Hip & Buttock Pain

Hip and buttock pain: finding the real source

Pain in the hip or buttock does not always start in the hip joint. It can come from the joint itself, the tendons and bursae on the outside of the hip, the sacroiliac (SI) joint, the muscles deep in the buttock, or a pinched nerve in the lower back. Because the same spot can hurt for different reasons, the first job is finding the source. That decides which treatment has the best chance of helping.

At Garden State Medical Center, our pain management and sports medicine physicians evaluate hip and buttock pain with a focused exam and, when needed, imaging. We then build a plan that starts with the least invasive options.

Common causes of hip and buttock pain

• Hip osteoarthritis: deep groin or front-of-hip pain and stiffness, often worse after rest.
• Trochanteric bursitis and gluteal tendon problems: pain on the outside of the hip, often worse lying on that side.
• Hip labral tears: catching, clicking or groin pain with certain movements.
• Hip flexor strains, hip tendonitis, IT band syndrome and snapping hip syndrome: often linked to activity or overuse.
• Sacroiliac joint dysfunction: pain low in the back or upper buttock, sometimes spreading into the thigh.
• Sciatica and piriformis-related pain: buttock pain that travels down the leg, sometimes with numbness or tingling.
• Hip fractures: sudden pain after a fall, especially in older adults. This needs emergency care.

When to get evaluated

Make an appointment if hip or buttock pain lasts more than a few weeks, keeps you up at night, makes walking or stairs difficult, or spreads down the leg. Seek emergency care after a fall with severe hip pain, or for new leg weakness or loss of bladder or bowel control.

Treatment options at GSMC

Your plan depends on the cause. Options our team may discuss include:

• Physical therapy: targeted exercises and stretches to improve strength and flexibility.
• Medications: anti-inflammatory and other medicines to manage pain.
• Image-guided injections: to reduce pain and inflammation, and to confirm where the pain is coming from.
  • Hip joint injections (corticosteroid or hyaluronic acid)
  • Trochanteric bursa, iliopsoas bursa and gluteal tendon injections
  • Sacroiliac joint injections
  • Piriformis, trigger point and sciatic nerve injections
  • Platelet-rich plasma (PRP) for the hip
  • Radiofrequency ablation and nerve blocks
• Hip artery embolization: a newer option for some patients with ongoing hip pain, performed by interventional radiologist Dr. Douglas Gibbens.
• Minimally invasive procedures: for confirmed SI joint pain that has not improved with other care, SI Joint Fusion may be considered.
• Surgical referral: GSMC does not perform hip surgery. If your evaluation shows surgery may help, we can refer you to a surgeon.

Your first visit

Bring a list of your medicines and any X-ray, MRI or CT reports. Be ready to describe where the pain is, when it started, what makes it better or worse, and what you have already tried. This helps us narrow down the source quickly.

GSMC is led by Dr. Dharam Mann, who completed fellowships in pain management, cardiac anesthesia and critical care at Massachusetts General Hospital/Harvard. To get started, fill out our new patient form or find an office near you.