It is not uncommon for people to end up with pain in their gluteal region and confuse it with back pain. This is because there seems to be some confusion as to where the lower back ends and the gluteal region begins. If you place your hands on your hips, anything above that line is your lower back and anything below that line is part of the gluteal region or your buttocks. The patients I treat often times complain of pain at a point just below this delineation between the lower back and gluteal region. They are still told that this is considered the lower back pain. Ultimately, they are susceptible to falling into the trap of getting an MRI which indicates a herniated disc in the lumbar spine and being told that that is the cause of their gluteal pain.

What's Really Causing Your Pain

This can't be any farther from the truth. The fact that the pain is in the gluteal region and not the lumbar spine should raise some suspicion. The next thing to understand is that the gluteal region is filled with muscles. The muscle most commonly strained creating pain at the gluteal region is the piriformis muscle. This muscle attaches from the sacral spine--the portion of the spine just below the lumbar spine--and travels across the gluteal region on a diagonal to the hip joint.

The reason this muscle is so commonly strained and creates pain is because it is one of the deepest muscles in the gluteal region. It is deep to the gluteus maximus, gluteus medius, and gluteus minimus. Muscles have a tendency to strain from the closest to the surface to the deepest. So the gluteus maximus might strain, but the deeper muscles will try to compensate before a symptom that is experienced. Additionally, the same may occur with the gluteus medius. This cycle will occur until the piriformis strains. There is no other muscle to compensate; thus the pain is experienced in the gluteal region.

Preventing Pains in the Butt

The key to preventing pain in the gluteal region is strengthening of the muscles that are superficial to the piriformis; namely the gluteus maximus and medius. Along with the hamstrings, these muscles, when strong, will prevent the piriformis from straining. Straight-leg deadlifts can be employed to strengthen the gluteus maximus, and the hamstrings and hip abduction can be performed to strengthen the gluteus medius.

Don't get caught in the trap of being told that the cause of gluteal region pain is something that is located in the lumbar region. The cause of gluteal region in most cases is a strained piriformis. Strengthen the appropriate muscles and the piriformis will not strain or create pain. The ability to resolve this pain or even prevent it is in your capacity with the right understanding of what is causing it and the right remedy for that cause.