic nerve
    C - trochanteric bursitis -
    Inflammation of the bursae
    of the hip joint
    D - Combined hip impingements -
    Cam impingement
    (Camshaft impingement) and
    Pincer impingement
    (Pincer impingement)

You can find an overview of all Dr-Gumpert images at: medical illustrations

Causes of buttock pain

Buttock pain can have a variety of causes.
In most cases there is no actual disease.
The complaints perceived by the affected patient are therefore triggered by external triggers (for example a new bicycle saddle) causes and disappears within a very short time without medical intervention.

Even the classic "aching“Is one of the typical causes of pain in the buttocks area.
However, the most common reasons for the appearance of complaints of the buttocks are dysfunction of the locomotor and holding organs of the body (Tendons, ligaments and muscles).

In this context, different forms of functional disorders can be distinguished. Many of the affected patients have so-called "myofascial pain" on.
It concerns tension in the muscles and / or tendons, which are mainly caused by incorrect posture and monotonous movements.

Typically, significant indurations can be felt in these patients during the physical examination.

You might also be interested in this topic: Inflammation of the bone skin on the coccyx

Other common causes of buttock pain are:

Piriformis Syndrome

Piriformis syndrome is one of the so-called functional causes of pain in the buttocks.
This condition is caused by permanent irritation of the sciatic nerve. Typically, the affected patients experience pain in the buttocks that can range from the hips to the thighs.

In most cases, the symptoms resemble that of a classic herniated disc of the lumbar spine.
Differentiating a piriformis syndrome from a herniated disc of the lumbar spine is difficult, even for an experienced doctor.
The name of this syndrome goes back to the piriformis muscle, which can exert both internal and external pressure on the sciatic nerves.
The development of the piriformis syndrome usually goes back to long-lasting, monotonous stress.
For this reason, especially athletes (for example endurance runners) affected.
However, pain in the buttocks area caused by irritation of the sciatic nerve can also be caused by accidents or falls on the buttocks.
In addition, bending over, bending over or lifting heavy objects from a straddle position often lead to such pain symptoms.

Read more on the topic: Piriformis Syndrome and Symptoms of Piriformis Syndrome.

Another cause of pain in the buttocks can also be a torn muscle fiber in the buttocks. The muscle fiber tear often occurs when the muscles are not yet warmed up and the muscles are stretched and strained beyond the physiological level. You can feel a strong, stabbing pain that can also pull towards your back or thigh. Depending on the severity of the injury, there may also be a bruise or swelling in the affected area. If you suspect a torn muscle fiber, you should immediately stop exercising and cool and protect the affected area.
Read more on the subject at: Torn muscle fiber in the buttocks

Sacroiliac joint disorders

Furthermore, diseases of the Sacrum and iliac joint cause pain in the buttocks area.
In this context, a blockade of the joint. Due to the blockage, the interaction of the individual ligaments, tendons and muscles in the area of ​​the joints between the lower back and pelvis is disrupted (so-called sacroiliac joint; in short: ISG).

This functional disorder results in tension in the muscles and recurring blockages that lead to severe pain in the buttocks.
In most cases, the cause of the dysfunction in the affected patients is mechanical factors.

Above all, poor posture and athletic ones Overloads often play a role in the development of the disease. It can also be unilateral Leg shortening, increased curvatures of the Lumbar spine forward and degenerative Joint changes (for example hip arthrosis) be the cause.

real sciatica

Functional changes lead to pain in the buttocks much more often, but direct damage to the sciatic nerve can also be responsible for the development of the symptoms.
In most cases, direct damage to the nerves is caused by irritation in the immediate vicinity of the nerve root.
In these cases, the affected patients feel a sharp pain starting from the buttocks in one defined skin area pulls the leg down. The course of the symptoms perceived by the patient roughly corresponds to the course of a side trouser seam.
In this same area there is also a tingling sensation and / or a Numbness.

Due to the throttling of the nervous innervation of the leg muscles triggered by the nerve damage, a Muscular atrophy to be watched.

The irritation to the root of the sciatic nerve is usually caused by a disc prolapse caused. Furthermore, bony spurs and diseases of the bone structure (for example a osteoporosis) lead to damage to the nerve root.


An x-ray can lead to the diagnosis.

Patients who suffer from persistent or recurring pain in the buttocks area should urgently consult a doctor and clarify the underlying disease.

The most important step in the diagnosis of buttock pain is a detailed doctor-patient consultation (Technical term: anamnesis).

During this conversation, both the intensity, as well as the quality the pain felt are revealed.
The temporal relationship between physical activities and the occurrence of the symptoms can also provide an initial indication of the underlying problem.

The doctor-patient interview is usually followed by an extensive physical one examination in which attention is paid to pain triggers and possible misalignments of the body axis.

Usually, if the buttocks are painful, imaging is done by making MRI of the pelvis - or more rarely one CT-Admission.
These methods are compared to the classic X-ray a more targeted diagnosis is possible.


Treatment for pain in the buttocks area depends on the underlying condition.
Because of this, it is an extensive one Diagnosis essential for optimal therapy.
Affected patients can feel buttock pain the first time they take Painkillers (Analgesics) help.
Especially drugs with the active ingredients Ibuprofen and Paracetamol can be taken without hesitation for the time being.

If minor injuries to the gluteal muscles are responsible for the discomfort, compliance with one can already be Resting phase and prudent Cool of the painful area lead to relief.

Pain in the buttocks area that must be triggered by functional causes usually physiotherapeutic be treated.
During each treatment session will be stretching and complementary physical therapy applications (for example electricity or ultrasound applications) carried out.

The aim of the physiotherapeutic treatment of buttock pain is to relieve the strong ones Muscle tension.
If the cause is functional, painkillers can be taken if necessary.

In addition to ibuprofen and paracetamol, patients who suffer from very pronounced symptoms can receive a weak one Opium supplement get prescribed.
Buttocks pain caused by a Sciatica in most cases require more extensive therapy.

Various treatment strategies are currently in use, which are used depending on the respective symptoms of the individual patient.
One of the most frequently performed methods is the so-called "Step storage“.
Through this method, the lower back can be relieved and the Sciatic nerve be relaxed.

It also includes general physiotherapy and the use of Electrical impulses one of the most common treatments for patients suffering from buttock pain.

Drug therapy for affected patients includes drugs to inhibit inflammatory reactions and pain.
In most cases it will be Non-steroidal anti-inflammatory drugs (NSAIDs like aspirin) and cortisone-Preparations used.

Another effective treatment for pain in the buttocks area caused by nerve damage is the so-called "periradicular therapy“ (in short: PRT).
This method is a special one Injection therapy in which a drug is applied locally to numb the nerve.

Pain in the buttocks caused by a abscess of the pelvis, or caused by an injury or foreign body-induced abscess, must be treated surgically in most cases.
In the affected patients, the Abscess cavity opened through a skin incision and the pus in it removed. In addition, after the abscess has opened, a Antibiotic therapy be initiated.


In the majority of cases, pain in the buttocks area is due to congenital misalignments of the body axis or acquired postural problems.

For this reason, most of the causes that lead to the emergence of such pain symptoms can be through one adapted lifestyle be prevented.

Especially the Weight reduction and a sufficient level of physical Move play a vital role in preventing buttock pain.

Localization of pain

Pain in the buttocks and thigh pain

Pain that originates in the buttocks or lower back sometimes extends down to the legs.

If a pain radiates from the lower back to the legs, in many cases a specific nerve can be identified as the cause. Nerves, which are responsible for muscles and skin areas in the leg, originate in deep areas of the spine between the last lumbar vertebrae and the beginning of the sacral vertebrae, in the area of ​​the sacrum.

A well-known syndrome that causes pain that starts in the buttocks and extends to the leg is the so-called "piriformis syndrome". The pain is described as drawing and stabbing on the back of the thigh. In severe cases, tingling and numbness in the toes can occur. The cause of this nerve pain is the "piriformis muscle" that runs in the immediate vicinity of the large sciatic nerve.
In the event of severe irritation, pain from the lower back down to the toes occurs. A herniated disc in the lower back can also trigger similar symptoms. A detailed examination by the orthopedic surgeon is important in order not to incorrectly diagnose a "slipped disc".

If the patient is allowed to lift their legs in the supine position with their knees extended, no pain should be felt with piriformis syndrome. If it still hurts, it can be assumed that it originated in the spine or the sacrum. If it hurts the patient when he pulls the bent legs up to the upper body and at the same time rotates internally, this can be an indication of a piriformis syndrome. However, since these examinations do not allow a 100% diagnosis, an orthopedic surgeon should definitely be consulted in the case of buttock pain radiating to the legs.

Treatment of piriformis syndrome is mainly done through physiotherapy. The piriformis muscle needs to be trained and the sciatic nerve relieved through specific exercises following the instructions of orthopedists or physiotherapists. The pain should be relieved in advance with pain-relieving drugs from the "NSAID" group. These include ibuprofen, diclofenac or aspirin, for example.

Read more about pain in the right buttock in our article Pain in the right buttock.

Read more on the topic: Thigh pain

Pain in the buttocks and hips

In addition to piriformis syndrome, which can also cause pain in the hip, nerve, muscular and also bony causes are possible. Degenerative damage to the joints can cause uncomfortable pain in the long term. Symptoms often begin in the form of pain after physical activity, after getting up in the morning or after exercising, and develop into permanent discomfort after months to years.

A frequent consequence of permanent incorrect or overloading is the so-called "ISG blockade". It can be triggered by muscle tension in the pelvis, irritation of the sensitive nerves on the sacrum or hip arthrosis.

The cause of pain can also lie in the area of ​​the outer hip and extend into the buttocks. If the externally rotating muscles of the legs are irritated or inflamed at their attachments on the outside of the hips, a drawing, stabbing pain can extend into the buttock fold.

The pain itself can be treated with medication. Since the causes of the pain can be extremely diverse, you should see a doctor with permanent symptoms.

This article might also interest you: Pain over the buttocks

Right and left side pain in the buttocks

In most cases, pain in the buttocks is unilateral. Only rarely is the pain exactly in the middle or equally pronounced on both sides. Many causes of pain are easy to fix and are only temporary. This includes above all Muscle tension and light Nerve irritation due to improper stress or excessive stress during physical work or sport.

If the posture or load is inclined to a certain side, the weight shifts to this side as well, and one-sided pain quickly develops there.

If there is a permanent one-sided load, the body gets used to it. The muscles on one side shorten, the tendons as well and in severe cases it can lead to degenerative changes bone come, especially the Vertebral bodies. The pain persists and can worsen over time.
Bad posture and incorrect stress in everyday life or in sport must always be prevented and counteracted. If a slight pain occurs due to incorrect posture, the body automatically adopts relieving postures, which favor the incorrect posture and make it worse in the long run.

Pain can be stopped with pain relievers and anti-inflammatory drugs. Professionally guided physiotherapy is often necessary to correct severe bad posture.

Pain in the buttocks when sitting

Not infrequently, pain is described in the buttocks, especially when sitting.
The causes are obvious:
A large part of all professions take place in a sitting position and represent a permanent, extraordinary strain on the pelvis and lower spine.
In order to maintain the whole body and the back while sitting, permanent strain on the muscles and ligaments is necessary. In order to take the strain off your hips and back, you have to take relieving postures in between, which are particularly bad for your lower back. Those who sit for many hours a day find it difficult to sit optimally in terms of ergonomics over the long term.
So if the pain comes from sitting too much, only a few things are recommended:
a desk chair that is adapted to the shape of the back can work wonders. Likewise, despite long working hours, you should try to reduce sitting to a minimum and do some work while standing if possible.