03 / Understand the area
Buttock & back of the pelvis
The buttock sits at the meeting point of the hip, pelvis and lower back. Several symptom patterns can overlap here.
An educational guide that covers the left and right sides alike. Where it hurts is a useful clue, but only a clue.
A useful starting point
What this area can tell you.
Pain that stays in one buttock is different from pain that comes with tingling down the leg, though neither one settles the cause. How long you can sit, how walking feels, and if symptoms go below the knee all tell us something. An assessment may look at the hip, the lower back and the sacroiliac region. Feeling like your pelvis is uneven doesn't show that the pain is coming from the sacroiliac joint. If we think that joint is involved, we'll tell you which findings point there.
Notice the pattern
Three questions to bring with you.
You don't need to know what it is before you come in. These are details that help when you tell us what you're feeling.
- Does the pain stay in the buttock, or travel below the knee with tingling or numbness?
- What's hardest: sitting, walking or getting up from a chair?
- Did it start after a fall, a change in activity or a stretch of back pain?
When to get help sooner
Buttock or leg pain with new bladder or bowel changes or numbness around the genitals or anus needs emergency care. Progressive leg weakness or severe pain after a fall needs urgent assessment.
Follow the connection
Possible explanations. Better questions.
These guides cover conditions and patterns that may overlap with this area. Think of them as a place to start our conversation: no body map can tell you which one, if any, you have.
Hip pain
Groin, outer-hip and buttock pain can point to different structures and different next steps.
Read the guide Condition guideSciatica
Leg pain from an irritated nerve, what a scan can and can’t tell you, and when to get help.
Read the guide Condition guideBack pain
Common back-pain patterns, the warning signs, and what progress looks like in everyday life.
Read the guideWhat the studies found, and where they stop
How the research fits this area.
The small SI joint study checked combinations of clinical tests against diagnostic injections. It didn't test alignment correction. The sciatica research applies when an exam finds a nerve-related leg pain pattern, not pain that stays in the buttock.
How we select and explain sources ↗Follow the evidence
Research, with context.
Selected published sources behind what we've written, each with what it found and what it can't tell us. We give you both halves because no paper can diagnose you or predict how your own care will go.
Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests
48 patients assessed with clinical provocation tests and intra-articular anesthetic injections.
What it foundA cluster of pain-provoking tests was more useful than relying on a single finding to identify SI-joint pain in this sample.
What it can't tell usThe sample was small and selected. It's research on diagnosis, so it doesn't prove a pelvic misalignment or that any treatment works.
Publication details & citation
Laslett et al. Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Manual Therapy. 2005. DOI: 10.1016/j.math.2005.01.003.
Read the publication recordSurgery versus prolonged conservative treatment for sciatica
283 patients with severe sciatica lasting 6 to 12 weeks, assigned early surgery or prolonged conservative care with surgery if needed.
What it foundEarly surgery provided faster relief and recovery, while one-year outcomes were similar.
What it can't tell usAbout 39% of those first assigned conservative care went on to have surgery. It wasn't a chiropractic trial, and it doesn't show that any treatment shrinks discs or guarantees avoiding surgery.
Publication details & citation
Peul et al. Surgery versus prolonged conservative treatment for sciatica. New England Journal of Medicine. 2007. DOI: 10.1056/NEJMoa064039.
Read the publication record
Our editorial policy explains how to read these sources and what our clinical-review labels mean.
Your next step
Bring your questions.
We’ll start there.
Your answers to those three questions are where we start. We go over your history and symptoms, examine you, and explain what we found before we recommend anything. If it turns out to be something another doctor should look at, we'll tell you.
Anatomy: BodyParts3D, © DBCLS, CC BY 4.0. Model & rendering credits. Return to the full body explorer.