Diagnostic Guide - Buttock Pain

Injuries > Buttock Pain

Pain in the buttock region is a common clinical presentation particularly in individuals with associated lower back pain or stiffness. In athletes, buttock pain is most common in sprinting or kicking sports. Symptoms may present suddenly due to a specific incident or gradually over time and can arise from local structures or can be referred from the spine or sacroiliac joints.

Below are some of the more common causes of pain in the buttock region with a brief description of each condition to aid diagnosis. Find out what may be causing your buttock pain:

Sudden Onset Buttock Pain

Common Injuries

Referred Pain

Pain referred into the buttock from another source such as the lower back or sacroiliac joint, often associated with symptoms above or below the buttock (such as lower back pain or stiffness or pain in the thigh, lower leg, ankle or foot). Typically associated with pain on firmly touching the region responsible for the referred pain. Sometimes in association with pins and needles or numbness in the affected leg or foot.

Less Common Injuries

Gluteal Strain

Sudden onset pain in the buttock / gluteal region (figure 1) due to tearing of one or more gluteal muscles, usually due to a specific incident. A pulling or tearing sensation may be experienced during injury and there is typically tenderness on firmly touching the affected muscle. Swelling and bruising may also be present.

Avulsion Fracture of the Ischial Tuberosity

Fracture of the bony process of the pelvis known as the ischial tuberosity (figure 2) or 'sitting bone' primarily in children or adolescents. Usually arising from a specific incident such as during sprinting and associated with significant pain and disability, pain on firmly touching the affected bone and often pain during sitting.

Gradual Onset Buttock Pain

Common Injuries

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Less Common Injuries

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Diagnosis of buttock pain

A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose the cause of pain in the buttock region. Investigations such as an X-ray, ultrasound, MRI, CT scan or bone scan are often required to confirm diagnosis and rule out other injuries.