Butt Pain During Pregnancy: Causes, Diagnosis And Treatment

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Butt pain during pregnancy may occur for several reasons, including hormonal changes and pressure from the growing baby. The butt pain is often due to painful stimuli from tissues in the region of the lower back or buttocks. The pain is usually common in the second and third trimesters, but some women may experience butt pain even during early pregnancy.

If butt pain is persistent or worsens, consult your doctor to determine the underlying cause. The treatment options may vary from medications to surgery if the cause is severe. Read this post to know the various causes, treatments, and preventive measures for butt pain during pregnancy.

What Are The Causes Of Buttock Pain During Pregnancy?

The exact cause of buttock pain in pregnancy is difficult to diagnose and may not be pinpointed in some cases. Several theories show that the body’s reactions to implantation, hormonal changes, etc., can cause buttock pain in the early weeks of pregnancy. However, buttock pain could also be due to extreme pressure from the uterus in later months. The causes can be different throughout the pregnancy.

Common causes of buttock pain in pregnancy may include:

1. Hemorrhoids

Hemorrhoids are swollen, enlarged veins in the rectum and anus. They can develop inside (internal hemorrhoids) and outside (external hemorrhoids or piles) the anus. Approximately 25-35% of pregnant women get affected by hemorrhoids, and nearly 85% of cases occur in the third trimester (1).

Hormonal changes and increased intra-abdominal pressure can predispose pregnant women to develop hemorrhoids. Sometimes, constipation during pregnancy can also lead to hemorrhoids due to strain during bowel movements. Bleeding from the anus, itching, and painful bowel movements are common symptoms of hemorrhoids.

2. Sciatica

Sciatica is the compression of the sciatic nerve that runs from the butt to the legs and causes shooting pain on the lower back and legs. This is caused by inflammation or pressure on the sciatic nerve, which runs on the lower back, legs, and toes. The pain can be mild or severe and often resolves with treatment or subsides after pregnancy. Although sciatica is common in the third trimester, it can occur anytime during the pregnancy (2). Sciatica does not harm the baby, and it usually disappears after delivery of the baby when the pressure over the nerve is relieved.

Loosening of pelvic ligaments by the effects of the relaxin hormone shifts location of the sciatic nerve and gets pinched, causing pain on the buttocks and back of the legs. A baby’s weight can put pressure on the sciatic nerve and cause pain and discomfort. The severity of pain may vary depending on the weight and position of the baby.

3. Pelvic girdle pain

Pelvic girdle pain, also known as symphysis pubis dysfunction (SPD) or pregnancy-related pelvic pain (PGP), is a collection of uncomfortable symptoms due to a shift of pelvic joints. Uneven movement of pelvic joints causes pain over the pubic bone, sides of lower back or buttocks, perineum (between vagina and anus), and thighs (3).

Buttock pain due to PGP tends to improve after delivery. However, these measures and treatments are advised to ease discomfort during pregnancy. Relaxation techniques are also recommended for women with chronic pelvic pain, back pain, and buttock pain during pregnancy.

4. Labor pains

Uterine contractions can cause buttocks to pain during labor in some women; however, they are not the most common symptoms of labor. Some may have only a little discomfort. This pain can also be felt on the abdomen, groin, thighs, and back. Some women may only experience lower abdominal pain during contractions. Labor pain intensity increases with the progressing labor (4).

Sometimes it is possible to have false labor pains such as Braxton Hicks contractions in the second and third trimester. True labor contractions follow the 5-1-1 rule: contractions in every five minutes lasting one minute for at least one hour. You may also notice other signs of delivery, such as water breaks followed by true contractions.

Although not specific to pregnancy, buttock pain may occur in the following conditions:

  • Constipation
  • Anal fissure (tear in the anus) and anal abscess (pus-filled cavity)
  • Deep gluteal syndrome when the muscles, blood vessels, and skin in the buttocks press the nerves
  • Piriformis syndrome occurs when the piriformis muscle in the buttock press the sciatic nerves
  • Certain activities and injuries such as tailbone fracture or strains
  • Gluteal muscle cramps
  • Tendon inflammation (tendinitis)
  • Hip arthritis
  • Bursitis (inflammation of joint cushions)
  • Pilonidal cysts (sacs on the tailbone with pus)
  • Shingles caused by chickenpox virus reactivation

These conditions are treated with conservative measures, medicines, or surgeries depending on the severity. A health care provider should evaluate buttock pain in pregnancy to rule out serious causes.

When To Consult A Doctor?

Although not harmful, it is recommended to seek medical care since pregnancy-related buttock pain can be uncomfortable. Immediate medical attention for buttock pain is recommended in the following scenarios:

  • Bladder or bowel incontinence
  • Numbness with pain
  • Trouble to control foot

You may also seek medical care for buttock pain during pregnancy in the following situations:

  • Worsening of pain
  • Feels like uterus contractions
  • Severe pain with nausea or vomiting
  • Pain is not improved after conservative management with dietary and lifestyle changes
  • OTC medications do not relieve pain
  • Significant bleeding after a bowel movement
  • Buttock pain begin after an injury

Always seek medical advice if you are concerned about any symptoms during pregnancy. Take your doctor’s suggestion before taking any medications including herbal remedies in pregnancy.

How Is Buttock Pain In Pregnancy Diagnosed?

Doctors may obtain medical history, ask for details of location, intensity, other pain characteristics, associated symptoms, and performs certain physical examinations to identify the cause of buttock pain in pregnancy. In addition, some women are referred to hip surgeons or orthopedic spine specialists for a detailed evaluation.

Sometimes doctors may recommend measures to help reduce pain and some treatments without any scans. Diagnostic tests are ordered only if the pain is associated with warning symptoms such as tingling, numbness, vaginal discharge, or bleeding.

How Is Buttock Pain Treated During Pregnancy?

The treatment for buttock pain depends on the cause. Doctors may recommend conservative measures to help reduce pain not to harm the baby, and the pain usually resolves after delivery.

Conservative management and medical treatments for buttock pain in pregnancy may include:

  • Try over-the-counter pain medications such as acetaminophen (Tylenol) as per doctors’ suggestions. Avoid NSAIDs and other pain relievers during pregnancy without prescription.
  • Apply topical pain relief (analgesic) creams, ointments, or suppositories for severe pain in hemorrhoids. However, ensure to consult your doctor before using them.
  • Use stool softeners as per the doctor’s advice for hemorrhoid-related buttock pain.
  • Use sitz baths and warm water showers to help reduce buttock pain.
  • Try physiotherapy, including strengthening exercises, water exercises, transcutaneous electrical nerve stimulation (TENS) to help alleviate pain.
  • Use equipment such as belts and crutches to help relieve buttock pain due to PGP.
  • Try comfort measures including massages, tubs, showers, cold or hot compress, and birth ball and mental strategies such as music and other relaxation techniques to manage labor pain.
  • Opt pharmacological options such as inhalation of nitrous oxide, intravenous opioid injections, and local anesthetics to help reduce severe labor pain, only if indicated by your doctor or during your stay at the hospital.
  • Doctors may recommend epidural block or spinal analgesia to numb specific body areas for labor pain relief.
  • Discontinue any activities causing or worsening sciatic pain
  • Pregnancy pillows are recommended for sleeping and massaging.

Trying herbal remedies such as witch-hazel, grape extract, and various other products may help reduce pain in some women. However, there is no evidence from randomized controlled trials on the safety of many alternative medicines during pregnancy, including these medications, and so are not recommended.

How To Prevent Buttock Pain During Pregnancy?

Although not all causes of buttock pain are not preventable in pregnancy, the following measures may help avoid some causes:

  • Avoid prolonged sitting. If possible, try to use a standing desk in the office. You may switch between standing and sitting to help reduce pressure on your buttocks.
  • Use coccyx seat cushions or donut pillows on the chair to help reduce pressure on the anal region while sitting. You may also use chairs with proper back support and a footrest to increase comfort.
  • Stay active by stretching your legs, walking around, and getting up often to help prevent the risk of buttock pain from continuous sitting.
  • Apply cold or hot packs or compress to ease the pain. This may also increase the blood flow and heal the pain and inflammation. Do not apply an ice pack for more than 10 to 15 minutes at a time.
  • Practice regular exercise and prenatal yoga to stretch and relax muscles for pain relief.
  • Drink enough water and consume fiber-rich foods to avoid constipation during pregnancy.

Please contact your doctor if you have pain in your buttock region in pregnancy, as the treatment options may vary depending on the underlying cause. Doctors may recommend pain relievers such as acetaminophen. In addition, regular exercises help reduce or avoid many causes of buttock pain in pregnancy.

Frequently Asked Questions

1. Can too much sitting cause buttock pain?

Sitting for too long may cause buttock pain. Experts often refer to it as the dead butt syndrome, technically known as gluteal amnesia. Gluteal amnesia is when the rear muscles forget to stabilize the pelvis and work on body alignment (5).

2. What helps sciatic pain in the butt during pregnancy?

Pregnant women with sciatica pain in the butt can do light back stretches to relieve pain. Massaging the back and using a foam roller for the buttocks are other ways to alleviate buttock pain. If the pain turns severe, women can consult their healthcare provider and take a pregnancy-safe over-the-counter pain killer (6).

Infographic: Sit Right To Avoid Butt Pain When Pregnant

Maintaining the correct sitting posture is essential to avoid back and butt pain during pregnancy. Try the tips in this infographic to prevent butt pain during pregnancy while at home or work.

proper sitting postures to prevent butt pain during pregnancy [infographic]
Illustration: MomJunction Design Team

Key Pointers

  • Body’s reactions to implantation, hormonal changes, and extreme pressure from the uterus can cause buttock pain in the early weeks of pregnancy.
  • Buttock pain may occur in conditions, including constipation, anal fissure, anal abscess, deep gluteal syndrome, or gluteal muscle cramps.
  • Seek medical care during a worsening of pain, severe nausea or vomiting, significant bleeding after a bowel movement, or buttock pain after an injury.


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