Pain in the lower body, often referred to as “butt pain,” originates from the lower spine, muscles, nerves, or the sensitive tissues of the anal region. The nature of the pain—whether it is a deep ache, a shooting sensation, or a sharp, localized burning—helps identify the underlying cause. Causes vary significantly, ranging from muscle strain and minor skin tears to more serious infections. This article categorizes potential causes by the type and location of the pain to distinguish between common, self-limiting issues and those that require professional attention.
Causes of Deep Aching and Shooting Pain
Deep pain within the buttocks and lower back typically arises from issues involving nerves, joints, or large muscle groups. This discomfort is often described as aching, throbbing, or shooting, and frequently intensifies with sitting or specific movements.
Irritation of the sciatic nerve is a common culprit, manifesting as true sciatica or piriformis syndrome. Sciatica results from the compression of nerve roots in the lower spine, often due to a herniated disc. This causes pain that radiates from the lower back, through the buttock, and down the back of the leg, sometimes accompanied by numbness or tingling. Piriformis syndrome originates deeper within the buttock when the piriformis muscle spasms, pressing directly on the sciatic nerve. The resulting pain is typically localized to the buttock but can radiate down the leg, mimicking sciatica symptoms.
Pain localized directly at the base of the spine is known as coccydynia, stemming from the coccyx or tailbone. This condition is often triggered by a direct fall, prolonged sitting, or childbirth, leading to a persistent ache or a sharp twinge when moving from sitting to standing. Gluteal bursitis is another source of deep, aching pain, involving the inflammation of the fluid-filled sacs (bursae) that cushion the hip joint. This inflammation causes tenderness and pain over the outer hip and buttock, which worsens when lying on the affected side or climbing stairs.
Causes of Surface and Acute Pain Near the Anus
Localized, sharp, or throbbing pain originating from the skin or mucosal lining of the anal canal is distinct from deeper muscular or nerve-related pain. This discomfort is often acute, burning, or throbbing, and is heavily associated with bowel movements.
Hemorrhoids, which are swollen veins in the lower rectum and anus, are a common cause of this localized discomfort. External hemorrhoids, located under the skin around the anus, cause itching, swelling, and sharp pain, especially if a blood clot forms (thrombosed hemorrhoid). Internal hemorrhoids are typically painless unless they prolapse outside the anus or cause bright red bleeding during a bowel movement.
Another source of intense, acute pain is an anal fissure, a small tear in the tissue lining the anus. Fissures cause a characteristic severe, sharp pain during a bowel movement that can linger as a deep burning or throbbing sensation afterward. This condition is usually caused by passing a hard or large stool, which overstretches the anal tissue.
A constant, throbbing pain accompanied by swelling, redness, and warmth may indicate an anal abscess, a collection of pus caused by an infection of the small glands near the anus. Unlike the movement-dependent pain of a fissure, abscess pain is typically constant and can be accompanied by systemic symptoms like fever and chills. Separately, a pilonidal cyst is an infected pocket in the skin near the tailbone, which can become acutely painful, swollen, and drain pus or blood.
Immediate Steps for Relief and Home Care
For mild discomfort, several at-home measures can provide relief while the underlying cause is addressed. Warm water soaks, such as a sitz bath, are effective for soothing inflammation and relaxing the anal sphincter muscles. Soaking the affected area in warm water for 10 to 20 minutes a few times a day helps increase blood flow and promotes healing.
Adjusting bowel habits is helpful, especially for surface issues like fissures and hemorrhoids, by increasing dietary fiber intake through fruits, vegetables, and whole grains. Adequate water consumption is important to ensure the fiber softens the stool, preventing straining that aggravates sensitive anal tissues. Over-the-counter topical treatments, such as anesthetic creams containing lidocaine, can temporarily numb localized pain and burning sensations.
For deeper, structural pain, positional changes can offer relief. Using a specialized donut-shaped cushion or a coccyx cushion helps to offload pressure from the tailbone, gluteal muscles, and irritated anal area when sitting. For muscular or joint pain, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can manage pain and reduce inflammation. Alternating periods of sitting with short walks or standing breaks also helps reduce chronic pressure on the deep structures of the pelvis and buttocks.
When to Seek Professional Medical Help
While many causes of buttock and anal discomfort resolve with simple home care, certain signs indicate the need for a consultation with a healthcare provider. Persistent pain that lasts for more than a few days despite home treatment, or pain severe enough to interrupt sleep or daily activities, warrants an evaluation. Any pain accompanied by a significant change in bowel habits, such as unexplained constipation or diarrhea lasting more than a week, should also be discussed with a doctor.
Signs of potential infection require prompt medical attention. These include fever, chills, or noticeable pus-like discharge from the rectum or a lump. Several other symptoms necessitate urgent medical assessment:
- Heavy, non-stop rectal bleeding or passing large blood clots.
- New or worsening weakness or numbness in the legs.
- Sudden loss of bowel or bladder control.
- Unexplained weight loss combined with persistent pain or bleeding.