Pain guide · Hip pain

Buttock pain (bum pain): the back, the hip, the sitting bone, piriformis and when to worry

Buttock pain, or bum pain, often comes from the lower back, the sacroiliac (SI) joint at the back of the pelvis, the hip joint or a tendon, such as the hamstring tendon at the sitting bone. Piriformis syndrome is real, but how often it's the cause is unknown, and the tailbone, piles and an abscess cause pain lower down.

This guide starts with the warning signs, from a 999 call or accident and emergency (A&E) to the National Health Service's 111 line (NHS 111) or a general practitioner (GP): numbness around the genitals or bottom, bladder or bowel changes, a hot, painful lump and an ache on walking that goes when you stop. It then maps the causes by the exact spot, answers whether buttock pain can be cancer, and gives a three-stage plan with written steps for sitting, driving, running and lifting.

3-stage exercise plan When to get help 33 sourcesUpdated 24 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E: loss of feeling or numbness around the genitals or bottom, new trouble peeing or controlling your bladder or bowels, changes in genital sensation during sex or problems with erections or orgasm, or pain, tingling, weakness or numbness in both legs. These are signs of cauda equina syndrome, which needs treating in hospital urgently. Don't drive yourself.
Call 999 or go to A&E: severe pain after a fall onto your hip or bottom, or you cannot walk or put weight on the leg.
Call 999: after a fall, you may have hurt your head, neck, back or hip, or you cannot get up.
Call 999 or go to A&E: you're bleeding non-stop from your bottom, there's a lot of blood or you see large blood clots when you poo, or you have piles and severe pain. Don't drive yourself.
Same day: a pop near the sitting bone, a large bruise high on the back of the thigh, or you cannot put weight on the leg. The tendon may have pulled away from the bone, which needs assessing before you start these exercises.
Ask for an urgent GP appointment or get help from NHS 111: you have a lump on or near your bottom that is painful, red or hot, or you feel hot, cold or shivery, or swelling or redness is spreading away from the lump. It could be an abscess.
A painful lump at the top of your bottom, between the buttocks, that is bleeding or leaking pus: ask for an urgent GP appointment or contact NHS 111. It can be an infected pilonidal sinus.
Same day (GP or NHS 111): back pain and you feel hot, cold, shivery or generally unwell, or severe pain that starts suddenly or is getting worse quickly.
Ask for an urgent GP appointment or get help from NHS 111 if you have severe hip pain that started suddenly but you've not had a fall or injured your hip, your hip is swollen and feels hot, the skin around your hip has changed colour, or you have hip pain, feel generally unwell and have a high temperature (or feel hot, cold or shivery). A hot, swollen hip with a high temperature can be a joint infection.
Same day: you have or have had cancer, and new back pain that is severe and doesn't let up, is getting steadily worse, is worse at night and disturbs your sleep, is worse when you cough, sneeze or strain, or comes with tenderness over the spine. Contact your cancer team or GP urgently. With cancer, new weakness, difficulty walking, numbness or bladder or bowel problems are an emergency.
Same day: leg weakness that is getting worse.
Contact your GP or midwife urgently: back pain in the second or third trimester of pregnancy, or back pain in pregnancy with a fever, vaginal bleeding, pain when you pee, or pain in one or more of your sides (under your ribs). It could be early labour or an infection.
Ask for an urgent GP appointment or get help from NHS 111 the same day if your child gets sudden pain in their hip, thigh or knee (hip problems can sometimes be felt in the thigh or knee), or is limping or cannot put any weight on 1 leg. This applies to teenagers too, and in some children knee pain is the only sign.

See a doctor or physiotherapist if

Back pain that hasn't improved after a few weeks of looking after it at home, stops you doing day-to-day activities, or worries you.
Pain in the back of the thigh with tingling, numbness, weakness, or pain spreading below the knee: it may come from the back (sciatica).
Leg ache when you walk that goes after a few minutes' rest: possible peripheral arterial disease (narrowed leg arteries), especially if you smoke or have diabetes.
An ache in the buttock or thigh that comes on as you walk and eases after a few minutes' rest: see a GP. It can come from narrowed arteries higher up, in the tummy or pelvis, NHS Scotland's vascular pathway says.
Back pain that started before 45 and has lasted more than 3 months, especially if it wakes you in the second half of the night, comes with buttock pain, eases with movement or within 48 hours of anti-inflammatories, or you have psoriasis or a parent, sibling or child with spondyloarthritis. These can point to inflammatory back pain (axial spondyloarthritis, such as ankylosing spondylitis); NICE refers people with four or more of these features to a rheumatologist.
Pain that doesn't improve with rest or is worse at night, or pain that is worse when you sneeze, cough or poo.
Unexplained weight loss, or a lump, swelling or change in the shape of your back.
Tailbone pain that hasn't improved after a few weeks of treating it at home, is affecting your daily activities, or comes with a high temperature and pain somewhere else, such as your tummy or lower back: see a GP. In many areas you can refer yourself to NHS physiotherapy.
Pain around your back passage when you poo that is getting worse or isn't improving with home treatment, keeps coming back, or comes with a change around your anus that isn't normal for you: see a GP. Painless bleeding from your bottom, pus, or a very high temperature with feeling unwell needs an urgent GP appointment or NHS 111.
A change in your poo, blood in your poo or bleeding from your bottom, needing to poo more often, tummy pain, bloating or losing weight without trying: see a GP. Buttock pain on its own isn't on the NHS's list of bowel cancer symptoms.
Tingling or burning pain on one side of your bottom or back, then a rash: try to see a pharmacist within 3 days of the rash appearing. It can be shingles.
Stiffness lasting more than 30 minutes after waking.
Bone pain that is constant or worse at night, especially with a lump, unexplained weight loss, fever or tiredness, or a past history of cancer.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

Buttock pain with low back pain, spreading down the back of the leg below the knee, sometimes with tingling, numbness or weakness

Sciatica, from a nerve root in the lower back. The leg often hurts more than the back.

Read: Sciatica →Buttock and low back pain without leg symptoms below the knee, changing with movement and position

Ordinary low back pain, which usually settles within weeks.

Read: Back pain →Low on one side by the dimple at the back of the pelvis, into the buttock, worse standing on one leg, on stairs, turning in bed or getting up from sitting

The sacroiliac joint.

Read: SI joint pain →A deep ache low in the buttock at the sitting bone, worse sitting on hard seats, running uphill, long strides, lunges and hamstring stretches

High hamstring tendinopathy, which builds up over weeks.

Read: High hamstring tendinopathy →A sudden pain at the back of the thigh near the sitting bone in a sprint, a high kick or a slip, sometimes with a pop and bruising

A hamstring strain, or a tendon pulled off the bone: a pop with a large bruise needs checking the same day.

Read: Hamstring strain →The bony point on the side of the hip, sore to lie on, spreading into the buttock or thigh

The gluteal tendons (greater trochanteric pain syndrome).

Read: Outer hip pain →A deep ache in the buttock, groin or front of the thigh from mid-life, stiff after rest, socks and car seats hard

Possibly hip arthritis: the hip joint is often felt in the buttock.

Read: Hip arthritis →Deep in the middle of the buttock, worse sitting (especially in a car), sometimes down the back of the thigh, without back pain

Possibly deep gluteal or piriformis syndrome, which is real but contested; how often it's the cause is unknown.

Read: Piriformis syndrome (deep gluteal syndrome) →Deep in the lower buttock with long strides, walking or running

Rarely, the gap between the hip bone and the sitting bone is pinched (ischiofemoral impingement): a sports or hip specialist can check.

Read: Piriformis syndrome (deep gluteal syndrome) →Both buttocks and legs aching, heavy or tingling on walking or standing, eased only by sitting or bending forward, usually from 50

Possibly a narrowed spinal canal (lumbar spinal stenosis).

Read: Lumbar spinal stenosis →An ache in the buttock, thigh or calf after walking a set distance that goes within minutes of standing still, especially if you smoke or have diabetes

It can be narrowed arteries: see a GP. Our exercise for peripheral arterial disease guide covers the walking programme once it's confirmed.

Read: Calf pain when walking →Right at the base of the spine, worse sitting, sitting down or standing up, bending forward or pooing

The tailbone (coccyx pain, or coccydynia).

Read: Tailbone pain →

Pain around the back passage when or after you poo, bleeding, or a lump at the anus

Usually piles or an anal fissure, not the buttock muscles: see a pharmacist or GP. Our exercise with piles guide covers staying active.

A hot, painful, swollen lump near the bottom, or at the top of the buttock crease leaking pus

A possible abscess or an infected pilonidal sinus: see the warning signs.

Low back and buttock pain since before 45, for over 3 months, waking you in the second half of the night, easing with movement

Possibly inflammatory back pain (axial spondyloarthritis): see a GP. Our exercise for ankylosing spondylitis guide covers the long-term plan.

Low back or buttock pain on one side brought on by running, in a distance runner

Rarely, a stress fracture of the sacrum: stop running and see a GP.

Read: Back pain when running →Low back, buttock or groin pain after a minor fall in later life, making walking very hard

A possible fragility fracture of the sacrum or pelvis.

Read: Broken pelvis →The back of the pelvis or the low back in pregnancy or after giving birth, sometimes spreading to the thighs

Pelvic girdle pain.

Read: Pelvic girdle pain (SPD) →

Tingling or burning on one side of the bottom, then a rash

Possibly shingles: try to see a pharmacist within 3 days of the rash appearing.

Buttock pain mostly when you sit

Our hip pain when sitting guide.

Read: Hip pain when sitting →Low back and buttock pain mostly when you sit

Our back pain when sitting guide.

Read: Back pain from sitting →The buttock or the back of the thigh when you run

Our hamstring pain when running guide.

Read: Hamstring pain when running →Hip or buttock pain when you run

Our hip pain when running guide.

Read: Hip pain when running →Buttock pain on the bike

Our hip pain when cycling guide.

Read: Hip pain when cycling →Buttock or hip pain at night

Our hip pain at night guide.

Read: Hip pain at night →Pain in the groin rather than the buttock

Our groin pain guide maps it.

Read: Groin pain →

Understand it

The buttock is where the back, the sacroiliac joint and the hip send painEmerging evidence

No study opened for this guide measures how often each cause explains buttock pain. What the pain-mapping studies show is where several sources are felt. The NHS says the symptoms of sciatica usually affect your bottom and the back of one leg. Of 50 people whose pain was confirmed to come from the SI joint by an injection, 94% felt it in the buttock, 72% low in the back, 28% below the knee and 14% in the groin. Of 51 whose hip joint was confirmed as the source, 71% felt it in the buttock, more often than in the groin, and none in the lower back; in people waiting for hip or spine surgery, buttock and groin pain were commoner with hip arthritis than with a narrowed spine.

A family-medicine review sorts pain at the back of the hip and buttock into the lower back, the SI joint, deep gluteal syndrome, a pinch between the hip bone and the sitting bone, and the hamstring tendon at the sitting bone, and adds that pelvic and gynaecological problems can be felt there too, with clues such as pain that follows your periods or comes with bladder or bowel symptoms. So this guide says a spot points to a cause rather than proving it.

Sources 1, 2, 3, 4, 5

Numbness around the genitals or bottom is an emergencyStrong evidence

The NHS asks you to call 999 or go to A&E if you have back pain with pain, tingling, weakness or numbness in both legs, a loss of feeling around your genitals or anus, changes in your bladder or bowels such as difficulty peeing, or changes in how your genitals feel during sex; its sciatica page adds sciatica on both sides. These can be signs of cauda equina syndrome, a serious back problem that needs treating in hospital as soon as possible.

Sources 6, 1

The sitting bone: the hamstring tendonEmerging evidence

High (proximal) hamstring tendinopathy is a deep ache low in the buttock, at the sitting bone, felt with sitting and running, in athletes and non-athletes; it is often long-standing. Sitting, deep hip bending and hamstring stretches press the tendon against the bone and typically bring it on, which is why the plan leaves stretches out for now.

A sudden injury is different: sharp pain at the back of the thigh, sometimes with a snap or pop, then tenderness, swelling and bruising, the NHS says. In the most severe injuries, the tendon tears away from the sitting bone, sometimes with a piece of bone, and surgery is most often done for these, the American Academy of Orthopaedic Surgeons (AAOS) says.

Sources 7, 8, 9, 10

The side of the hip: the gluteal tendonsStrong evidence

Pain from the tendons on the side of the hip (greater trochanteric pain syndrome) can be felt in the hip, thigh or buttock, NHS inform says, and is worse lying on that side, sitting with your legs crossed and on stairs. Our outer hip pain guide covers it.

Source 11

Piriformis and deep gluteal syndrome: real, but contestedEmerging evidence

Piriformis syndrome means pain from the sciatic nerve being irritated deep in the buttock by the piriformis muscle. Across 55 studies, mostly case reports, its commonest features were buttock pain, pain worse sitting, tenderness near the notch of bone where the nerve leaves the pelvis, and pain when the muscle is stretched; an update says these four define it.

But the same review says how accurate the tests are, and how common it is among people with back pain and sciatica, can't be concluded from the studies so far, and a straight-leg raise doesn't rule it out. A family-medicine review treats it as one kind of deep gluteal syndrome. So it is a possible cause of deep buttock pain worse sitting, not the usual explanation for buttock pain.

Sources 12, 13, 14, 5

Pain on walking: the spine, or the arteriesEmerging evidence

Pain in both buttocks and legs that comes on walking or standing and eases only by sitting or bending forward is the classic pattern of a narrowed spinal canal (lumbar spinal stenosis), which our spinal stenosis guide covers.

An ache in the leg muscles when you walk that goes after a few minutes' rest can be peripheral arterial disease, narrowed arteries in the legs; smoking is the biggest risk, with diabetes, high blood pressure and high cholesterol, the NHS says. The NHS describes the legs; NHS Scotland's vascular surgery pathway, a page past its review date, says the muscles of the thigh and buttock can also be affected when the narrowing is higher up, in the main artery in the tummy or the arteries into the pelvis. So an ache in the buttock that comes on as you walk and eases with rest can come from the arteries, and needs a GP, who compares the blood pressure in your arm and your ankle.

Sources 15, 16

The tailbone, the back passage and lumpsStrong evidence

Tailbone pain is at the base of the spine near the top of the bottom, worse sitting, sitting down or standing up, bending forward or having a poo; childbirth, a fall, long sitting while driving or cycling and being overweight or underweight are among the causes the NHS lists.

Pain around the back passage when you poo is usually piles (lumps inside and around the anus, with pain, itching or bleeding after a poo) or an anal fissure (a small tear that causes a severe, sharp pain when you poo and a burning pain that can last hours afterwards). A lump that is painful, red or hot can be an abscess; a painful lump at the top of the buttock crease can be an infected pilonidal sinus; and an abscess near the anus causes swelling, redness and a high temperature (the NHS anal fistula page, which is past its review date).

Sources 17, 18, 19, 20, 21, 22

Can buttock pain be cancer?Strong evidence

Rarely. Buttock pain on its own isn't on the NHS's list of bowel cancer symptoms, which are changes in your poo, blood in your poo or bleeding from your bottom, needing to poo more or less often, tummy pain, a lump in your tummy, bloating, losing weight without trying, and tiredness or breathlessness. Bone cancer causes bone pain or tenderness that may be constant or worse at night, a lump or swelling, and problems moving, and the NHS asks you to see a GP for bone pain, especially at night, or a lump. New back pain with a past cancer needs your cancer team or GP the same day.

Sources 23, 24

A burning patch, then a rash: shinglesStrong evidence

Shingles starts with a tingling or painful feeling in an area of skin, sometimes with a headache or feeling unwell, and a rash usually appears a few days later, on one side of the body only. It's usually on the chest and tummy but can appear anywhere on the body, the NHS says, and rarely it causes pain without a rash. Try to see a pharmacist within 3 days of the rash appearing.

Source 25

Inflammatory back painStrong evidence

NICE (the National Institute for Health and Care Excellence) asks for a rheumatologist's assessment when back pain started before 45 and has lasted more than 3 months with four or more of these: it started before 35, it wakes you in the second half of the night, buttock pain, it improves with movement, it improves within 48 hours of anti-inflammatory painkillers, a close relative with spondyloarthritis, or current or past arthritis, enthesitis or psoriasis.

Source 26

PregnancyEmerging evidence

Back pain is very common in pregnancy, the NHS says, and pelvic girdle pain can be felt across the lower back and the joints of the pelvis and spread to the thighs (a page past its review date). The NHS asks you to contact your GP or midwife urgently for back pain in the second or third trimester, or with a fever, vaginal bleeding or pain when you pee, and to call 999 if you lose feeling in one or both legs, your bum or your genitals.

Sources 27, 28

When a scan or test helpsStrong evidence

For back pain and sciatica, NICE doesn't routinely offer imaging outside specialist care, and only if the result would change what happens; NHS inform says most back problems don't need an X-ray or magnetic resonance imaging (MRI). No single test confirms the SI joint as the source; injections are used in research and specialist care.

For the sitting bone, the examination comes first; a scan matters when a tendon may have pulled off the bone, which needs a surgeon quickly. When deep gluteal syndrome is suspected, MRI of the deep buttock and nerve tests help if the picture is unclear. For the arteries, a GP compares the blood pressure in your arm and your ankle.

Sources 29, 30, 2, 7, 10, 5, 15

How it usually goesEmerging evidence

Sciatica usually gets better in a few weeks to a few months, but it can last longer and can come back, the NHS says; NHS inform expects the biggest change in back problems in the first couple of weeks and most to improve within 6 weeks. High hamstring tendon pain is slow: both groups in a trial of 100 people improved over a year. Tailbone pain may improve after a few weeks but can last longer. NHS Scotland's pathway says 75% of people with an ache from narrowed leg arteries stay the same or improve. No one can promise a date.

Sources 1, 30, 7, 17, 16

What helps, and how strong the evidence is

Back pain and sciatica: stay active, and exerciseStrong evidence

NICE advises carrying on with normal activities and considering a group exercise programme, with manual therapy only alongside exercise, and no belts, foot orthotics, traction or acupuncture. The NHS says keep doing your normal activities, start gentle exercise as soon as you can, use heat packs, and don't sit or lie down for long periods: even if moving hurts, it's not harmful. NHS inform says resting in bed doesn't help, and offers back exercises (knee rolls, pelvic tilts, one knee to chest, both knees to chest and the cat-cow back curl) with a pain limit of 0 to 5 out of 10.

Sources 29, 1, 30, 31

The sitting-bone tendon: load it, don't stretch itEmerging evidence

In 100 people with high hamstring tendon pain in Australian primary care, 6 sessions of individual physiotherapy and 6 of shockwave therapy, both with the same advice and education, did equally well over a year. The physiotherapy built from holds to slow, heavy strength with the hip straight, then brought hip bending back gradually, then running and speed, which is the plan our high hamstring guide sets out. A review says the evidence on diagnosis and treatment is limited.

Sources 7, 8

Piriformis and deep gluteal syndrome: no treatment proven better than anotherEmerging evidence

A review of 13 studies (508 people: 8 trials of injections and 5 surgical series) found low-quality evidence and no conservative treatment better than another. It advises following the guidance for back pain and sciatica first, physiotherapy, and says surgery may have a place for long-standing cases. No trial shows that stretching treats it; our piriformis guide keeps gentle stretches only if they ease the pain, alongside hip and trunk strength.

Sources 14, 13

The gluteal tendons: change how you sit and lieEmerging evidence

NHS inform advises spreading your weight evenly across both feet rather than leaning on one leg, not sitting with your legs crossed, and not sleeping on the painful side: lie on your back with a pillow under your knees, or on your good side with a pillow between your legs. Our outer hip pain guide has the exercise programme with the best trial evidence.

Source 11

The tailbone: cushions and time, then other treatmentsEmerging evidence

The NHS advises sitting with your lower back supported, a specially designed coccyx cushion, pelvic floor exercises, a laxative if pooing hurts, and not sitting for long. If those don't help, physiotherapy and steroid and local anaesthetic injections are the next treatments, and surgery to remove part or all of the tailbone is kept for when they don't work.

Source 17

An ache from narrowed arteries: a GP firstEmerging evidence

If a GP confirms narrowed arteries, regular exercise and stopping smoking are the main treatments, the NHS says, and NHS Scotland's pathway offers supervised exercise programmes. Our claudication walking workout and exercise for peripheral arterial disease guide cover the walking plan once it has been confirmed.

Sources 15, 16

Medicines, injections and surgery for sciaticaStrong evidence

NICE doesn't offer gabapentinoids, other anti-epilepsy medicines, steroid tablets or benzodiazepines for sciatica, and considers an epidural injection for severe, short-lived sciatica. The NHS lists sealing off nerves (radiofrequency denervation), epidurals and surgery to release a trapped nerve for severe pain that hasn't responded to other treatment.

Sources 29, 1

How much pain is OK while you exercise?

Up to about 5 out of 10, settled within an hour, and nothing spreading down the leg; the sitting bone and the tailbone have their own rulesEmerging evidence

This guide uses the back hub's rule. Some discomfort during exercise is fine, and it does not mean you are doing damage. Aim for pain you would call mild to moderate, no more than about 5 out of 10. It should settle within an hour or so, and your back should be no worse the next morning. If it is worse, do less next time (fewer reps, a smaller range, a lighter load), not nothing. NHS inform's back exercises use the same 0 to 5 limit, and the NHS says that even if moving hurts, it's not harmful.

Leg symptoms are the exception: stop or shrink any movement that sends pain, pins and needles or numbness further down your leg. Nerve glides follow a stricter rule from NHS physiotherapy services: a pull in the leg is fine, pain is not.

At the sitting bone, use the 2025 trial's rule: keep pain at 4 out of 10 or less during exercise and activity, running included, with no more than a 2-point rise over your usual level in the 12 to 24 hours afterwards. For the tailbone, judge sitting by time, not by pain: sit for as long as you comfortably can, stand up and move before the pain builds, and stretch the time by a few minutes every few days (our suggestion; the NHS advises not sitting for long).

The 5 out of 10 figure matches this site's other pain guides and hasn't been tested in a back or buttock pain trial; in trials of long-lasting muscle and joint pain, exercise that allowed some pain did no harm. Numbness around the genitals or bottom, bladder or bowel changes, a hot lump, bleeding from the bottom and an ache on walking that goes when you stop are never pain-rule questions: see the warning signs.

Sources 31, 1, 7, 32, 17

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Settle: keep moving, sit less, and find what eases it

About the first 2 weeks: carry on with normal activities, start gentle exercise as soon as you can, use heat packs if they help, and don't sit or lie down for long periods, as the NHS advises. Take short walks several times a day and break up sitting every 30 to 45 minutes (our piriformis guide). With pain at the sitting bone, leave out hamstring stretches and deep hip bending for now and use the holds below. With sciatica, the SI joint, the hamstring tendon, the hip joint, the gluteal tendons, the tailbone or a narrowed spinal canal, that guide's plan can replace this one.

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

5 to 10 min, several times a day · As in our back pain guide; walking outdoors or around the house is just as good

Harder: Treadmill jogging

Hip windshield wipers demonstrated on the 3D figure

3D demoHip windshield wipersBeginner · No equipment

2 to 3 at a time, little and often, building to sets of 8, up to 2 sets of 15 · NHS inform's knee rolls, with its pacing (the move page's own dose is editorial)

Easier: Supine heel slide · Harder: 90/90 switch

Single knee-to-chest stretch demonstrated on the 3D figure

3D demoSingle knee-to-chest stretchBeginner · No equipment

Hold 20 to 30 s, 2 to 3 sets, 2 to 3 times a day · NHS inform's one knee to chest, with its stretching dose. Keep it only if it eases your pain, and leave it out if bending forward sends pain down a leg, as the move page says

Harder: 90/90 hip lift-off

3D demoCat-cowBeginner · No equipment

8 slow waves, small range · As in our back pain guide; NHS inform's back curl is the same movement

Harder: Half lord of the fishes (Ardha Matsyendrasana)

Glute bridge demonstrated on the 3D figure

3D demoGlute bridgeBeginner · No equipment

With sitting-bone pain, 5 holds of 30 to 45 s with 90 s rest, feet a little further from the hips; otherwise 2 sets of 10 · The holds are from the high hamstring trial's programme, as in our high hamstring guide; the sets are our piriformis guide's

Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge

Seated sciatic nerve slider (nerve glide) demonstrated on the 3D figure

3D demoSeated sciatic nerve slider (nerve glide)Beginner · A bench or box

10 slow reps, 2 to 3 times a day; try it for two weeks and keep it only if it eases your leg · The move page's dose (one NHS service's). Optional, for leg symptoms; no pain at any point

Easier: Lying sciatic nerve slider (nerve glide)

Move on when: You can walk for 15 to 20 minutes and get through normal daily tasks, sitting is a little easier, and nothing is spreading further down the leg (the back hub's and the piriformis guide's checks, combined).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Build: hips, trunk and the back of the thigh

About weeks 2 to 6, two or three days a week: strength round the pelvis, and the hamstrings with the hip straight. For pain at the sitting bone, follow our high hamstring guide's progression; for the rest, the back and piriformis guides'.

Staggered-stance bridge (offset bridge) demonstrated on the 3D figure

3D demoStaggered-stance bridge (offset bridge)Beginner · No equipment

5 slow reps each side once a day, building to 2 sets of 5 to 10 at a somewhat hard effort · The move page's dose, from the LEAP trial's programme for the outer hip tendons

Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge

Single-leg glute bridge demonstrated on the 3D figure

3D demoSingle-leg glute bridgeIntermediate · No equipment

2 to 3 sets of 10 to 15, building to 4 to 5 sets of 6 to 8, 2 s up and 3 s down · As in our high hamstring guide, from the trial's programme

Easier: Glute bridge · Harder: Barbell hip thrust

Standing hamstring curl demonstrated on the 3D figure

3D demoStanding hamstring curlBeginner · A wall

5 holds of 30 to 45 s each leg at the top, then the same progression with an ankle weight · As in our high hamstring guide (the move page's own dose is a knee programme's)

Harder: Slider hamstring curl

3D demoClamshellBeginner · No equipment

2 to 3 sets of 10 to 12 · As in our piriformis guide

Easier: Supine isometric hip abduction (belt press) · Harder: Lateral band walk

3D demoBird dogBeginner · No equipment

2 sets of 8 each side · As in our piriformis guide

Easier: Bird dog, one limb at a time · Harder: Bear crawl

Sit to stand from a chair demonstrated on the 3D figure

3D demoSit to stand from a chairBeginner · A bench or box

3 sets of 8 to 10 · As in our back pain guide

Easier: Sit to stand, pushing on the thighs · Harder: Bodyweight squat

Move on when: These have felt fine for at least 2 weeks within the pain rule (the high hamstring guide's check), leg symptoms aren't increasing (the piriformis guide's), and you can sit a little longer each week (the tailbone guide's).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Strengthen, then sitting, driving, running and lifting come back

From about week 6: bring back hip bending under load gradually, then running and lifting, while everyday activities come back by the written steps below. Keep 2 to 3 strength exercises going twice a week once you're back (our high hamstring guide).

Hip-hinge practice demonstrated on the 3D figure

3D demoHip-hinge practiceBeginner · No equipment

2 sets of 8, shallow at first · As in our high hamstring guide, to learn the movement

Harder: Dumbbell Romanian deadlift

Dumbbell Romanian deadlift demonstrated on the 3D figure

3D demoDumbbell Romanian deadliftIntermediate · A dumbbell

2 sets of 4 to 6, building to 3 sets of 6 to 8, adding hip bend over the weeks · As in our high hamstring guide; our back pain guide uses 3 sets of 8 to 10 once you're used to it

Easier: Hip-hinge practice · Harder: Single-leg Romanian deadlift

Split squat demonstrated on the 3D figure

3D demoSplit squatIntermediate · No equipment

3 sets of 8 each side · As in our piriformis guide

Easier: Bodyweight squat · Harder: Reverse lunge

Side plank demonstrated on the 3D figure

3D demoSide plankIntermediate · No equipment

3 holds of 20 to 30 s each side · As in our back pain guide

Easier: Knee side plank · Harder: Side plank with leg lift

3D demoStep-upBeginner · A step

3 sets of 8 each side · As in our back pain guide

Easier: Low step-up · Harder: Dumbbell step-up

Treadmill jogging demonstrated on the 3D figure

3D demoTreadmill joggingIntermediate · Cardio machine

If you stopped: 2 minutes of running in 1-minute bouts within a walk, adding 1 to 3 minutes a run; or the NHS walk-jog weeks · As in our high hamstring guide (the trial's advice), or the NHS sports medicine service's programme

Easier: Treadmill walking · Harder: Sprint intervals

Move on when: Our suggestion: a normal day's sitting, a long drive and, if you run, 20 to 30 minutes of running stay within the pain rule, with nothing spreading down the leg the next morning. Keep two strength sessions a week; if a busy week flares it, drop back a stage for a few days rather than stopping.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

What to change for now (written steps)

Our 3D figure can't show these changes. They come from the NHS, NHS inform and the hamstring trial; where a step is our suggestion, it says so.

1. Sitting: don't sit or lie down for long periods (the NHS); if you have to, change position regularly (NHS inform). Get up and move every 30 to 45 minutes (our suggestion).
2. Seats and cushions: with pain at the sitting bone, a firm, higher seat rather than a low, soft one, and a cushion that takes the pressure off the sitting bones (our suggestion: sitting presses the tendon against the bone). With tailbone pain, a specially designed coccyx cushion and a supported lower back (the NHS).
3. Stretching: leave hamstring stretches out while the sitting bone is sore, because stretching squeezes the tendon. Piriformis stretches are fine if they ease the pain, but no trial shows they treat it.
4. Heat and ice: heat packs can help sciatica (the NHS); use heat or ice with a towel between it and your skin, and not if you have problems with circulation or feeling (NHS inform).
5. Lying down: with pain on the side of the hip and buttock, don't sleep on the painful side; lie on your back with a pillow under your knees, or on your good side with a pillow between your legs (NHS inform). Don't sit with your legs crossed.
6. Pooing: a laxative to soften your poo if pooing hurts the tailbone (the NHS), and plenty of fibre and fluid if you have piles (the NHS).
7. Work: stay at work, or go back as soon as you can; you don't need to be free of pain first (NHS inform).

Sources 1, 30, 7, 17, 11, 18

Sitting, driving, running and lifting come back (written steps)

No trial has tested how to bring these back after buttock pain as a location. These steps are our suggestion unless a source is named.

1. Sitting: judge it by time, not pain. Sit for as long as you comfortably can, stand and move before the pain builds, and add a few minutes every few days.
2. Desk days: get up every 30 to 45 minutes, and walk when you can rather than sit (the NHS advises not sitting for long).
3. Driving: break up long drives with a short walk, and set the seat so your hips aren't far below your knees. Long sitting while driving is among the NHS's causes of tailbone pain.
4. Running: easy, flat running first. With a hamstring tendon problem, build running time before speed and hills, with fast or hill runs no more than twice a week (as our high hamstring guide sets out from the trial); otherwise follow the NHS walk-jog weeks once 30 minutes of brisk walking is pain-free (the OxSport leaflet).
5. Lifting: practise the hip hinge first, then add load one change at a time, keeping the weight close to your body.
6. Cycling: short rides and a well-fitted saddle first, as our tailbone guide suggests.
7. If it isn't improving: see a GP if sciatica isn't better after a few weeks of home treatment, is getting worse or is stopping your normal activities (the NHS), or if tailbone pain hasn't improved after a few weeks. High hamstring tendon pain is slow: give it months.

Sources 17, 7, 33, 1

Positions to swap, and why

Habit or position	Why it matters	Instead
Long spells of sitting, especially on hard seats	The NHS says don't sit or lie down for long periods with sciatica, sitting presses a sore hamstring tendon against the sitting bone, and the NHS advises not sitting for long with tailbone pain.	Get up every 30 to 45 minutes; a firm, higher seat and a cushion.Try: Treadmill walking
Hamstring stretches with pain at the sitting bone	Stretching the hamstring and deep hip bending squeeze the tendon against the bone and typically bring the pain on.	Bridge holds with the hip straight.Try: Glute bridge
Pushing deep pigeon stretches into pain	No trial shows stretching treats piriformis or deep gluteal syndrome, and the review advises back pain and sciatica care first.	A gentle reclined figure four, only if it eases the pain.Try: Reclined figure four (eye of the needle, Sucirandhrasana)
Bed rest	NHS inform says resting in bed doesn't help back pain and often makes it harder to get going again, and the NHS says moving isn't harmful.	Short walks several times a day.Try: Treadmill walking
Sitting cross-legged, or lying on the sore side, with pain on the side of the hip and buttock	NHS inform advises against both with gluteal tendon pain.	Weight on both feet; lie on your back with a pillow under your knees, or on your good side with a pillow between your legs.
Rolling hard on a ball when it sends pain down the leg	There's no evidence either way for rolling the buttock, and leg symptoms are a reason to stop (our piriformis guide).	Knee rolls instead.Try: Hip windshield wipers
Heavy hinging during a flare of a disc problem	The move page asks for a current disc-related back problem to be assessed before loading a hinge.	Light hip hinge practice.Try: Hip-hinge practice
Walking through a buttock, thigh or calf ache that goes when you stop, without getting it checked	It can come from narrowed arteries, which a GP needs to check before you start a walking programme.	See a GP first; then the claudication walking workout.
Ignoring a hot, painful lump near the bottom, or bleeding from the bottom	An abscess or an infected pilonidal sinus needs treating, and heavy bleeding is a 999 call.	See the warning signs.

Routines to follow

Lower back stretch routine

Seven gentle stretches and mobility moves for a stiff lower back, done lying and kneeling.

12 minBeginner7 movesA wall

Pilates for back pain (gentle routine)

A gentle 15-minute Pilates-based routine for ongoing low back pain, built from neutral-spine moves with options for backs that dislike bending or arching.

15 minBeginner10 movesNo equipment

Glute workout at home

A 25-minute glute workout with bodyweight and a mini band: bridges, clamshells, band walks, kickbacks and lunges.

25 minBeginner9 movesA wall, A band

3-minute desk movement break

A 3-minute standing break to repeat every 30 to 60 minutes at your desk: sit-to-stands, calf raises, marching, an upper-back turn and chin tucks.

3 minBeginner5 movesA bench or box, A wall

Strength workout for runners at home

A 40-minute strength workout for runners at home: hops, Bulgarian split squats, single-leg deadlifts, step-ups, calf raises and side planks.

40 minIntermediate15 movesA wall, A bench or box

Claudication walking workout: walk-rest-walk

The walk-rest-walk session for leg pain from narrowed arteries: walk until the pain is close to the most you can bear, rest until it goes, repeat to 30 minutes.

45 minBeginner8 movesA wall, Cardio machine

More moves for this area

Questions people ask

What causes buttock pain?

Usually the lower back (sciatica or ordinary back pain), the sacroiliac joint at the back of the pelvis, the hip joint, or a tendon: the hamstring tendon at the sitting bone or the gluteal tendons at the side of the hip. Less often it's the tailbone, narrowed arteries, an abscess or piles. Where exactly it hurts and what brings it on point to the cause.

Why does my buttock hurt when I sit?

Sitting presses on a sore hamstring tendon at the sitting bone, which is worse on hard seats; it also aggravates tailbone pain and the deep buttock pain blamed on the piriformis. Long sitting can make back pain and sciatica worse too. Get up every 30 to 45 minutes, and try a firmer, higher seat or a cushion.

Why does my buttock pain go down my leg?

Pain from the buttock down the back of the leg, especially below the knee with tingling, numbness or weakness, is usually sciatica, which the NHS says usually affects your bottom and the back of one leg. Keep moving and don't sit or lie down for long periods. Numbness around the genitals or bottom, bladder or bowel changes, or symptoms in both legs need 999 or A&E.

Is it piriformis syndrome?

Possibly, but nobody knows how often. It's defined by buttock pain, pain worse sitting, tenderness near the notch where the sciatic nerve leaves the pelvis and pain on stretching the muscle, but how common it is can't be concluded and no test has been shown to be accurate. The back, the sacroiliac joint and the hip commonly send pain to the buttock, and treatment starts with the same steps as back pain and sciatica.

Can buttock pain be cancer?

Rarely. Buttock pain on its own isn't on the NHS's list of bowel cancer symptoms. See a GP for bone pain that is constant or worse at night, a lump, or weight loss you can't explain, and contact your cancer team or GP urgently for new back pain if you've had cancer.

Why does my buttock hurt when I walk?

Pain in both buttocks and legs on walking or standing that eases when you sit or bend forward can be a narrowed spinal canal. An ache in the buttock, thigh or calf that comes on after a set distance and goes within a few minutes of standing still can come from narrowed arteries, especially if you smoke or have diabetes, and needs a GP. The hip joint and the sacroiliac joint can hurt on walking too.

What is the pain at my sitting bone?

A deep ache low in the buttock at the sitting bone, worse sitting, running uphill and with long strides or lunges, is usually high hamstring tendinopathy. Leave out hamstring stretches for now, because they squeeze the tendon, and start with the holds in our high hamstring guide. A sudden pop there with a big bruise needs checking the same day.

What exercises help buttock pain?

Keep moving with short walks and NHS inform's back exercises (knee rolls, pelvic tilts, knees to chest and the cat-cow back curl) within its 0 to 5 pain scale; NICE advises staying active and considering a group exercise programme for back pain. Then strengthen the hips, trunk and hamstrings, as in the plan on this page. For the sitting bone, a physiotherapy programme did as well as shockwave over a year in a trial of 100 people.

Should I rest a sore buttock?

Not completely: the NHS says carry on with normal activities and don't sit or lie down for long periods, because even if moving hurts it's not harmful, and NHS inform says resting in bed doesn't help back pain. Rest from what flares it, and keep the rest of life going.

Why does my bum hurt when I poo?

Pain around the back passage when you poo is usually piles or an anal fissure, a small tear that causes a sharp pain and a burning ache afterwards. See a GP if it's getting worse or not improving with home treatment, get help from NHS 111 for a very high temperature or pus, and call 999 for heavy bleeding. Tailbone pain can also be worse when you poo.

Is buttock pain normal in pregnancy?

Back pain is very common in pregnancy, and pelvic girdle pain can be felt across the lower back and the joints of the pelvis and spread to the thighs. Contact your GP or midwife urgently for back pain in the second or third trimester, or with a fever, vaginal bleeding or pain when you pee, and call 999 if you lose feeling in your legs, bum or genitals.

When should I worry about buttock pain?

Call 999 or go to A&E for numbness around the genitals or bottom, new trouble peeing or controlling your bladder or bowels, or symptoms in both legs. Get help the same day for a hot, painful lump near the bottom, a pop at the sitting bone with a big bruise, or back pain with feeling feverish and unwell. See a GP if it hasn't improved after a few weeks, or for an ache on walking that goes when you stop.

Related exercise guides

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.