
Buttock pain can feel like a deep ache, a sharp pinch, or even a burning sensation in the glute area. For some people, it stays local. For others, it travels into the hip, lower back, or down the leg.
If you live or work in New York City, long commutes, desk jobs, and hours on your feet can all contribute. Staying in one position too long often makes the area more sensitive, especially if you already have hip or lower back issues. Common symptoms include:
Aching or burning pain in the buttocks
Pain that spreads to the hips, pelvis, or low back
Numbness or tingling down one leg
Discomfort when sitting, lying on your side, or getting up from a chair
Stiffness after prolonged sitting
In many cases, buttock pain improves with the right movement strategy and guided strengthening. That’s where physical therapy plays a central role.
Buttock pain is not a single diagnosis. It is a symptom that can come from different structures around the hip and lower spine.
Here are some of the most common causes we see in our NYC clinic:
1. Gluteal Tendinopathy (Greater Trochanteric Pain Syndrome)
This condition involves irritation of the tendons that attach the glute muscles to the outer hip. It often causes:
Pain when lying on one side
Tenderness over the outer hip
Discomfort with walking or climbing stairs
It is frequently mistaken for “hip bursitis,” but research shows tendon changes are often the primary issue.
2. Sacroiliac (SI) Joint Dysfunction
The sacroiliac joint connects the spine to the pelvis. Irritation here can cause deep buttock pain, especially:
When standing for long periods
During transitions from sitting to standing
With uneven weight bearing
3. Sciatica
Sciatica refers to symptoms caused by irritation or compression of the sciatic nerve. The nerve travels from the lower back, through the buttock, and down the back of the leg.
Symptoms may include:
Sharp or burning pain in the buttock
Tingling or numbness down one leg
Weakness in the leg
4. Proximal Hamstring Tendinopathy
The hamstrings attach near the sitting bone. If irritated, you may feel:
Pain when sitting for long periods
Discomfort during running or bending
Tightness in the back of the thigh
5. Hip Arthritis
Changes inside the hip joint can refer pain into the buttock. This often presents with:
Stiffness in the groin or hip
Pain that worsens with walking
Difficulty putting on shoes
6. Local Injury or Fall
A fall onto the tailbone or direct impact to the glute area can make sitting and lying down painful due to pressure on irritated tissue.
Because several conditions can overlap, a detailed physical therapy evaluation is essential. Treating the wrong structure can delay recovery.
Physical therapy is one of the most effective conservative treatments for buttock pain. The goal is not just to reduce symptoms but to address the underlying cause.At our clinic, treatment plans are built around three main principles:
1. Reducing Irritation
We start by identifying positions and movements that aggravate your symptoms. Small adjustments in posture, sitting mechanics, and daily habits often bring early relief.
This may include:
Modifying how you sit at work
Adjusting side-lying positions
Changing exercise loads
2. Strengthening Key Muscles
Weak hip abductors and extensors can increase stress on tendons and joints. Targeted strengthening improves support around the hip and pelvis.
Common exercises may include:
Glute bridges
Side-lying hip abduction
Bird dog stabilization drills
Progressive hamstring loading
Stronger muscles reduce compression on irritated tendons and improve overall movement control.
3. Improving Lumbopelvic Stability
The lower back, pelvis, and hips work together. If one area is not functioning well, the others compensate.
We focus on:
Core activation
Hip stability
Movement retraining
Gradual return to walking, running, or gym activities
Many patients notice meaningful improvement within 8 to 12 weeks when they follow a structured plan consistently.
Exercise selection depends on your diagnosis, but several movements are commonly helpful when done correctly.
Knee to Chest Stretch
This helps mobilize the lower back and front of the hip.
Lie on your back with legs extended
Bend one knee and gently pull it toward your chest
Hold 20 to 30 seconds
Repeat on the other side
Keep your lower back gently pressed into the floor.
Piriformis Stretch
This can reduce tension in deep glute muscles that may irritate the sciatic nerve.
Lie on your back with knees bent
Cross one ankle over the opposite knee
Pull the bottom leg toward your chest
Hold 20 to 30 seconds
You should feel a stretch in the buttock, not sharp pain.
Hamstring Stretch
Tight hamstrings can increase stress at the sitting bone.
Lie on your back
Lift one leg and gently straighten it
Support behind the thigh
Hold 20 to 30 seconds
Avoid pulling directly on the knee.
Bridge Exercise
Bridges improve blood flow and strengthen the glutes.
Lie on your back with knees bent
Lift your hips off the floor
Hold briefly
Lower slowly
This movement also shifts your spine and hips out of prolonged sitting posture, which many patients find helpful.
Your first session at Manhattan Physical Therapy is focused on clarity. We want to understand exactly what is driving your pain, not just where it hurts.
During your evaluation, we look at:
How your pain started
What positions or movements make it worse
Your work setup and daily routine in NYC
Walking mechanics and hip strength
Lower back and pelvic control
We perform specific tests to determine whether your symptoms are coming from the gluteal tendons, sacroiliac joint, lower spine, hamstring origin, or a combination. By the end of the session, you will know:
The most likely source of your pain
What movements are safe
What to temporarily avoid
The first exercises you should begin
Physical therapy is structured in phases. We do not jump straight into aggressive strengthening if your tissues are irritated.
Short-Term Goals
Reduce pain with sitting and lying down
Calm irritated tendons and joints
Improve basic hip and trunk control
Increase tolerance for daily activities
Long-Term Goals
Build strength in the gluteus medius and maximus
Reduce compressive stress on irritated tendons
Improve lumbopelvic stability
Restore confidence in walking, training, and daily activity
Prevent flare-ups
Recovery depends on the underlying condition, how long symptoms have been present, and how consistent you are with your program.
Here is a realistic overview:
Gluteal Tendinopathy
Most patients notice meaningful improvement within 8 to 12 weeks with structured strengthening. Long-term results are better when exercise and education are combined rather than relying on injections alone.
Proximal Hamstring Tendinopathy
This condition often requires several months of progressive loading. Patience is important. Gradual return to running or sport is built into the plan.
Sacroiliac Joint Pain
Many patients improve within weeks when hip strengthening and stabilization are prioritized. Persistent cases may require additional medical management, but conservative care is typically the first step.
Sciatic-Type Symptoms
If the nerve is irritated but not severely compressed, symptoms often improve with targeted mobility work, postural adjustments, and strengthening. True nerve compression cases may need further medical evaluation.
Your daily habits in New York City can either help or slow your progress. Here are practical strategies:
Change Positions Frequently
There is no single perfect posture. The real issue is staying in one position too long.
Stand up every 45 to 60 minutes
Adjust your chair tilt if possible
Use lumbar support if needed
Shift weight when standing
Small changes reduce prolonged pressure on the glutes and tendons.
Use Ice or Heat
Both can be helpful.
Ice may calm irritation after activity
Heat may reduce stiffness before movement
Choose what feels better for your body.
Most cases of buttock pain improve with conservative care. Injections may be considered when:
Pain remains severe despite structured therapy
Inflammation needs to be calmed to allow rehab progression
Surgery is rare and typically reserved for:
Confirmed nerve entrapment that does not respond to rehabilitation
Severe tendon damage
Structural issues that fail conservative treatment
For the majority of patients, guided physical therapy remains the safest and most effective first-line approach.
Consider scheduling an evaluation if:
Pain has lasted more than a few weeks
Sitting or sleeping is consistently uncomfortable
Pain radiates down your leg
You feel weakness or instability
Symptoms keep returning
Buttock pain can interfere with work, sleep, exercise, and everyday life. The good news is that most causes respond well to structured physical therapy.
If you are in NYC and dealing with persistent glute or hip pain, the team at Manhattan Physical Therapy can help you identify the source and build a clear recovery plan. Call (212)-213-3480 to schedule your evaluation and take the first step toward sitting, walking, and living more comfortably in New York City.
Alexander Liu
"Everyone on the team at Manhattan Physical Therapy is super nice and caring. They were able to pretty quickly diagnose my knee and hip problems and immediately put me to work to reduce the pain.."
Henry Myerberg
"Everyone on the team at Manhattan Physical Therapy is super nice and caring. They were able to pretty quickly diagnose my knee and hip problems and immediately put me to work to reduce the pain.."
Hakyung Kim
"Everyone is so kind and helpful! my knee and hip pain have improved massively since starting Manhattan PT, highly recommend to anyone. special thanks to Bianca, Lidia, Joe, and John!"
Manhattan Physical Therapy
✆ Phone (appointments):
(212) 213-3480
Address: 385 5th Ave, Suite 503, New York, NY 10016