Pain in the hip and buttocks: 13 causes and the most effective therapies

Hip pain can be treated in two different ways. It is important to understand the cause in order to be able to choose the best therapy.

  1. After conventional therapy, the diagnosis depends on joint wear, injury, inflammation or tumor diseases. The most prescribed treatment is the use of walking aids, taking medication or surgery.
  2. Naturopathy approaches the problem quite differently because it tries to understand and eliminate the causes based on scientific studies and physical principles. This treatment includes: diet and lifestyle changes, exercises and natural remedies.

The hip consists of a ball inserted into a cavity and is the largest joint in the body.

The ball is the end of the femur, i.e. the head of the femur, the cavity is formed by the acetabulum, i.e. an opening in the pelvis.

Pain felt in the hip can also be caused by the disease of an organ or nerve, and not just the hip itself.


Causes of hip and buttock pain according to conventional medicine

1) Arthritis

Arthritis is a condition that causes pain and joint stiffness.

The cause is a reaction of the immune system that attacks the joints.

Arthritis of the hip joint can cause pain that radiates to the buttocks.

Pain and stiffness can be worse in the morning and gradually improve with the movement of the joints.

2) Arthritis and ankylosing spondylitis

Ankylosing spondylitis is a type of arthritis that affects the spine.

It is characterized by stiffness and permanent pain in the back, buttocks and hips that last longer than three months.

Spondylitis often begins at the level of the sacroiliac joints, where the sacrum connects to the ilium.

The consequences include excessive bone growth and bone fusion.

These cause a restriction of movement.

3) Sacroiliitis is the inflammation of one or both sacroiliac joints between the spine and pelvis.

Pain from sacroiliitis occurs mainly in the buttocks and lower back.

It can also cause pain in the legs, groin and even in the feet.

4) Facet syndrome

This disease consists in inflammation of the intervertebral joints (in the posterior vertebral region).

Symptoms include:

  1. Intermittent neck and low back pain. The pain increases with extension (bending backwards) and decreases with flexion (bending forward).
  2. discomfort at the level of the inflamed facet,
  3. Rigidity
  4. The pain spreads to the buttocks and a little further down.
  5. Rarely, the patient feels pain in the hip, groin, knee or foot.

5) Tendinopathy of the middle gluteal muscle

The middle gluteal muscle originates from the pelvis (ilium) and ends at a tendon that attaches to the large trochanter of the femur (laterally).

Tendinopathy of the middle gluteal muscle are complaints characterized by microlesions and irritation of the tendon.

Symptoms include:

  1. pain in the area of the tendon (above the trochanter), which can extend to the lateral areas of the thigh,

The pain is felt when walking, as well as climbing and descending stairs,

  1. weakness in abduction (lateral spreading of the leg),
  2. redness (rare),

6) Hip bruise

A hip bruise is a trauma that causes a hematoma.

There are many muscles in this area of the body, including the gluteal muscle and the tensor fasciae latae muscle.

In some cases, patients experience bone edema, that is, when part of the bone becomes inflamed and causes severe pain.


The symptoms are: pain during activities, swelling, hematomas, muscle spasms and movement restrictions.

7) Trochanteric bursitis

Bursitis of the hip is also called trochanteric bursitis. It occurs when the fluid-filled bursa becomes inflamed outside the large trochanter.


Some common causes of hip bursitis include:

  • hip injury, including falling to the side, a bump or sports trauma;
  • rheumatoid arthritis and other autoimmune diseases;
  • Hip replacement;

Conventional medicine also speaks of:

  • Overload
  • scoliosis and other diseases of the spine;
  • Different leg length;
  • Bone spurs or calcium deposits in the hip.

These latter causes are very common and cannot be safely associated with bursitis of the trochanter.

On the other hand, pain on the outside of the hip is more often caused by:

  1. Active trigger points,
  2. Muscle imbalance overloading the gluteal muscle and the middle small gluteal muscle (Bewyer – 2003)


Symptoms include:

  • pain on the outside of the hip and pelvis;
  • The symptoms increase at night or when lying on their side.

8) Piriformis syndrome

Piriformis syndrome is a common cause of pain in the back hip. This pain arises deep in the gluteal muscle.

Symptoms worsen when sitting, walking, and turning the body in bed.

The pain may radiate downwards and into the back of the thigh.

The muscle is painful during palpation and stretching (flexion of the hip and internal rotation).

The most common therapy consists of:

  1. Deep tissue massage in the area,
  2. Strengthening of rotators and abductors of the hip.

Recovery times can be long, especially if the right therapy is not given immediately. It can then take weeks or months until recovery.

Fibromyalgia is associated with diffuse muscle pain and stiffness, which can cause significant discomfort throughout the body.

Other symptoms include:

  • Insomnia
  • muscle spasms,
  • Spasms
  • numbness of many muscle groups throughout the body,
  • Weakness.

Sciatica, or inflammation of the sciatic nerve, can also manifest itself in the form of hip pain and tingling along the lower limb up to the foot.

It can be caused by a herniated disc that presses on the nerve.

The nerve roots of L2 and L3 can cause pain in the upper buttocks that spreads to the front of the thighs.

11) Inguinal tunnel syndrome

This is a disorder characterized by pressure on the lateral cutaneous nerve of the thigh.

Symptoms include:

  1. pain in the anterior and lateral area of the thigh,
  2. Tingle
  3. Loss of sensitivity.

12) Tumor

The most common symptom of a tumor or cancer of the spine is back pain that spreads to the legs.

The pain increases:

  1. At night
  2. In the morning after awakening,
  3. During the movement.

13) Kidney disease

Some kidney diseases can cause pain from the back to the buttocks:

  1. Kidney stones
  2. Renal failure
  3. Advanced kidney infection.

The pain may radiate to the groin and the patient may have difficulty urinating.

Other less common causes:

  • femoral head necrosis,
  • lesion of the acetabulum,
  • Pelvic fracture (Goldford – 1996).

Pain in the hip and buttocks during pregnancy

The sciatic nerve originates at the back and runs to the feet.

If the uterus widens, it presses on the nerves and can cause pain, tingling, loss of strength and sensitivity:

  1. In the gluteal muscles,
  2. In the flanks,
  3. In the thighs.

Over time and when the child changes his position in the uterus, the pain may subside.

Therapy for hip and buttock pain

In conventional medicine, there is a special therapy depending on the disorder.

For example, in the case of:


The doctor prescribes anti-inflammatory drugs, painkillers and antidepressants.

Hip bruise

A mild hip bruise heals on its own under rest, non-steroidal anti-inflammatory drugs (NSAIDs) and ice packs.

If the trauma is pronounced, physiotherapy is useful to absorb the hematoma and inflammation, especially Tecar therapy.

Trochanteric bursitis

Usually, bursitis heals with immobilization, ice packs and medications to relieve pain and swelling. Other helpful therapies include:

Other helpful therapies include: shock waves, osteopathy, cortisone injection, and in rare cases, surgery.

Natural therapy for pain in the hip and buttocks

According to naturopathy, hip pain is caused by:

  • Muscular imbalance,
  • Circulatory
  • Some foods.

There are exercises to correct muscle imbalance and stimulate blood circulation.

By avoiding certain foods that trigger an immune system response, inflammation can also be reduced in a herniated disc.

The abductors and even the middle gluteal muscle are often weakened in people with pain in the hip and buttocks.

Muscular imbalance can cause:

  1. An overload of the small and medium gluteal muscles,
  2. activation of trigger points (pain points),
  3. Trochanteric bursitis.

Exercises for pain in the hip and buttocks

Blood circulation is crucial for people with back pain.

In principle, you should go for a walk for at least one hour a day.

People who do not walk much can do this exercise every hour:

  1. Starting position: standing upright
  2. Stand on your tiptoes,
  3. return to the starting position,
  4. Repeat 10 times.

This exercise stimulates venous return flow from the legs to the heart.

Exercises for the middle gluteal muscle

This muscle works especially when the body is only on one leg to maintain balance.

  1. Starting position: stand with the “aching” leg on one step and support the other on the floor,
  2. raise the leg resting on the floor,
  3. Stretch both knees,
  4. return to the starting position,
  5. Repeat 10 times.

Lying exercises for the gluteal muscles

  1. Starting position: lying on his back with bent knees,
  2. raise the pelvis,
  3. Stretch the knee of the healthy leg,
  4. return to the starting position,
  5. Repeat 10 times.

Diet and nutrition for hip and buttocks pain

Everyone knows that there are intolerances and allergies to food. But many believe that these symptoms only affect the intestines.

In truth, the back and hips can also develop inflammation due to some foods.

For example, milk and dairy products can cause inflammation of the colon, which can result in hip pain.

Irritable bowel syndrome can lead to sciatica (Zeitz – 2016).

Read more: