A real pain in the…

A bit of contention, but we all have big butts for a reason – or compared to your biceps, shoulders or calves anyway! This is because the glutes need to be able to do so much, with the main control being the extension of the hip (i.e. pulling your thigh behind you as you walk).

We're often presented with issues related to the buttock at our clinics. Although pain in the hip, buttock, groin and upper thigh tend to be interrelated, typically people will come to see us and say “I have a pain in my hip”, and point to the top area of their backside.

Although the hip joint has a front and back, pain that presents through the top of the buttock is usually not actually coming from the hip, but is largely referred pain from the low back or sacrum region.

The hip joint actually sits slightly lower – in the groin to be precise – and most commonly presents with pain at the front of the upper thigh, side of the hip, or inner knee.


So what causes buttock pain?

If you are suffering from a pain in the butt, there are three main areas of referral...


1. Low back

The facet joints in the lowest part of the spine can refer pain into the buttock and thigh. This sort of pain is generally easy to resolve, however sometimes if the sciatic nerve is irritated it can be felt as a deep aching pain in the buttock.

Typically if the sciatic nerve is pinched, then you will likely feel a sharp, lightening pain down the leg with pins and needles in the toes. This will take longer to treat and resolve.


2. Hip joint

Wear and tear or osteoarthritis of the hip can result in buttock pain, which can also radiate to the knee. This pain can be made worse by movement, but it will absolutely get worse with inactivity as inflammation builds up in the joint. Some people will notice a delay in the pain and become aware of it at night due to the lack of movement.


3. Greater trochanteric pain syndrome (GTPS)

Formerly known as trochanteric bursitis, this is a chronic condition potentially affecting a number of structures around the hip. It is characterised by pain and tenderness from the lateral aspect of the buttocks and into the lateral upper thigh, and can be caused by either the tendons of the gluteal muscles or trochanteric bursitis. If the symptoms of GTPS don’t settle with osteopathic soft tissue massage or Western acupuncture techniques, then consider extracorporeal shockwave therapy as it is very effective at healing the tendons in this area.


It’s important to remember that the glutes are just as important as the core (abdominal muscles) in preventing low back pain. The glutes are large muscles that, if they aren’t being used, then are far more likely to result in low back pain. A simple exercise to test the strength of your glute muscles is a squat – you should be able to hold it comfortably for a couple of minutes. See how to properly perform a squat on Rhian’s video here.

Or if you are currently undergoing treatment then speak to your osteopath about some glute exercises, or you can join our Squat Challenge Facebook closed group for support, advice and techniques.


The bottom line is that there can be a number of causes of buttock pain, and a thorough examination by your osteopath will highlight the likely cause. Get in touch with us today on 01722 512 043.


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