How to Treat Sit Bone Pain: More than Just a Pain in the Butt!

What are the bones that you sit on?  

Whether you want to call them sit bones or sitting bones, what we’re talking about are technically called the ischial tuberosities.  Ischial refers to the name of the area of bone on your pelvis and a tuberosity is a large bump. They can be felt on either side under the buttock muscles especially while sitting.


What causes Sit Bone pain?  

It usually comes from overloading of the hamstring muscles where they attach.  This can inflame the bursa, a fluid filled sack that provides cushioning between the tendons and bone. This condition is called Ischial Bursitis.  It can be caused by:

  • Prolonged sitting especially on hard surfaces
  • Overdoing forward bends, especially if you bend your knees first, and can inflame the area where hamstrings attach.
  • Over stretching (minor tearing) of the hamstring muscles or tendon which usually happens with an audible pop.
  • Trigger points that are referring into the sit bone area.
  • A strain or injury involving running, bicycling, or any sport that require rapid acceleration, kicks, and extreme hip movements such as dance.

How does sit bone pain usually present itself?  

It  presents with sharp pain at the center of the buttocks that can radiate down the back part of the thigh and leg to the knee. It is often confused with Sciatica a condition where the sciatic nerve can become inflamed or compressed. 

Pain can occur during:

  • Walking
  • Sitting
  • Flexing the hip forward

How do you treat it?

  • Simply resting and temporarily stopping the activities that aggravate the pain
  • Apply ice packs to the tender area
  • Take NSAID’s such as ibuprofen (Advil), naproxen (Aleve) or aspirin as directed
  • Perform some gentle stretching of the involved muscles (nothing should be painful):  Lie on your back, with your head on a cushion and the knee on your  affected side bent upward. Grasp the back of your knee with both hands and gently pull the knee toward your chest. Hold this position for 5–10  seconds and repeat 6–10 times.
  • Try using a cushion while sitting to take the pressure of the painful area.

If these treatments are not working, consider scheduling an appointment with Southwest Pain Management in Irving, Texas where we can perform a steroid injection near the ischial bursa done with image guidance.  If the pain is due to hamstring tendon tears, we can also inject something to help the tendons heal.

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