Buttock Pain Vs Hip Pain.

One of the most common problems patients present to our clinic with would have to be pain around the buttock.  Although pain in the hip, buttock, groin and upper thigh tend to be interrelated, typically people will come to see us and say ‘I have a pain in my hip, and point to the top area of their backside’.  Although the hip joint has a front and back, pain that presents through the top of the buttocks is commonly not actually coming from the hip, but is largely lumbosacral in origin, meaning that it is referred pain from the low back or sacrum region.   The hip joint actually sits slightly lower and most commonly presents with pain at the front of the upper thigh, side of the hip, or inner knee.

So what causes buttock pain?

There can be a number of causes of buttock pain and a thorough examination by your osteopath will highlight the likely cause.  Some common problems that can cause pain in the buttock may include:

• -Low back referral pain – joint, disc, ligament, arthritis or muscle dysfunction
• -Sacro iliac joint dysfunction.
• -Gluteal muscle tightness, strain or ligament irritation.
• -Pelvic imbalance.
• -Bursitis/tendinitis

Where is the hip joint?

If you place your hand over the front of your pelvis you will feel part of the big pelvic bones sticking out. If you slide your finger a few centimetres below that and slightly towards the inside of you thigh you will be in the area of the hip joint.

Where does hip joint pain present?

Although there are always exceptions to the rule, typically pain stemming from the hip joint can present with pain around the groin, upper thigh, inner thigh and inner knee.

And what causes pain at the front of the hip?

As mentioned, a thorough case history and examination performed by your osteopath will clarify the diagnosis, however some of the more common causes of pain at the front of the hip include:

• -Hip joint strain.
• -Hip joint Osteoarthritis
• -Muscle strain or tightness.
• -Hernia (inguinal or femoral)
• -Mechanical imbalance (stemming from pelvis, knee, foot).
• -Bursitis

A common condition that can cause pain around the hip is that of Trochanteric Bursitis.

Trochanteric Bursitis:

Throughout our body we have a number of small fluid filled sacs known as ‘bursa’.  These bursa act to aid in lubrication and decrease friction between two surfaces, often between bone and the overlying soft tissues (muscle, tendons etc).  Sometimes these bursa can become inflamed and irritated. One of the most common bursa to become irritated is one that sits on the outside of our hip (on the outer most part of our upper thigh), the Trochanteric Bursa.

Symptoms of Trochanteric Bursitis may include:

• -Tenderness over the most outside part of the hip, which can radiate down the outside of the thigh.
• -Tenderness over the outside of the hip and thigh with lying on the affected side at night.
• -Pain in the area with or after exercise (walking,running,cycling).
• -Tenderness over the outside of the hip to touch.
• -Relief with the use of anti inflammatories or ice.

Causes of Trochanteric bursitis:

• -The recent onset of or increase intensity of an exercise program that includes use of the lower limbs.
• -Sleeping on a too hard bed (if side sleeper)
• -Overuse…sport related. Eg.running, walking, cycling.
• -Mechanical change – possibly predisposed by pelvic imbalance, muscle tension, foot dysfunction, incorrect footwear.

If you are suffering from any of the symptoms in the area of the hip or buttock, please feel free to speak to one of our osteopaths to discuss whether an assessment, referral or treatment is necessary.

Dr Peter Parker, Osteopath