Sit bone pain, medically known as Ischial Tuberosity Pain or Ischial Bursitis, is discomfort localized in the lower buttocks. The pain originates from the ischial tuberosities—the two bony prominences at the base of the pelvis that absorb body weight when sitting. It usually results from inflammation of the ischial bursa, a fluid-filled sac cushioning the bone and soft tissues, such as the hamstring tendons. Repetitive pressure, often from prolonged sitting on hard surfaces, irritates and inflames the bursa, causing a deep, aching sensation. Tight hamstrings or a sudden injury can also contribute.
Adjusting Your Seating and Posture
Reducing the direct mechanical pressure on the affected area is the immediate and most effective step in relieving sit bone pain. The goal is to redistribute your body weight away from the inflamed ischial tuberosities. This is often accomplished by using specialized cushions designed for pressure relief.
Cushions with a specific cutout at the back, sometimes called coccyx cushions, are recommended because they allow the tailbone and sit bones to hover without contact. While donut cushions relieve pressure, a wedge or U-shaped cutout specifically targets the posterior pelvic bones. These specialized cushions, typically made of high-density foam, also promote better spinal alignment, reducing strain on the lower pelvic structures.
Beyond equipment, adopting an upright sitting posture is important. Slouching rolls the pelvis backward, placing maximum pressure directly onto the ischial tuberosities. Instead, sit with your back straight and your feet flat on the floor, allowing your weight to be borne by the upper, fleshier part of the buttocks. Regular position changes are also helpful; stand or walk for a few minutes every 30 to 60 minutes to remove pressure and encourage circulation.
Targeted At-Home Treatments and Stretches
Conservative treatments help manage inflammation and muscle tightness. For acute pain involving swelling or a burning sensation, apply ice packs for 15 to 20 minutes several times daily to reduce bursa inflammation. If the pain is chronic or accompanied by stiffness and muscle tension, moist heat application can relax the surrounding gluteal and hamstring muscles.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can also be taken to temporarily alleviate pain and decrease inflammation. It is important to follow the recommended dosage instructions. Consult a medical professional if these medications are needed for more than a few consecutive days. Since tightness in the hamstring, gluteal, and piriformis muscles often contributes to or worsens sit bone pain, gentle stretching is highly beneficial.
A seated hamstring stretch involves sitting on the floor with one leg extended and the other bent, then gently leaning forward until a stretch is felt behind the extended thigh. For the glutes and piriformis, the Figure-Four stretch is effective: lie on your back, cross one ankle over the opposite knee, and gently pull the bottom knee toward your chest. Hold these stretches for 20 to 30 seconds without bouncing, ensuring the movement does not cause sharp, localized pain directly on the sit bone.
When to Consult a Healthcare Professional
Most sit bone pain improves with at-home conservative measures. Consult a healthcare professional if the pain persists or worsens despite two to four weeks of consistent self-care, including adjusting seating and performing gentle stretches. Persistent pain may indicate a more severe issue, such as hamstring tendinopathy or an underlying condition.
Immediate medical attention is warranted if the pain is accompanied by systemic symptoms, such as fever, chills, or unexplained weight loss. Pain that radiates down the back of the leg, especially with numbness, tingling, or muscle weakness, suggests potential nerve involvement, like sciatica. A doctor can rule out other causes through a physical examination and, if necessary, order imaging tests like an ultrasound or MRI. Treatment options may include a referral for formal physical therapy or, for severe, localized inflammation, a corticosteroid injection directly into the bursa.