There are a wide variety of reasons you could be experiencing pain in the backside, buttock or hip region.

A little background

  • The Gluteals or bottom muscles are some of the biggest and most dense muscle in the body.
  • The hips functionally form the largest hinge in the body.
  • It’s here the weight of your upper body is distributed and split across both legs.
  • All the nerves and blood supply for your legs have to travel through your hips.

These simple facts are important when it comes to figuring out why you’re hurting in this area.

Massage for gluteal and buttock pain

Common culprits

Sciatica and other nerve entrapments

Basically, sciatica is pain arising from the sciatic nerve and felt along it’s pathway. The sciatic nerve starts in the lower back, runs through the hip region into the rear of the thigh and then splits around the back of the knee and branches into the calf and lower leg.

The sciatic nerve isn’t the only nerve that can cause pain in the hip and buttock region. Some lesser known nerve entrapments in this region are:

  • Pudendal nerve entrapment (cyclists syndrome)
  • Cluneal nerve entrapment
  • Thoracolumbar syndrome

Massage can help with nerve entrapment problems by relaxing the area in question. This will help ease the nervous system and also take pressure off the nerve.

The piriformis muscle

Piriformis, means pear (piri) shaped (formis). This muscle is deep to the big gluteals muscles and travels across the buttock.

Again, the dreaded sciatic nerve comes into play here and can easily be irritated by the piriformis due to the close proximity of the two structures as they cross each other, the sciatic nerve heading downwards and the piriformis going across.

In some people the sciatic nerve may even dive right through the middle of the piriformis muscle.

Massage can be really effective at easing piriformis syndrome, just like any spasmed and tight muscle it needs the encouragement to relax and lower it’s resting tone.


A bursa is basically a little fluid filled sack that acts as a cushion to surrounding structures helping them move freely and smoothly.

If this sack gets irritated, it can be quite painful. Mostly people describe bursitis type pain as nagging and constant.

There are two bursa in the hip, one on the sit bone and the other on the outside of the upper thigh bone.

Massage isn’t going to reduce the inflammation but it can ease the pressures being applied to the bursa by surrounding structures.

Trigger points

These are classified as a highly irritable localised spot or nodule of tenderness in a palpable taut band of muscle.

Basically tender spots or what many people commonly call muscle knots in the area of the buttock or distal but referring pain to that region.

There is a very engaging theory that Trigger Points are in fact mini nerve entrapments.

Trigger points usually respond well to soft tissue massage work.

Sacroiliac or SI joint issues

The SI joint joins the sacrum to the ilium. For a joint, it has very little mobility or movement.

It acts more like a shock absorber or dampener than a mobile joint.

Like all joints though it has the potential to become irritated and inflamed.

Massage might help settle an irritated SI joint down by helping surrounding structures move a little easier.


Specifically Osteoarthritis, a degenerative condition of the bones and joints.

Although massage can ease symptoms it’s never going to make osteoarthritis go away.