There are lots of things that are a pain in the butt: forgetting your hair tie at the gym, coming home to a sink full of dirty dishes, needing to do laundry. Then, there’s a literal pain in your butt.
Butt pain can come in different forms: shooting pain, cramping, even an irritating “do I have a paper cut down there?” type of pain. No matter which type of pain you’re experiencing, you probably want it gone ASAP.
Here are the most common causes of butt pain–plus how to make it stop.
1. You have your period.
Fun fact: Your periods can mess with your poop. Hormone-like compounds called prostaglandins–they make the uterus contract, causing cramps–can stray into the bowel area and cause some people to poop more during their period.
These prostaglandins may cause diarrhea, too. “Looser stools than normal, having to go to the bathroom more often, and feeling more urgency–like, ‘I gotta go now’–are all very common side effects of a sharp rise in prostaglandins,” , MD, an ob-gyn in San Francisco, previously told WH.
Severe period cramps can also extend to the lower abdomen, and feel as if they’re affecting your butt area.
2. You have hemorrhoids.
Hemorrhoids are swollen blood vessels that form on the anus and rectum, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Pregnant women are especially susceptible, and so are people who either stand or sit for long periods of time, and people who have constipation.
There are also two types of hemorrhoids: external and internal. Itching or pain around the anus, along with a lump (an inflamed blood vessel), can signal an external hemorrhoid, per the NIDDK. Internal hemorrhoids also cause rectal pain, and may be accompanied by bleeding.
Hemorrhoids will usually go away on their own (or with a little over-the-counter prescription cream). But if your hemorrhoids don’t go away after a week, or if they cause a lot of pain or occur frequently, then you should check in with your primary care doctor.
3. You have endometriosis.
About 11 percent of women have endometriosis, according to the Office on Women’s Health (OWH). Endometriosis happens when tissue that normally lines the uterus (the same stuff that sheds with your period each month) grows outside of the uterus.
The overgrowth of this tissue is most often found on fallopian tubes, ovaries, and the outer surface of the uterus, but it can also also extend to the bowel area. If endometrial tissue grows in the bowel, it can cause painful bowel movements, according to the American College of Obstetricians and Gynecologists (ACOG).
Endo can be notoriously difficult to diagnose, given that there are so many conditions that can cause pelvic pain and discomfort, and symptoms of endo vary from person to person. “Black and Latinx populations are only about half as likely to be diagnosed with endometriosis. However, Asian women were more likely to be diagnosed with endometriosis when compared to white women,” Jodie Horton, MD, a board-certified ob-gyn and chief wellness Advisor for Love Wellness, previously told WH. (Part of the issue here is racial bias in the medical community, she notes, and the mishandling or dismissing of BIPOC patients’ pain and concerns.)
There is no cure for endometriosis, but treatment typically requires either medication, surgery, or both. If pain is the primary problem, doctors will most likely recommend meds.
4. You have genital herpes.
There are two types of herpes viruses: herpes simplex virus-1 (HSV-1) and herpes simplex virus-2 (HSV-2). HSV-1 causes cold sores (and is extremely common), while HSV-2 is known as genital herpes and is a little less common. The latter can cause painful sores and fluid-filled blisters on your anal or genital area, .
If you notice sores on your anus or your genitals, it’s important to be tested for STIs and to contact all of your sexual partners if you test positive so they can also be tested. Herpes doesn’t have a cure, but it can be managed. Doctors prescribe antiviral medications to lessen the number of outbreaks and to shorten the duration and lessen the severity of an outbreak when it does happen.
5. You have an anal fissure or anorectal abscess.
Anal fissures are splits and cracks in the lining of the anal opening (sounds pleasant, right?). Often, they happen when you have either very hard–or conversely, very watery poop–which can cause irritation to the anus.
The cracks expose the muscle that controls bowel movements, which can lead to burning pain or bleeding after you poop. The resulting tear is easily visible, so all it takes is a doctor’s visit to confirm, according to the U.S. National Library of Medicine (NLM). If your doctor suspects that the fissure was caused by an underlying condition like Crohn’s disease, you may need further testing.
Anorectal abscesses are caused when the tiny anal glands on the inside of the anus become blocked, or an anal fissure becomes infected, per the NLM. The abscesses become filled with pus, which can be painful, and if you have one you’ll have to see your doctor to open and drain the abscess.
6. You have sciatica.
The sciatic nerve is as thick as your thumb and runs from your lower back, down through your buttocks and to your foot. When the nerve gets pinched, it can cause pain, sometimes in the butt. “If irritated, it can feel like a dog bite in the butt,” says , a board-certified clinical specialist in women’s physical therapy and spokeswoman for the American Physical Therapy Association.
Numbness, tingling, and a burning or prickling sensation are also common sciatica symptoms. If you think this might be the cause of your butt pain, you can go to the American Physical Therapy Association‘s website to find a physical therapist in your area.
7. You have piriformis syndrome.
Piriformis syndrome can sometimes be mistaken for sciatica, because the symptoms are very similar. But piriformis syndrome is a neuromuscular condition (a miscommunication between your nerves and muscles) that causes hip and butt pain. Piriformis syndrome is basically cramping and spasming of the piriformis muscle (located behind your gluteus maximus), says Pagliano.
Piriformis syndrome can cause a sharp, radiating pain when you move your hips (so, pain in your butt while walking, siting, running, and so on). This kind of pain, as well as sciatic pain, typically stems from back issues, says Pagliano. Physical therapy, exercise, and stretching can all help treat and manage piriformis syndrome.
8. You have bursitis.
“Bursitis is an inflammation of the bursa sacs, which cushion the bones, muscles, and tendons near your joints,” says Jonathann Kuo, MD, an anesthesiologist and pain medicine doctor with . These sacs are all over your body, but if a sac bursts around the hip region, it could lead to butt pain, though it’s likely you’ll feel it around the sides of your butt and hips rather than just in your bum.
If you have bursitis in your hips, the joints will be really stiff and hurt (in an achey way) if you move them. Bursitis will usually calm itself down in a few weeks with rest and anti-pain meds, but if you suddenly develop a fever, swelling, redness, warmth, or the inability to move your joint, you should see a doctor ASAP to make sure you’re not dealing with any complications.
9. You have a nasty bruise.
Taken a fall recently? You might just have butt pain due to a developing bruise. Usually characterized by black and blue markings, bruising occurs when blood vessels under the skin have been damaged, therefore pooling under the skin. It can occur after contact sports, when you’ve fallen on the floor, or hit something hard, and can manifest as a dull pain over the bruised region. (And it might take a few days before it shows up visually, though you’ll feel the pain right away.)
Often, the area will be swollen and tender, but the pain usually fades away with time. Icing the area and rubbing vitamin C cream on it can help speed up the healing process, adds Dr. Kuo. However, if you’re suddenly bruising more than usual, or find that your pain is increasing, you should go see a medical professional, as this could be a sign of other conditions.
10. You have shingles.
Shingles is less likely to cause butt pain, according to Dr. Kuo, but it is important to notice its main symptom–a painful, splotchy rash that itches, tingles, or burns. It’s caused by the same virus as chickenpox, and can lay dormant in your body for years. So, you just never know when it might start up again, and it could manifest near your bum, leading to pain in the area. The shingles rash develops as a stripe of blisters around a certain side of your torso.
If you do suspect you have shingles, contact your doctor so you can get treated with antiviral meds which will heal the blisters and pain.
11. You have muscle pain from a tough workout.
“When you exert your gluteus medius and minimus, aka the muscles that make up your butt, it can cause significant pain,” says Dr. Kuo. It can happen when you overuse the muscles to the point where they tear, or it could just happen because of muscle tension. Mostly, it manifests as an ache, which increases if you move the muscle, and you’ll know you have it if you’ve worked out significantly the day before, only to find you have muscle soreness when you wake up. Runners and weight lifters are most likely to feel this kind of pain.
“Mostly, muscle aches can heal at home, with adequate rest, ice, and an over-the-counter pain relief medication,” says Dr. Kuo. However, if you find the pain is getting worse with time, he recommends making sure it isn’t something more severe by talking with your doctor. And be on the lookout of the symptoms of rhabdomyolysis if you’ve just finished a particularly strenuous effort.
12. You have arthritis in your sacroiliac joints.
The sacroiliac joints connect the spine to the hips, provide support and stability, and play a major role in absorbing impact when walking and lifting weights. Arthritis in these joints can result in lower back and butt pain, due to intense inflammation, and is usually characterized by sharp, shooting pain. Unfortunately, this condition is common in young women, notes Dr. Kuo.
“If you suspect you have arthritis in the sacroiliac joints, contact your doctor,” says Dr. Kuo. Through a variety of testing methods, including hands-on tests and MRIs, your doctor can determine a specific treatment method, which can include anything from physical therapy to medication to ease the pain.
13. You have a herniated disc.
A herniated disc occurs when one of the discs (rubbery, cushion-like substances) between the vertebrae of your spine gets dislocated and protrudes out. This causes a sharp pain in the lower back and butt area, as well as numbness or tingling if it hits the nerves.
If you experience any of the symptoms, it’s best to see a doctor: The longer you go without treating it, the worse it can get. You may even need surgery, depending on the severity of the slipped disc. You doc will likely have x-rays taken and then develop a treatment plan to help with the pain and function of your spine.