Chronic pain around the hip or lower butt is often described as a dull irritating ache, burn, or tingling sensation that can vary in intensity and seems to be impacted by sitting. For some, it hurts while they are sitting, and for others, it’s painful when they get up from sitting too long. In most cases, It comes on gradually with no specific injury and is challenging to manage on your own.
Many of us sit for several hours a day. In fact, a 2019 publication from the Washington Post cited a study by the Journal of American Medical Association that the average American adult sits for 6.5 hours/day. Even more staggering, the average American teen sits for 8 hours daily.
Multiple research articles demonstrate the harmful effects of prolonged sitting on various body regions, including the neck, lower back, and hips. Since our lifestyles are trending towards even more significant amounts of sitting, we must understand how this impacts these body regions. This information is vital for prevention and treatment to ensure a comfortable lifestyle as we age and live longer lives.
Once lower back and specific hip joint pathology are ruled out, four primary syndromes cause pain in the lower butt and hip. Each condition has a typical pain pattern and various characteristics.
Deep Gluteal Syndrome
Pain: Ache in the lower inner buttock with some burning or tingling in the hip or back of the thigh
Characteristics:
Usually just on one side
Can’t sit longer than 20-30 minutes
Limps when walking
Some possible loss of sensation
Pain can be worse at night and better during the day
Often has a history of lower back pain
Hamstring Syndrome
Pain: Deep ache or burn in the lower outer buttock (lateral to the butt bone) and refers to the back of the thigh
Characteristics:
Pain often begins gradually and worsens over time
Pain is worse when sitting on a hard surface
Felt during and after physical activity
Worsened by stretching
Pain occurs just before you put your heel down when walking or running
History of hamstring injury increases the risk
Piriformis Syndrome
Pain: Deep ache in mid-buttock that can be felt down to the back of the knee
Characteristics: Worse with sitting, especially on soft chairs and when leaning back
Ischiofemoral Impingement Syndrome
Pain: Deep pain at or below the butt bone and towards the hip
Characteristics:
Pain occurs when walking with longer strides; Short strides often alleviate the pain
Painful with sitting, stretching, and during exercise that causes compression and traction
Learning which syndrome you may be suffering from can be very helpful in narrowing down a treatment plan and recovery strategy. These syndromes are exactly what orthopedic specialists and physical therapists are sorting through when determining your source of pain and diagnosis.
The correct diagnosis is just the starting point. Once this distinction has been made, your physical therapist can more easily and successfully guide you through the appropriate treatment plan.
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