What Causes Butt Pain? Your Symptoms Explained

Spinal stenosis

The spine, or backbone, protects the spinal cord and allows people to stand and bend. Spinal stenosis causes narrowing in the spine. The narrowing puts pressure on nerves and the spinal cord and can cause pain.

Next steps including visiting a primary care physician. For this condition, a physician might suggest further investigation including imaging of the spine. Treatments may include medications, physical therapy, or braces. For severe cases, surgery is sometimes recommended.

Sciatica

Sciatica is a general term describing any shooting leg pain that begins at the spine and travels down the outside of the leg. It is also called pinched nerve, lumbar radiculopathy, sciatic neuralgia, sciatic neuritis, or sciatic neuropathy.

By far the most common cause is a herniated or "slipped" disc in the lower spine. This means some of the cushioning material inside the disc has been forced outward and is pressing on a nerve root. Spasms of the piriformis muscle around the sciatic nerve, as well as the narrowing of the spinal canal called spinal stenosis, can also cause sciatica.

Symptoms include shooting leg pain that begins suddenly or develops gradually. There may be weakness, numbness, and a pins-and-needles sensation. In severe cases, there may be difficulty moving the foot or bending the knee.

Diagnosis is made through patient history, physical examination, and simple leg-raise tests.

Treatment involves physical therapy, nonsteroidal anti-inflammatory drugs, and muscle relaxants. In some cases, corticosteroid spinal injections and surgery may be tried. Massage and acupuncture are also sometimes helpful.

Piriformis syndrome

Piriformis syndrome

The two piriformis muscles, left and right, each run from the base of the pelvis to the top of the thighbone. The two sciatic nerves, left and right, are each attached to the spine and run down between the pelvic bone and the piriformis muscle to the back of each leg.

If the piriformis muscle is damaged through sudden trauma, or through overuse as in sports, the resulting inflammation or spasm of the muscle can trap the sciatic nerve between the pelvic bone and the muscle.

Piriformis syndrome is most often found in women over 30.

Symptoms include pain over one or both sides of the low back, and shooting pain (sciatica) down one or both legs.

Diagnosis is made through physical examination and sometimes imaging such as CT scan or MRI.

Treatment involves rest; over-the-counter, nonsteroidal anti-inflammatory drugs; physical therapy; therapeutic injections; and, rarely, surgery.

The best prevention is a good regimen of stretching before exercise, to help prevent damage to the piriformis.

Rarity: Common

Top Symptoms: pelvis pain, butt pain, pain when passing stools, leg numbness, hip pain

Symptoms that never occur with piriformis syndrome: involuntary defecation, leaking urine

Urgency: Primary care doctor

Peripheral artery disease (reduced blood flow in the legs)

Peripheral artery disease (PAD) is a chronic condition that reduces blood flow in the arteries, usually arteries that lead to the legs. This reduced blood flow happens when clumps of fat (called plaques) build up inside these arteries, causing them to narrow. Symptoms include leg numbness, foot and thigh pain, cold feet, and muscle fatigue. These symptoms often occur when walking or exercising. The risk of developing PAD is higher in those who smoke or have diabetes. High blood pressure, high cholesterol, being overweight, and not getting much exercise also can put one at higher risk.

You should consider visiting a healthcare provider in the next two weeks to discuss your symptoms. Your provider can evaluate PAD with a review of your symptoms and a physical exam. An MRI may be performed as well. Once diagnosed, treatment involves medication, surgery, or procedures to open or bypass blocked arteries. Lifestyle changes regarding diet, exercise, and smoking cessation may also help.

Mechanical low back pain with sciatica

Sciatica is a general term describing any shooting leg pain that begins at the spine and travels down the outside of the leg. It is also called pinched nerve, lumbar radiculopathy, sciatic neuralgia, sciatic neuritis, or sciatic neuropathy.

By far the most common cause is a herniated or "slipped" disc in the lower spine. This means some of the cushioning material inside the disc has been forced outward and is pressing on a nerve root. Spasms of the piriformis muscle around the sciatic nerve, as well as the narrowing of the spinal canal called spinal stenosis, can also cause sciatica.

Symptoms include shooting leg pain that begins suddenly or develops gradually. There may be weakness, numbness, and a pins-and-needles sensation. In severe cases, there may be difficulty moving the foot or bending the knee.

Diagnosis is made through patient history, physical examination, and simple leg-raise tests.

Treatment involves physical therapy, nonsteroidal anti-inflammatory drugs, and muscle relaxants. In some cases, corticosteroid spinal injections and surgery may be tried. Massage and acupuncture are also sometimes helpful.

Hemorrhoids

Hemorrhoids, or "piles," are swollen veins in the anus or rectum. They may be located inside the rectum (internal) or outside the body at the anus (external.)

The condition is caused by straining during bowel movements and/or from increased pressure during pregnancy and childbirth.

Hemorrhoids are a common occurrence, especially in older people. Pregnant women are susceptible, as is anyone who has chronic constipation or is obese.

Symptoms include discomfort, pain, pressure, and itching. There may be small amounts of bleeding during bowel movements, though some hemorrhoids cause no symptoms at all.

Severe pain can indicate a thrombosed hemorrhoid, meaning a clot has formed within it. This is not serious but the pain can be debilitating and requires treatment right away. Also, rectal bleeding can also be a sign of more serious diseases such as diverticulitis or cancer and should always be diagnosed by a medical provider.

Diagnosis is made through physical examination and sometimes through colonoscopy.

Treatment begins with good hygiene, cold compresses, and over-the-counter pain relievers. Surgery may be done for some cases.

Fibromyalgia

Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.

The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.

Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.

Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.

There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.

Fibromyalgia does not go away on its own but does not get worse, either.

Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.

Coccydynia

The tailbone, called the coccyx, is the lowest part of the spine. Coccydynia is pain around the area of the tailbone, which is triggered by activities that cause pressure on the tailbone such as sitting on a hard chair. Symptoms get better with standing or walking. Doctors are not completely sure what causes this pain.

You can safely treat this condition on your own. This condition has no directed treatment, so you are advised to take over-the-counter pain medication and take pressure off the tailbone by sitting on a soft cushion whenever possible.

Rarity: Uncommon

Top Symptoms: back pain, lower back pain, painful sex, back pain that shoots to the butt, constant butt pain

Symptoms that always occur with coccydynia: constant butt pain

Symptoms that never occur with coccydynia: warm and red tailbone swelling

Urgency: Self-treatment

Bruised buttocks

A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the buttocks are common, given the location on the body.

You can treat this at home with rest (exercise as tolerated) and ice (10-20 minutes at a time).

Rarity: Rare

Top Symptoms: constant butt pain, butt pain, butt pain from an injury, recent buttocks injury, butt bruise

Symptoms that always occur with bruised buttocks: butt pain from an injury, recent buttocks injury, constant butt pain

Urgency: Self-treatment

Ankylosing spondylitis

"Ankylosing" means a joint has become stiffened and fixed in one position due to injury or disease. "Spondylitis" means inflammation in the joints of the spine.

In ankylosing spondylitis, inflammation has damaged the vertebrae of the low back and caused a form of arthritis, leaving the lower spine inflexible.

The exact cause is unknown. It is thought to be an inherited, abnormal immune response that is triggered following damage to the lining of the intestines.

Most susceptible are those with a family history of ankylosing spondylitis and a history of intestinal damage from illness. However, anyone can be affected at any age.

Symptoms include pain and stiffness in the back and hips, and sometimes in the neck and shoulders. The pain will be worse during sleep and rest.

Early treatment can help to manage the symptoms, prevent complications, and improve quality of life.

Diagnosis is made through physical examination and x-rays.

Treatment involves nonsteroidal anti-inflammatory drugs; new forms of biologic medications; physical therapy; and, in some cases, surgery to repair damaged joints.

Anal fissure

An anal fissure is a break, or tear, in the mucous membrane lining of the anus. The anus is the opening at the end of the digestive tract where stool leaves the body.

A fissure is caused primarily by constipation, which leads to straining to pass large hard stools; trauma caused by insertion of objects or by anal sex; and illnesses such as any type of inflammatory bowel disease or sexually transmitted disease.

Symptoms include pain and bleeding during and after a bowel movement; discomfort and difficulty with urination; and a visible tear, resembling a crack, in the anal tissue that may have a foul-smelling discharge.

Diagnosis is made through physical examination.

Treatment primarily involves relieving constipation, and the straining it causes, by adding fiber and more fluids to the diet; and easing anal irritation by soaking in a warm bath and gently cleansing the tissues of the anus. In some cases, medicated creams or suppositories may be prescribed.

Anal cancer

Anal cancer is a neoplasm, or tumor, growing in the tissues of the anus. The tumor may be malignant (cancerous) or benign (non-cancerous.)

Most anal cancers are linked to the human papilloma virus, or HPV. However, many people carry HPV and have no symptoms or illness of any kind.

Most susceptible are men who have sexual contact with men; women who have had cervical cancer; and anyone who has engaged in anal intercourse, had anal warts, or is HIV positive. Smoking and lowered immunity are also factors.

Symptoms include minor anal bleeding and itching, which may be attributed to hemorrhoids; pain or fullness in the anal region; and abnormal anal discharge.

It is important to see a medical provider about these symptoms so that if needed, treatment can begin as soon as possible.

Diagnosis is made through patient history; physical examination; anal swab; and biopsy. CT scan, ultrasound, or endoscopy of the anus may also be done.

Treatment involves some combination of surgery, radiation therapy, and chemotherapy depending on the needs of each individual patient.

Rarity: Rare

Top Symptoms: abdominal pain (stomach ache), stool changes, constipation, diarrhea, pain when passing stools

Urgency: Primary care doctor

Tailbone bruise

A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the tailbone are common, given the location on the body.

Rarity: Rare

Top Symptoms: constant butt pain, tailbone pain, tailbone pain from an injury, tailbone injury, butt bruise

Symptoms that always occur with tailbone bruise: tailbone pain from an injury, tailbone injury, constant butt pain

Urgency: Self-treatment

At-home treatments

Simple stretching, rest, or improved form while exercising can sometimes provide relief.

• Rest and stretching: This may heal hamstring pulls or other muscular issues causing your butt pain.
• Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) may help.

When to see a doctor

Radiating pain can be an important sign of larger problems. If the pain is located in or around the anus, infection or internal damage is possible, which makes it important to see a doctor.

• Prescription pain medication: Narcotics may be prescribed for pain related to sciatica, arthritis, or traumatic pain.
• Antibiotics: These are used to treat infections.
• Spinal injections: These are used to treat chronic or extreme pain.
• Surgical procedures:* If the body does not respond to less invasive techniques or it is deemed that aggressive action is necessary to prevent long-term effects, surgery may be needed.

Why do I have pain in my buttocks when sitting for too long?

Many lower back conditions result in radiating pain to the butt. These issues can be worsened after sitting for extended periods of time. The sciatic nerve begins in the lower back, passes through the butt, and runs down the leg. Issues with the sciatic nerve, commonly called sciatica, can result in pain in the butt after prolonged sitting.

Why does my butt hurt when I walk?

Walking utilizes the many muscles found in the legs and butt. A strain, pull, or cramp in one of them can result in butt pain while moving. Other, more chronic conditions related to blood flow and circulation to the lower back can also cause pain while walking.

Why do I have buttocks pain on only one side?

Butt pain is frequently linked to lower back issues. Dysfunction in the joints and nerves of the lower back can affect the butt in a variety of ways, including pain on only one side. The pain may also be an isolated pull or strain of a muscle on that side of the butt.

How long does it take to recover from piriformis syndrome?

As with all medical conditions and treatments, the recovery time can vary. Symptoms may disappear for periods of time, or piriformis syndrome may require several procedures. Recovery will depend on how invasive the procedure is how much therapy is needed afterward.

Why is my anus burning when I poop?

A burning sensation while pooping can result from several conditions. Hemorrhoids and anal fissures can cause burning sensations exacerbated by straining due to anal inflammation.

Questions your doctor may ask about butt pain

• Do your symptoms worsen when sitting?
• Are you sexually active?
• Have you had any changes in your weight?
• Any fever today or during the last week?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.