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Back Pain That Shoots to the Butt Causes & Questions

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Last updated March 22, 2022

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Back pain that shoots down to the butt is a very common condition and can be caused by damage or narrowing of the spine, inflammation, or it may even be hereditary.

7 most common causes

Sciatica
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Bulging disc
Common Problems During Pregnancy
Sciatica
Spinal Stenosis
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Low back strain
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Piriformis syndrome

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Back pain that shoots to the butt symptoms

Back pain is a very common complaint. Because we need to stand, walk, and do physical work on two legs, this leaves the lower back vulnerable to damage and strain. Pain that shoots to the butt and thighs occurs in many people with back issues due to the interconnected nerves and muscles. "Back pain that shoots to the butt" is also called sciatica or lumbar radiculopathy.

Common characteristics of back pain that shoots to the butt

Your pain can likely be described by the following.

  • Severe: The pain may be sharp and mainly in the lower back and radiate or shoot into the butt and back of the thighs.
  • Worse with straightening: The pain can be sensitive to extension and get worse when standing, walking, or lying face down.
  • Worse with bending: It may get worse while sitting or bending forward.
  • Better while lying on your side

Common accompanying symptoms

Along with the back pain, you may also experience:

  • Abnormal sensations: Numbness, tingling, and a "pins-and-needles" feeling may be present.
  • Muscle spasms: These often occur in the low back and buttocks.

Duration of symptoms

Back pain that shoots to the butt can be short- or long-term depending on both the initial cause and how recovery is addressed.

  • Acute form: Pain that begins suddenly and sharply is usually due to a ruptured disc.
  • Chronic form: Pain that comes on more gradually is usually due to narrowing of the spinal canal or from an inflamed muscle in the butt irritating the sciatic nerve.

Who is most often affected?

People who are most likely to experience back pain that shoots to the butt include the following.

  • Older people: Anyone over age 50.
  • Anyone with loss of physical fitness: People who are obese or who have lost muscle tone due to inactivity.
  • Weightlifters: This includes people who do lift heavy loads during manual labor or as a sport.

Is back pain that shoots to the butt serious?

This type of back pain can vary in severity depending on the cause.

  • Not serious: This would involve a mild strain that resolves with a day or two of rest, stretching, and over-the-counter pain relievers.
  • Moderately serious: Ongoing pain and spasms that interfere with activities of daily living are moderately serious.
  • Serious: Pain that includes numbness, weakness, difficulty moving, and loss of bladder or bowel control requires prompt medical attention.

Back pain that shoots to the butt causes

Many conditions can cause back pain that shoots to the butt. The following details may help you better understand your symptoms. If your pain worsens or persists, however, you should see a physician.

Traumatic causes

Damage to a disc in the spinal column can cause back pain that shoots to the butt. The disc cushioning may have been forced out and is irritating the nerves.

Narrowing of the spinal canal

If the spinal canal narrows, this can pressure and irritate nearby nerves, leading to shooting pain and sometimes numbness and tingling. This is called spinal stenosis.

Inflammatory causes

Irritation and inflammation of a small muscle found on either side of the buttocks can lead to this type of back pain. The sciatic nerve runs very close to these muscles and sometimes right through them. If one of the muscles is injured, it may swell, compress the nerve, and cause butt pain. This does not cause low back pain but is often found at the same time as something that does. The back pain may seem to shoot down into the buttocks and legs, but they are actually two separate conditions.

Rare and unusual causes

In rare cases, this type of back pain can be due to the following.

  • Heredity: Inherited traits can cause small malformations of the spine, leaving it more prone to narrowing or disc damage. Either of those can lead to back pain that radiates to the butt and legs.
  • Tumor: A tumor growing on or near the spinal column can interfere with the sciatic nerve, causing shooting back pain that reaches the buttocks and legs.

This list does not constitute medical advice and may not accurately represent what you have.

Spinal stenosis

The spine, or backbone, protects the spinal cord and allows people to stand and bend. Spinal stenosis causes narrowing in the spine. The narrowing puts pressure on nerves and the spinal cord and can cause pain.

Next steps including visiting a primary care physician. For this condition, a physician might suggest further investigation including imaging of the spine. Treatments may include medications, physical therapy, or braces. For severe cases, surgery is sometimes recommended.

Sciatica

Sciatica is a general term describing any shooting leg pain that begins at the spine and travels down the outside of the leg. It is also called pinched nerve, lumbar radiculopathy, sciatic neuralgia, sciatic neuritis, or sciatic neuropathy.

By far the most common cause is a herniated or "slipped" disc in the lower spine. This means some of the cushioning material inside the disc has been forced outward and is pressing on a nerve root. Spasms of the piriformis muscle around the sciatic nerve, as well as the narrowing of the spinal canal called spinal stenosis, can also cause sciatica.

Symptoms include shooting leg pain that begins suddenly or develops gradually. There may be weakness, numbness, and a pins-and-needles sensation. In severe cases, there may be difficulty moving the foot or bending the knee.

Diagnosis is made through patient history, physical examination, and simple leg-raise tests.

Treatment involves physical therapy, nonsteroidal anti-inflammatory drugs, and muscle relaxants. In some cases, corticosteroid spinal injections and surgery may be tried. Massage and acupuncture are also sometimes helpful.

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Piriformis syndrome

Piriformis syndrome

The two piriformis muscles, left and right, each run from the base of the pelvis to the top of the thighbone. The two sciatic nerves, left and right, are each attached to the spine and run down between the pelvic bone and the piriformis muscle to the back of each leg.

If the piriformis muscle is damaged through sudden trauma, or through overuse as in sports, the resulting inflammation or spasm of the muscle can trap the sciatic nerve between the pelvic bone and the muscle.

Piriformis syndrome is most often found in women over 30.

Symptoms include pain over one or both sides of the low back, and shooting pain (sciatica) down one or both legs.

Diagnosis is made through physical examination and sometimes imaging such as CT scan or MRI.

Treatment involves rest; over-the-counter, nonsteroidal anti-inflammatory drugs; physical therapy; therapeutic injections; and, rarely, surgery.

The best prevention is a good regimen of stretching before exercise, to help prevent damage to the piriformis.

Rarity: Common

Top Symptoms: pelvis pain, butt pain, pain when passing stools, leg numbness, hip pain

Symptoms that never occur with piriformis syndrome: involuntary defecation, leaking urine

Urgency: Primary care doctor

Mechanical low back pain with sciatica

Sciatica is a general term describing any shooting leg pain that begins at the spine and travels down the outside of the leg. It is also called pinched nerve, lumbar radiculopathy, sciatic neuralgia, sciatic neuritis, or sciatic neuropathy.

By far the most common cause is a herniated or "slipped" disc in the lower spine. This means some of the cushioning material inside the disc has been forced outward and is pressing on a nerve root. Spasms of the piriformis muscle around the sciatic nerve, as well as the narrowing of the spinal canal called spinal stenosis, can also cause sciatica.

Symptoms include shooting leg pain that begins suddenly or develops gradually. There may be weakness, numbness, and a pins-and-needles sensation. In severe cases, there may be difficulty moving the foot or bending the knee.

Diagnosis is made through patient history, physical examination, and simple leg-raise tests.

Treatment involves physical therapy, nonsteroidal anti-inflammatory drugs, and muscle relaxants. In some cases, corticosteroid spinal injections and surgery may be tried. Massage and acupuncture are also sometimes helpful.

Low back strain

Low back strain

A strain is defined as a twisting, pulling, or tearing injury to a muscle, or to the tendon that connects the muscle to the bone. (A sprain is an injury to a ligament, which connects two bones together.)

Strains may be acute (happen suddenly) or chronic (show up gradually.) They are usually caused by overuse, improper lifting of heavy objects, or sports. Being overweight or having weak back muscles are both risk factors for back injury.

Symptoms may include a pop or tear at the time of injury; pain that is worse when moving; and sudden muscle cramping or spasm at the site of the injury.

Diagnosis is made through patient history, physical examination, and sometimes x-ray.

Treatment involves rest; ice packs; and over-the-counter pain relievers, followed by a gradual return to normal activities within two weeks. Prolonged immobility actually weakens the back and causes loss of bone density.

Proper lifting techniques, strengthening exercises, and good nutrition can be very helpful in preventing further injury.

Rarity: Common

Top Symptoms: lower back pain, back pain that gets worse when sitting, back pain that gets worse when straightening it, lower left back pain, lower right back pain

Symptoms that always occur with low back strain: lower back pain

Symptoms that never occur with low back strain: involuntary defecation, first time leaking urine, back numbness, toe numbness, foot numbness

Urgency: Self-treatment

Herniated (slipped) disk in the lower back

A herniated, ruptured, or "slipped" disc means that a vertebral disc – one of the soft pads of tissue that sit between each of the vertebral bones – has becomes squeezed out of shape. Its cushioning material has been forced against, and possibly through, the ring of fibrous tissue that normally contains it. This causes pain, numbness, and weakness in the legs.

The normal aging process causes the discs lose moisture and become thinner, making them more vulnerable to "slipping."

Most susceptible are men from ages 30 to 50. Smoking, obesity, lack of exercise, and improper lifting are also risk factors.

Symptoms include pain, weakness, numbness, and tingling in the back, leg, and foot.

Diagnosis is made through patient history, neurological examination, and MRI scan.

Treatment begins with rest, nonsteroidal anti-inflammatory drugs, physical therapy, and sometimes epidural steroid injections into the back to ease pain and inflammation.

Surgery to remove the herniated part of the disc – the part that was squeezed out of place – can also be helpful.

Rarity: Common

Top Symptoms: lower back pain, moderate back pain, back pain that shoots down the leg, back pain that gets worse when sitting, leg weakness

Urgency: Primary care doctor

Fibromyalgia

Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.

The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.

Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.

Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.

There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.

Fibromyalgia does not go away on its own but does not get worse, either.

Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.

Chronic low back pain

Chronic low back pain is a common condition. It is defined by low back pain lasting more than six weeks. Unfortunately, a clear cause can only be found in twenty percent of cases. The rest of the time, it is believed to be due to strain on the bones and muscles of the back from heavy lifting, prolonged sitting, or bad posture.

For back pain persisting longer than six weeks, it is recommended to make an appointment with a physician. Treatments may include a program of back exercises, as well as pain medicine such as ibuprofen (Advil) and acetaminophen (Tylenol). It is also recommended to stay active and carry on with the things you usually do as much as possible, to help you recover faster. Sitting or lying still for long periods can actually make the pain worse. Your joints may become stiff which will make it harder and more painful to move your back.

Back pain due to pregnancy

Pregnancy is a strain on the body and can cause many temporary ailments. Back pain is one of the common problems during pregnancy. As the baby grows and more weight is added in the mid-section, pressure is put on the back causing lower back pain

Rarity: Common

Top Symptoms: back pain, lower back pain

Symptoms that always occur with back pain due to pregnancy: back pain

Symptoms that never occur with back pain due to pregnancy: fever

Urgency: Self-treatment

Ankylosing spondylitis

"Ankylosing" means a joint has become stiffened and fixed in one position due to injury or disease. "Spondylitis" means inflammation in the joints of the spine.

In ankylosing spondylitis, inflammation has damaged the vertebrae of the low back and caused a form of arthritis, leaving the lower spine inflexible.

The exact cause is unknown. It is thought to be an inherited, abnormal immune response that is triggered following damage to the lining of the intestines.

Most susceptible are those with a family history of ankylosing spondylitis and a history of intestinal damage from illness. However, anyone can be affected at any age.

Symptoms include pain and stiffness in the back and hips, and sometimes in the neck and shoulders. The pain will be worse during sleep and rest.

Early treatment can help to manage the symptoms, prevent complications, and improve quality of life.

Diagnosis is made through physical examination and x-rays.

Treatment involves nonsteroidal anti-inflammatory drugs; new forms of biologic medications; physical therapy; and, in some cases, surgery to repair damaged joints.

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Back pain that shoots to the butt treatments and relief

As long as your back pain is not particularly severe, there are several methods you can try at home that may be effective. If you do not find relief or your symptoms worsen or persist, you should consult your physician.

At-home treatments

There are various remedies for back pain that you can try at home.

  • Rest: A moderate amount of rest is important with back injuries; however, prolonged or constant bedrest will weaken the muscles of the back.
  • Change positions frequently: This includes sitting, standing, walking, and so on.
  • Pain medication: You can try non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin).
  • Heat treatment: This helps address muscle spasms.
  • Cold packs: This helps calm inflammation.
  • Wear a back brace: This should only be used temporarily so that muscles are not weakened.
  • Exercise: This will improve fitness and increase core (abdominal) strength so that the muscles can support the back.
  • Lift weights the right way: This will protect the back from any further damage.
  • Make lifestyle changes: Try to maintain proper weight, manage your stress, and stop smoking.

When to see a doctor

You should consult your physician in order to discuss the following options if your back pain worsens or persists. Together, you can decide what is best for you.

  • Referral for physical therapy: This can include an exercise program, appropriate stretching, and therapeutic massage.
  • Treatment of emotional conditions: Anxiety, depression, or insomnia can make any physical pain seem more intense. Sometimes antidepressant medication can reduce nerve pain.
  • Treatment of night sweats and night pain: Most conditions are exacerbated by poor sleep and may also cause poor sleep.
  • Procedures: You can discuss the benefit of steroid injections into the nerves of your back or possible surgery for ruptured discs.

When it is an emergency

If you have weakness or numbness in the legs and genital region or a loss of bladder or bowel control, seek immediate medical attention.

FAQs about back pain that shoots to the butt

Can an old back injury, even from years before, suddenly begin to cause shooting pain?

It's possible for an earlier injury to a vertebral disc — one of the "cushions" between the bones of the spine — to eventually deteriorate and rupture. The soft material within the disc is pressed out through the break in the disc's tough outer material, irritating the sciatic nerves and causing the shooting, radiating back pain.

Can arthritis or gout cause shooting back pain?

Arthritis means there is a loss of protective cartilage within a joint, causing the bones to rub together. Gout is a form of arthritis caused by mineral crystal deposits in the joint. Both are very painful, especially when found within the spinal column, but do not cause radiating or "shooting" back pain.

Can a spinal infection cause shooting back pain?

Almost never. An infection of any part of the spine — the discs, the vertebrae, or the membranous lining of the spinal canal — can be very painful, but the pain will be localized and does not radiate into the buttocks or legs. There will also be fever and chills, as with any other systemic infection. This requires immediate medical attention.

Can a hip injury cause shooting back pain?

Hip pain and back pain often overlap, since the pelvis (hip bone) is near the spine. A hip injury will cause pain in the groin rather than in the back. Shooting back pain is caused by compression and irritation of the sciatic nerve, which branches off of the spine very low in the back.

Why is inactivity bad for shooting, radiating back pain?

The sciatic nerves are actually bundles of many nerves branching out of the different levels of the spine and form two branches that run down each side of the low back. Lack of fitness creates weak, shortened muscles that press on the sciatic nerves and cause constant pain. Exercises to stretch and strengthen the muscles can be very helpful. Sitting for prolonged periods can also cause back pain to flare or worsen due to poor posture. Try to sit up straight with your shoulders back and your lower back supported with a special chair, a rolled towel, or pillow. You should also try to stand and stretch every so often.

Questions your doctor may ask about back pain that shoots to the butt

  • Does your back pain radiate anywhere?
  • Do you currently smoke?
  • What is your body mass?
  • Any fever today or during the last week?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Hear what 1 other is saying
3 years of a lower back/ upper glute injuryPosted September 16, 2021 by T.
3 years ago I had injured myself while repetitively working out with heavy weights. At the time of the injury, I was in a lunge position with my right leg (injury side) forward, while holding (2) 25 lbs dumbbells. When I went down into a lunge I had a “snap/pop” sensation right beside L5- S1. It felt as if I had holes in my back that were super sensitive to touch. Everything hurt with any movement. I’ve had 3 rounds of PT (6 weeks each) and labrum reconstruction where they shaved off impingement and joint on both sides. Everyone wanted to look around my problem and never directly. Then, I had L5-S1 disc replaced 5 weeks ago. All I know is that it feels the exact same since all of the surgeries. Since this injury has been so long I’m finally to the point that I can self-massage the tender knots. They are large and highly sensitive. I have issues with lunges, squats, bridges, and sometimes walking. Before touching the knots it felt like extreme tightness. I would get a pinch in my low back with extension and then, irritation. Massaging the knots feels good and I can tell this will be a slow process. Any advice? I’m also a massage therapist that had to stop altogether because of the injury. My dad is a chiropractor so I’ve had it all. Adjustments make the pain worse and I’ve had damage from my personal massage therapist that had gone way too deep. At this point, I feel like I can only rely on myself to work this issue out. Any pointers?
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

  1. Sciatica. American Academy of Orthopaedic Surgeons: OrthoInfo. Updated December 2013. OrthoInfo Link
  2. Low back pain fact sheet. National Institute of Neurological Disorders and Stroke. Updated August 7, 2018. NINDS Link
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