Pain over the buttocks


Pain over the bottom is pain that occurs above or in the area of ​​the iliac crest.
Pain in the lower lumbar spine (lumbar spine) can also be felt as pain over the buttocks, which is why pain in the buttocks is often associated with back or lower back pain. Inflammatory diseases can also cause complaints in the buttock region, fistulas or eczema in the gluteal folds are, for example, frequent causes of pain over the buttocks.


The causes of buttock pain can vary. In addition to sore muscles and acute stress, which can lead to the corresponding symptoms, chronic stress and functional disorders are often the cause of the symptoms.

In everyday life, we are often in a seated or bent position, whereby the structures of the buttocks region are stressed on one side and are constantly stretched. The blood circulation situation deteriorates and it comes to adhesions and tension, which can be the cause of the pain. So-called trigger points, or pain points, form in the muscles.

Even with functional disorders of the spinal joints, it can lead to radiating pain in the upper buttock region. The frequently occurring irritation of the sciatic nerve, on the other hand, leads to pain in the thigh region or directly in the buttock region rather than pain over the buttocks and can therefore usually be ruled out.

Also read our articles:

  • Ischial pain
  • Lumboischialgia

Coccyx fistula

Coccyx fistulas arise from chronic inflammation of the gluteal folds.
Ingrown hairs, inflammation of the roots of the hair or malformations of the coccyx are often the cause of coccyx fistulas. Deep passages are created from which pus or blood can escape. In addition to often severe pain, e.g. when lying or sitting, the fistula can also manifest itself as severe itching. Men are affected more frequently than women.

Therapy can be conservative or surgical. Since new fistulas often form after some time after surgical removal, laser treatment should also be considered. Personal hygiene, hair growth in the region and tight, air-impermeable underwear play a role in the development of coccyx fistulas.

Also read on this topic:

  • Surgery of the coccyx fistula
  • Ointment for a coccyx fistula

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Eczema can occur with chronic inflammation of the buttocks region, especially in the anal fold. This leads to reddened, oozing and sore skin, which can sometimes be very painful or itchy.

Risk factors for developing eczema in the buttock region are prolonged sitting, haemorrhids and infectious diseases and injuries to the gluteal folds caused by bacteria or fungi. Personal hygiene and weakness also play a role. Synthetic underwear that is too tight can encourage the development of eczema.

Further information can also be found at: Get rid of eczema on the buttocks

Concomitant symptoms

Accompanying symptoms may occur depending on the underlying cause of the buttock pain. In the case of disorders of the musculoskeletal system, movement restrictions or tension add to the pain symptoms. In the case of functional disorders of the joints and muscles, the pain can usually be caused by targeted movements or after excessive stress.

Inflammatory processes such as fistulas or eczema can lead to purulent or oozing discharges from the sore region. Itching can also be associated with a fistula or eczema. In inflammatory diseases, the pain also occurs at rest without specific movements, or it is triggered by local pressure, for example when lying down. The inflammation can also cause a fistula, for example, to have a slight fever and a general feeling of illness as an accompanying symptom.

Hemorrhids often lead to eczema, which is why blood deposits in the stool, which the patient may notice when using the toilet, are not uncommon. In addition to hemorrhids, infections caused by fungi, for example, are often involved in the development of anal eczema; these basic symptoms must be treated in order to improve the eczema.

Please also read: Inflammation of the gluteal folds / anal folds


Right side pain

If the symptoms occur increasingly on the right side, hip problems on the right side should also be considered. For example, if the joint is changed by osteoarthritis or other inflammatory or degenerative diseases affect the right hip joint, this can lead to pain radiating to the right buttock. The tissue directly above the iliac crest is often very sensitive to pressure and muscle tension in the gluteal muscles can also occur. Joint diseases of the spine, which are increasingly localized on the right side, can also lead to nerve irritation and pain over the right buttocks.

Also read: Symptoms of osteoarthritis or pain in the right buttock

Pain in the left side

Left hip pain can also be caused by functional disorders of the left hip joint. Nerve irritation caused by problems with the vertebral joints is often responsible for buttock pain. Then pain often occurs in an area belonging to the segment.

Left-sided pain in the buttocks region or above the buttocks can also be caused by tension in a specific gluteal muscle. This muscle is called the piriformis muscle and is prone to tension, especially in people who sit down. This can lead to irritation of the sciatic nerves and then to pain in the buttocks, which can also radiate into the thigh.

Of course, if there is left buttock pain, the region should also be examined to rule out eczema or fistulas.

Read about it:

  • Piriformis Syndrome
  • Pain in the left buttock

Radiating pain

Buttock pain that radiates into the back and occurs on both sides is often caused by tension and sticking of the connective tissue. The gluteal muscles also attach to the lower lumbar spine and are connected to the back muscles via a fascia plate, which forms a connective tissue skin. One-sided postures such as leaning forward while sitting, constantly stretching the muscles, can lead to circulatory disorders and tissue sticking. Pain / trigger points can also arise. The pain then occurs from under to the lower back. The mobility of the lumbar spine and hips can be restricted.

An examination of the kidneys can rule out an organ-related cause that may produce symptoms similar to deep flank pain.


The diagnosis is made after a detailed discussion with the patient, in which the patient describes his pain in terms of its type, occurrence, intensity and localization. A physical exam is also important. Here the doctor looks for any redness or swelling, bloody or purulent discharge from fistulas, but also for the condition of the muscles and connective tissue. To rule out hemorrhids, a digital rectal examination may be necessary, during which the doctor palpates the inside of the rectum.

A more precise diagnosis can then be initiated after a suspected diagnosis has been made. An X-ray examination can be connected here, for example, in the event of functional disorders of the vertebral joints. The therapy depends on the diagnosis.


The therapy takes place differently depending on the cause of the complaints above the buttocks.

Surgical therapy may be necessary for fistulas. Any abscesses that may have arisen are opened up, creating a drainage facility for the wound secretion.Every now and then, a relapse, i.e. a fistula that has appeared again, may require a second intervention. Smoking and alcohol consumption presumably promote the development.

Eczema can often be addressed by treating the underlying condition. A fungal infection should be treated with appropriate medication so that the eczema can then heal. Hemorrhoids can be surgically removed. Good hygiene and the right underwear aid healing and prevent such diseases from occurring.

If the symptoms arise due to problems with the musculoskeletal system, physiotherapy as a conservative therapy is a good way of eliminating the problems. If necessary, a pain reliever can also be used. If the pain is resistant to therapy, for example in the case of advanced hip osteoarthritis, an operation may be necessary.

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The duration of the healing depends to a large extent on the cause of the complaints. Coccyx fistulas can be chronic or acute. After an operation, the patient is usually symptom-free quickly, but recurrences can occur.

Chronic coccyx fistulas can lead to long-term relapsing symptoms before the patient see a doctor. The healing of eczema depends heavily on its cause. When the underlying disease has been treated and controlled, healing can begin. Before that, it can be difficult to get rid of eczema for good. In the case of orthopedic complaints, the duration of the complaint strongly depends on the clinical picture and the individual treatment.

Chronic, degenerative diseases such as osteoarthritis cannot be cured, so symptoms can be controlled with therapy, but often do not go away completely. Complaints caused by acute overload, on the other hand, usually disappear quickly.