Butt Pain and Arthritis: Symptoms, Causes, and Treatments (2023)

Butt Pain and Arthritis: Symptoms, Causes, and Treatments (1)

When you have arthritis, buttoning a shirt or fastening a clasp can be a pain in the butt. So is folding laundry with achy joints, blow drying your hair, or even signing paperwork. But then there’s actual pain that can occur in your buttocks — and it may actually be caused by arthritis.

(Video) Hip Joint Pathologies causing back, groin, buttock, & knee pain

The buttock is a large area, with many different structures within it, explains Claudette Lajam, MD, orthopedic surgeon with NYU Langone in New York City. The giant muscle at the surface of the buttocks is called the gluteus maximus. It overlies other layers of muscle and two major joints: the hip joint and sacroiliac (SI) joint, which is situated on each side of your spine, and connects the sacrum (base of your spine) to the ilium (top part of your pelvis).

Buttock pain may indicate a problem in either of the sacroiliac joints, the lumbar spine (lower back), muscles of the pelvis or any of those other layers, says Dr. Lajam, who also serves as spokesperson for the American Academy of Orthopaedic Surgeons.

How Arthritis Can Cause Buttock Pain

“Any form of arthritis that affects the hips or lower back can cause buttock pain,” says Dr. Lajam. Some types include:

Osteoarthritis of the hip

The hip is a ball-and-socket joint. The “ball” is the top of your thigh bone, and it sits in a “socket” that’s formed by part of your pelvic bone. Slippery tissue called cartilage covers the bone surface and helps cushion the joint. Osteoarthritis (OA) occurs when the protective cartilage gradually wears down, which over time leads to pain and stiffness. The most common symptom of hip osteoarthritis is pain around the hip joint. As hip OA disease progresses, low-grade inflammation can set in, explains physical therapist Colleen Louw, PT, spokesperson for the American Physical Therapy Association (APTA). That results in increased sensitivity of the surrounding nerves, which can cause pain in and around the low back and buttocks.

(Video) Hip Arthritis: Symptoms, Diagnosis, Management, And Treatment

Osteoarthritis of the spine

The bones in your spine (vertebra) are separated by spongy discs, which act as shock absorbers. With age, these discs can wear or shrink, which narrows the space between the spinal joints, or “facet” joints. “The facet joints are a series of small joints in the lower back that contain the same type of cartilage that is found in your knees,” explains Louw. Disc changes can lead to more strain on the joints, which can cause the cartilage to wear down and the facet joints in the vertebrae to rub against one another, leading to the pain and stiffness of OA. “It is not uncommon for these joints to refer pain into the buttocks, especially with prolonged standing or even walking,” says Louw.

Ankylosing spondylitis (AS)

Ankylosing spondylitis is a form of arthritis that causes inflammation in the joints in your spine. Most commonly, it affects the vertebra in your lower back and the SI joints. Over time, inflammation can cause some of the vertebrae to fuse, which makes your spine less flexible and leads to chronic pain and discomfort. Early symptoms of AS are frequent pain and stiffness in the lower back and buttocks, which comes on gradually over the course of a few weeks or months. Some people even use the phrase “alternating buttock pain” to describe their AS symptoms.

Rheumatoid arthritis

With rheumatoid and other forms of inflammatory arthritis, the immune system mistakenly attacks a protective lining in your joint called the synovium, and destroys cartilage. Though RA tends to affect smaller joints first (such as those in your hands and feet), symptoms can spread to both your hips as the disease progresses. Inflammatory arthritis in your hip will feel painful and stiff. You may also experience a dull or aching pain in the buttocks that’s worse in the morning, and gradually improves with activity.

Other Reasons for Buttock Pain

“Unless there is a direct trauma that occurs to the buttock itself, like falling on an object or getting kicked, buttock pain is usually referred from somewhere else,” says Louw. Here are other reasons aside from arthritis that your butt may be in pain.

(Video) Osteoarthritis Hip Pain: Symptoms and Treatment

Muscle strain

Your buttocks are made up of three muscles: the gluteus maximus, the gluteus medius, and the gluteus minimus. You can strain one of these or other overlapping muscles in the area, which can cause pain, says Dr. Lajam. “The hamstrings attach right at the bottom of the pubic bone,” she says; “injury or tears of the hamstrings can cause deep buttock pain. Sprains or strains of the abductor muscles [the side muscles of the hip] can cause buttock pain.”

Injury/bruising

Your buttocks may develop a painful bruise (or black-and-blue mark) if you get hurt, such as falling off your bike or kicked by your kiddo during an overly aggressive wrestling match. You may notice swelling, discoloration, and tenderness to the touch.

Bursitis

This painful condition occurs when the small, fluid-filled sacs — called the bursae — that cushion the bones, tendons, and muscles near your joints become inflamed. The most common causes are repetitive motions or positions that put pressure on the bursae around a joint. Bursitis most often affects the shoulder, elbow, and hip. “Bursitis of the hip can lead to buttock pain,” says Dr. Lajam.

You also have bursae in your buttocks called ischial bursa, which can become inflamed and cause ischial or ischiogluteal bursitis. This can result from sitting for a long time on a hard surface, direct trauma, or injury to the hamstring muscle or tendon from activities like running or bicycling.

(Video) What causes ischial tuberosity pain (butt pain)?

Sacroiliitis

This is inflammation of the SI joints, which can cause pain in your buttocks, and well as your lower back, hips, or groin. Some forms of inflammatory arthritis, such as ankylosing spondylitis and psoriatic arthritis, as well as osteoarthritis, can cause sacroiliitis, so might an injury, pregnancy, and infection. Learn more about sacroiliitis.

Sciatica

Pain that radiates from your lower back to your buttock and down the back of your leg is the hallmark symptom of sciatica. It most commonly occurs when a herniated disk, bone spur on the spine, or narrowing of the spine (spinal stenosis) compresses part of the nerve. Injuries or overuse of the piriformis muscle, which is located in the buttocks near the top of the hip joint, can contribute to sciatica too. This causes inflammation, pain, and often some numbness in the affected leg. The pain can range from mild ache to a sharp, burning, or excruciating pain. Usually only one side of your body is affected.

How to Ease Buttock Pain from Arthritis

If you’re experiencing buttock pain and you’re not sure why, your primary care doctor is a good place to start. They may refer you to a rheumatologist or orthopedic doctor depending on your symptoms and circumstances.

If you’re already diagnosed with arthritis and are experiencing buttock pain that’s new or different, it’s important to let your doctor know. You might have an additional kind of arthritis or injury alongside your current diagnosis. (For example, buttock pain could be a sign that you have osteoarthritis in your spine in addition to rheumatoid arthritis.)

(Video) Sacroiliac Joint Pain, Diagnosis, and Treatment - Dr. McNally

Step one for buttock pain treatment is following your arthritis treatment plan, says Dr. Lajam. Taking your medication as prescribed and maintaining a healthy weight can help relieve buttock pain caused by arthritis. Your doctor may recommend steroid injections in affected joints to help relieve the related buttock pain.

Also key: Staying active. Exercises that help stretch and strengthen low back, hip, and buttock muscles can also ease pain. Your doctor may advise physical therapy. You can also try these buttock pain exercises, recommended by Louw at APTA and Dr. Lajam from the AAOS.

Keep Reading

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FAQs

What are the symptoms of arthritis in the buttocks? ›

Rheumatoid arthritis

Inflammatory arthritis in your hip will feel painful and stiff. You may also experience a dull or aching pain in the buttocks that's worse in the morning, and gradually improves with activity.

What is the main cause of buttock pain? ›

Causes of pain in the buttocks range from temporary annoyances, such as bursitis, bruising, piriformis syndrome, muscle strain, and shingles, to more serious diseases with long-term consequences, such as cancer, arthritis of the sacroiliac joints, and herniated disc with sciatica.

What causes the bones in your buttocks to hurt? ›

The pain in butt bones when you sit too long is caused by inflammation or irritation of the ischial bursa. It's a condition where the fluid-filled sacs in the pelvis become inflamed and swollen, causing the sit bone pain. Ischial Bursitis can cause a lot of problems with sitting, walking, or running.

Does arthritis in the hip cause buttock pain? ›

The typical pain from hip arthritis is located in the groin thigh or buttock. The pain is generally worse with weight bearing activities (e.g., walking, standing, or twisting).

How can I relieve buttock pain? ›

You can
  1. Apply ice or heat to bring down swelling and relieve pain. You can use one or the other, or switch back and forth between ice and heat. ...
  2. Do gentle stretches of your legs, hips, and buttocks.
  3. Rest to give the injury time to heal.
  4. Take over-the-counter pain relievers, such as naproxen (Aleve) or ibuprofen (Advil).

What exercise is good for buttock pain? ›

Piriformis Stretch

Cross one leg on top of the other, so one ankle is resting on the opposite knee. Grab through the legs and pull the bent-knee leg up toward your chest until you feel a stretch in your buttock and hip. Hold the stretch for 20 to 30 seconds, then relax for 20 to 30 seconds.

What causes buttocks pain when sitting? ›

There are many reasons a person may experience pain in their buttocks when sitting. The causes range from minor injuries and bruises to more severe conditions, such as sciatica and damaged disks. People spend a lot of time sitting down, and experiencing pain in the buttocks when sitting can cause concern.

Can sitting too much cause buttock pain? ›

If you've ever been on a long car ride, then you know that sitting for hours at a time can be a pain in the buttocks – literally. That's because sitting for long periods of time can compress the sciatic nerve and cause what is known as piriformis syndrome.

What does nerve pain feel like in buttocks? ›

If you've ever had a pinched nerve in your buttocks, you know exactly how it feels: painful. It could be a relatively mild, achy type of pain, like a muscle cramp. But it could also be a sharp, shooting pain that makes you wince.

Can hip problems cause buttock pain? ›

Hip arthritis can cause pain that radiates to the buttocks. Also a hip labral tear — a tear in the soft tissue that covers the hip socket. A variety of spine issues. A problem with a spinal nerve can cause pain that radiates down into the buttocks or legs.

How do you get rid of sit bone pain? ›

You can try an over-the-counter non-steroidal anti-inflammatory drug (NSAID) like naproxen or ibuprofen to relieve inflammation. You can also try some gentle stretching. Lie on your back with cushions under your head and hips with your affected leg bent, knee pointing upward.

What is bursitis in the buttocks? ›

Ischial bursitis, also called ischiogluteal bursitis or “weaver's bottom,” is a condition that causes pain in the buttocks. It's caused by inflammation of the ischial bursae, the fluid-filled sacs that reduce friction between the hamstring muscles and the bony prominence of the pelvis that you sit on.

What painkiller is best for arthritis? ›

Nonsteroidal Anti-Inflammatory Drugs

NSAIDs are the most effective oral medicines for OA. They include ibuprofen (Motrin, Advil) naproxen (Aleve) and diclofenac (Voltaren, others). All work by blocking enzymes that cause pain and swelling.

How do you test for arthritis in hips? ›

A physical examination, in particular to see how well you can move the hip. Radiographs or X-rays to determine if there are any abnormalities in the joint. Blood tests to determine antibodies that may be associated with a specific type of arthritis (only if needed).

How can you tell the difference between hip bursitis and arthritis? ›

“The simplest way to understand the difference between hip bursitis and hip osteoarthritis is to understand where the pain is coming from,” says Dr. Sparling. “When you have hip osteoarthritis, the pain is coming from inside the joint. With hip bursitis, pain is coming from the outside.”

What causes buttock pain walking? ›

Overview. Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle also can irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).

Is walking good for buttock pain? ›

The National Health Service of Britain also recommends targeting the muscles of your back and abdomen. Physical therapy is often recommended for buttock pain and may include the following exercises and low-impact activities, such as walking. Lie on your left side with the hips and legs stacked.

What are 3 common causes of piriformis syndrome? ›

Causes of piriformis syndrome

Abnormal spine alignment (such as scoliosis) Leg-length discrepancy (when the legs are of different lengths) Prolonged sitting, especially if carrying a thick wallet in a pocket directly behind the piriformis muscle. Prior hip surgery.

How do I know if I have piriformis or sciatica? ›

In piriformis syndrome, buttock and hip pain is typically more common than lower back pain. In sciatica, the leg pain is usually greater than lower back pain and the pain may radiate into your toes. The affected leg may also feel heavy.

How can I test myself for piriformis syndrome? ›

Try pressing on the muscle in each buttock. Press slightly in the middle of the cheek. If you experience pain on one or both sides, then you may have piriformis syndrome. You can also try what is referred to as the “straight leg test.” You should ask a family member or friend to help you with this test.

How do you relieve sciatic pain in the buttocks? ›

Lie on the back with both legs bent, then place the ankle of the affected leg on the thigh of the other leg near the knee. Using both hands, gently pull the unaffected foot off the ground until a stretch is felt in the affected buttock. Hold stretch for 30 seconds, then slowly return the foot to the ground.

What nerve causes pain in buttocks? ›

The sciatic nerve travels from the lower back through the hips and buttocks and down each leg. Sciatica most often occurs when a herniated disk or an overgrowth of bone puts pressure on part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.

Can sciatica cause buttock pain? ›

Sciatica is a common cause of pain in the buttocks. Sciatica is not a condition in itself, but rather a symptom of various conditions. Sciatica can occur due to a condition that is known as piriformis syndrome. The piriformis is a muscle that starts in a person's lower back and runs down to their thigh.

What is deep gluteal syndrome? ›

Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space.

How long does it take for ischial bursitis to heal? ›

In most cases full return to activity will take from 2-6 weeks depending on the severity of the condition. As a preventive measure individuals should: Make modifications in work or daily activities to avoid prolonged pressure or unexpected blows on the ischial bursa.

What is Weaver's bottom? ›

Weaver's bottom: Inflammation of the bursa that separates the gluteus maximus muscle of the buttocks from the underlying bony prominence of the bone that a person sits on (ischial tuberosity).

Where is ischial bursitis located? ›

The Ischial bursa is a deep located bursa over the bony prominence of the Ischium and lies between the Gluteus Maximus and the Ischial tuberosity. Specifically, the bursa located deep: On the sagittal section - between the inferior part of the M. Gluteus maximus and posteroinferiorly part of the Ischial tuberosity.

What is the difference between arthritis and bursitis? ›

The key difference between arthritis and bursitis is the anatomical structures that they affect. Arthritis is a chronic condition that irreparably damages bone, cartilage, and joints, whereas bursitis is a temporary condition that involves the painful swelling of bursae for a time.

Can sitting cause bursitis? ›

Injury or overuse can cause the bursa to become inflamed, swollen, and painful — a condition called bursitis. Ischial bursitis can result from sitting for long periods on a hard surface, from direct trauma to the area, or from injury to the hamstring muscle or tendon through activities such as running or bicycling.

What can be mistaken for bursitis? ›

Tendons and bursae are located near joints. Inflamed soft tissues will often be felt by patients as joint pain. This will be mistaken for arthritis. Symptoms of bursitis and tendonitis are similar.

What are the six main treatments for arthritis? ›

Reactive Arthritis: 6 Treatments to Consider
  • Antibiotics.
  • NSAIDs.
  • Steroids.
  • DMARDs.
  • TNF blockers.
  • Physical therapy.
  • Call your doctor.

What vitamin is good for sore joints? ›

Vitamin D is important for keeping bones strong and preventing injuries from falls. Research shows that people with low levels of vitamin D may have more joint pain.

How do they test for arthritis? ›

Laboratory tests

The analysis of different types of body fluids can help pinpoint the type of arthritis you may have. Fluids commonly analyzed include blood, urine and joint fluid. To obtain a sample of joint fluid, doctors cleanse and numb the area before inserting a needle in the joint space to withdraw some fluid.

What is the best treatment for arthritis in the hips? ›

The first line of treatment of hip arthritis includes activity modification, anti-inflammatory medication, hip injections and weight loss. Weight loss helps decrease the force that goes across the hip joint. Giving up activities that make the pain worse may make this condition bearable for some people.

How should I sleep with hip arthritis? ›

Side sleepers should lie on the hip that isn't painful, and place one or more pillows between the legs. When lying on your back, place a pillow or rolled up blanket beneath your knees and possibly another under the small of your back. When sleeping on your back, place pillows beneath your knees.

Does arthritis hurt all the time? ›

Pain from arthritis can be constant or it may come and go. It may occur when at rest or while moving. Pain may be in one part of the body or in many different parts.

Does bursitis show up on xray? ›

Imaging tests.

X-ray images can't positively establish the diagnosis of bursitis, but they can help to exclude other causes of your discomfort. Ultrasound or MRI might be used if your bursitis can't easily be diagnosed by a physical exam alone.

What are two common symptoms of hip bursitis? ›

Symptoms of bursitis of the hip

Symptoms include joint pain and tenderness. You may also see swelling and feel warmth around the affected area. The pain is often sharp in the first few days. It may be dull and achy later.

What is the one leg test for hip arthritis? ›

Single Leg Stand Test | Clinical Physio - YouTube

Can you get arthritis in your bottom? ›

A sudden impact, such as a motor vehicle accident or a fall, can damage your sacroiliac joints. Arthritis. Wear-and-tear arthritis (osteoarthritis) can occur in sacroiliac joints, as can ankylosing spondylitis — a type of inflammatory arthritis that affects the spine.

What does nerve pain feel like in buttocks? ›

If you've ever had a pinched nerve in your buttocks, you know exactly how it feels: painful. It could be a relatively mild, achy type of pain, like a muscle cramp. But it could also be a sharp, shooting pain that makes you wince.

Can hip problems cause pain in the buttocks? ›

Hip arthritis can cause pain that radiates to the buttocks. Also a hip labral tear — a tear in the soft tissue that covers the hip socket. A variety of spine issues. A problem with a spinal nerve can cause pain that radiates down into the buttocks or legs.

How can you tell the difference between hip bursitis and arthritis? ›

“The simplest way to understand the difference between hip bursitis and hip osteoarthritis is to understand where the pain is coming from,” says Dr. Sparling. “When you have hip osteoarthritis, the pain is coming from inside the joint. With hip bursitis, pain is coming from the outside.”

What painkiller is best for arthritis? ›

Nonsteroidal Anti-Inflammatory Drugs

NSAIDs are the most effective oral medicines for OA. They include ibuprofen (Motrin, Advil) naproxen (Aleve) and diclofenac (Voltaren, others). All work by blocking enzymes that cause pain and swelling.

What causes pain in the buttocks when sitting? ›

There are many reasons a person may experience pain in their buttocks when sitting. The causes range from minor injuries and bruises to more severe conditions, such as sciatica and damaged disks. People spend a lot of time sitting down, and experiencing pain in the buttocks when sitting can cause concern.

Can arthritis be treated? ›

There is no cure for arthritis. The treatment goal is to limit pain and inflammation and preserve joint function. Treatment options include medicines, weight reduction, exercise, and surgery.

What nerve causes pain in buttocks? ›

The sciatic nerve travels from the lower back through the hips and buttocks and down each leg. Sciatica most often occurs when a herniated disk or an overgrowth of bone puts pressure on part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.

What are 3 common causes of piriformis syndrome? ›

Causes of piriformis syndrome

Abnormal spine alignment (such as scoliosis) Leg-length discrepancy (when the legs are of different lengths) Prolonged sitting, especially if carrying a thick wallet in a pocket directly behind the piriformis muscle. Prior hip surgery.

How do I know if I have piriformis or sciatica? ›

In piriformis syndrome, buttock and hip pain is typically more common than lower back pain. In sciatica, the leg pain is usually greater than lower back pain and the pain may radiate into your toes. The affected leg may also feel heavy.

Does bursitis show up on xray? ›

Imaging tests.

X-ray images can't positively establish the diagnosis of bursitis, but they can help to exclude other causes of your discomfort. Ultrasound or MRI might be used if your bursitis can't easily be diagnosed by a physical exam alone.

What's worse arthritis or bursitis? ›

Arthritis is a chronic condition that irreparably damages bone, cartilage, and joints, whereas bursitis is a temporary condition that involves the painful swelling of bursae for a time.
...
Do I Have Arthritis or Bursitis?
ArthritisBursitis
Pain is worst in the morning.Pain is worst at night.
4 more rows

What are two common symptoms of hip bursitis? ›

Symptoms of bursitis of the hip

Symptoms include joint pain and tenderness. You may also see swelling and feel warmth around the affected area. The pain is often sharp in the first few days. It may be dull and achy later.

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