Ischial Bursitis

Is pain in your lower buttock making sitting, driving or even relaxing uncomfortable?

Perhaps you've noticed a deep, aching pain when sitting at your desk, driving for extended periods or settling down to watch television. Even sitting through a meal or getting up from a chair can become surprisingly uncomfortable.

If you've been diagnosed with ischial bursitis, you'll know just how frustrating these seemingly simple activities can become.

Ischial bursitis is a condition involving inflammation of a small fluid-filled sac located beneath the pelvis, near the bones that support your weight when sitting.

The good news is that many cases improve with appropriate rest and conservative treatment. Understanding what's causing the irritation and how to reduce pressure on the affected area can help you take the right steps towards recovery.

What Is Ischial Bursitis?

Ischial bursitis is a form of bursitis affecting the lower part of the buttock, close to the bony area of the pelvis known as the ischial tuberosity. You may know this area more commonly as your sitting bones.

Between these bones and the surrounding muscles are small fluid-filled sacs called bursae. Their role is to provide cushioning and reduce friction as nearby tissues move against each other.

When the ischial bursa becomes irritated or inflamed, it can cause localised pain, tenderness and discomfort, particularly when sitting.

The condition is sometimes referred to as ischiogluteal bursitis, ischial tuberosity bursitis or weaver's bottom, a name associated with people who historically spent long periods sitting on hard surfaces.

Unlike trochanteric bursitis, which generally causes pain around the outside of the hip, ischial bursitis typically causes discomfort lower down in the buttock. [1]

For a broader explanation of the different types of bursitis affecting the hip, visit our Hip Bursitis Information page.

What Are the Symptoms of Ischial Bursitis?

One of the most frustrating things about ischial bursitis is how difficult it can be to avoid putting pressure on the affected area.

After all, sitting is something most of us do throughout the day without even thinking about it.

Common symptoms include:

• Pain in the lower buttock: A deep, aching discomfort around one or both sitting bones.

• Pain when sitting: Discomfort that becomes more noticeable when sitting for extended periods, particularly on hard surfaces.

• Tenderness: Increased sensitivity when pressure is applied directly over the affected area.

• Pain extending into the upper thigh: Discomfort that may travel from the lower buttock towards the back of the upper leg.

• Discomfort during physical activity: Certain movements, including climbing stairs, cycling or strenuous exercise, may aggravate symptoms.

• Difficulty sleeping: Pain that makes it uncomfortable to lie in certain positions.

Symptoms may develop gradually or appear following a fall or direct injury to the buttock.

What Causes Ischial Bursitis?

Ischial bursitis generally develops when repeated pressure or friction irritates the bursa. Although anyone can develop the condition, certain activities may increase the risk.

Prolonged Sitting:  Spending extended periods sitting, particularly on hard or poorly cushioned surfaces, can place considerable pressure on the sitting bones.

Cycling and Recreational Activities: Cycling, rowing, horse riding and other activities involving repeated pressure on the buttocks may contribute to irritation.

Repetitive Physical Strain: Activities that repeatedly load the hamstring muscles and surrounding tissues may increase friction around the bursa.

Direct Injury: A fall onto the buttocks or sudden impact to the area may trigger inflammation.

Underlying Inflammatory Conditions: Certain medical conditions, including inflammatory arthritis, may also contribute to bursitis.

Often, the problem develops gradually rather than from one particular injury.

Is Ischial Bursitis the Same as Sciatica?

No. Both conditions can cause pain around the buttock and sometimes extend into the back of the leg. However, the underlying causes are different.

Ischial bursitis involves inflammation of a bursa near the sitting bones. Pain is generally more localised and often becomes worse when sitting directly on the affected area.

Sciatica involves irritation or compression of the sciatic nerve, frequently causing pain that travels from the lower back through the buttock and down the leg.

Another condition that can produce similar discomfort is proximal hamstring tendinopathy, which affects the tendons attaching near the sitting bones.

Because these conditions can share symptoms, obtaining an accurate diagnosis is important before deciding on treatment. [2]

How Is Ischial Bursitis Diagnosed?

If you're experiencing persistent pain around the lower buttock, it's worth having the condition properly assessed. A healthcare professional will generally begin by discussing your symptoms, medical history and any activities that aggravate the pain.

They may examine the area for tenderness and assess your hip movement and surrounding muscles. In many cases, a clinical examination provides sufficient information to make an initial diagnosis. However, imaging such as ultrasound or MRI may be recommended when the diagnosis remains uncertain or other conditions need to be investigated.

What Are the Treatment Options for Ischial Bursitis?

If sitting has become increasingly uncomfortable, your first priority is understandably to find some relief. Treatment generally focuses on reducing pressure and irritation around the affected bursa while allowing the inflammation to settle.

1. Rest and Activity Modification

Temporarily avoiding activities that aggravate the affected area is often an important first step. Try limiting prolonged sitting, particularly on hard surfaces, and take regular breaks to stand or walk around.

If cycling or another recreational activity is contributing to the discomfort, it may be sensible to reduce or temporarily suspend that activity.

However, prolonged complete inactivity isn't generally necessary. Maintaining comfortable movement can help prevent stiffness and unnecessary muscle weakness.

2. Sitting Cushions and Support

Using a suitable pressure-relieving cushion may help reduce discomfort when sitting. Some cushions are designed to distribute pressure away from the sitting bones, making longer periods of sitting more manageable.

It may also help to adjust your seating position and take regular breaks rather than remaining seated for extended periods.

3. Heat Therapy

For ongoing stiffness or muscle tension around the buttock and hip, applying gentle heat for 15–20 minutes may help improve comfort.

However, heat may not be suitable immediately following an acute injury or when significant swelling is present. Cold therapy may be more appropriate during an acute flare-up.

4. Physiotherapy and Rehabilitation

During the painful stages of ischial bursitis, strenuous exercises that place additional pressure or friction around the inflamed bursa may need to be avoided or modified.

Gentle movement can often be maintained, provided it doesn't significantly aggravate symptoms. As the inflammation and associated pain begin to settle, physiotherapy may help restore flexibility, strengthen the surrounding muscles and reduce the likelihood of recurring problems.

The timing and intensity of rehabilitation should be appropriate to the individual's condition.

5. Medication and Medical Treatments

Pain-relieving or anti-inflammatory medication may be recommended to help manage symptoms, although these treatments aren't suitable for everyone.

In persistent cases, a healthcare professional may consider other options, including a corticosteroid injection. Surgery is rarely required and is generally reserved for selected cases that haven't responded to conservative treatment.

6. Drug-Free Home Treatment Options

Some people also prefer to explore drug-free, non-invasive home treatment options, particularly when medication is unsuitable or they wish to minimise its use.

These approaches may be considered alongside appropriate rest, activity modification and rehabilitation.

For more detailed information about managing hip bursitis, using our drug-free, non-invasive OSMO Patch, visit our Hip Bursitis Treatment page.

Managing Hip Bursitis Swelling and Associated Pain with OSMO Patch

When discomfort around the hip or buttock begins interfering with your work, sleep or everyday activities, finding a practical way to manage the symptoms becomes an understandable priority.

For people experiencing swelling and associated pain from hip bursitis, the OSMO Patch offers a drug-free, non-invasive home treatment option designed to help reduce swelling and associated discomfort.

>> Get OSMO Patch Today for Drug-Free Hip Bursitis Relief →

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How Long Does Ischial Bursitis Take to Heal?

Recovery times vary depending on the severity of the inflammation, how long symptoms have been present and whether the affected area continues to be irritated.

Some people notice improvement within a few weeks after reducing pressure on the bursa and modifying aggravating activities.

However, more persistent cases may take longer, particularly when prolonged sitting or other activities continue placing stress on the affected tissues.

Addressing the underlying cause and gradually returning to normal activities can help support recovery.

 

Frequently Asked Questions About Ischial Bursitis

Where Is Ischial Bursitis Pain Usually Felt?

Ischial bursitis typically causes pain in the lower buttock, close to the sitting bones beneath the pelvis. The discomfort may sometimes extend into the back of the upper thigh.

Why Does Ischial Bursitis Hurt When Sitting?

When you sit, much of your upper-body weight is supported by the sitting bones. This places pressure on the nearby ischial bursa, which can aggravate discomfort when the bursa is inflamed, particularly on hard surfaces.

Can Ischial Bursitis Cause Pain Down the Leg?

Yes. Pain may extend from the lower buttock into the upper part of the back of the thigh. However, pain travelling further down the leg, particularly with numbness or tingling, may suggest nerve involvement or another condition.

Is Ischial Bursitis the Same as Trochanteric Bursitis?

No. Although both are forms of hip bursitis, they affect different areas.

Ischial bursitis generally causes pain around the sitting bones in the lower buttock, while trochanteric bursitis typically causes discomfort around the outside of the hip.

Can Walking Help Ischial Bursitis?

Gentle walking may be comfortable for some people and can help maintain normal movement without prolonged sitting.

However, walking longer distances or climbing stairs may aggravate symptoms in others. It's important to adjust your activity according to your symptoms and medical advice.

Is Heat Good for Ischial Bursitis?

Heat may help relieve muscle tension and stiffness around the affected area, particularly when symptoms are ongoing.

However, heat may be unsuitable immediately following an acute injury or when significant swelling is present.

Can Ischial Bursitis Heal Without Surgery?

Yes. Many cases improve with conservative treatment, including reducing pressure on the affected area, modifying aggravating activities and appropriate rehabilitation.

Surgery is rarely required for uncomplicated ischial bursitis.

Can Ischial Bursitis Be Diagnosed Without an MRI?

Yes. A healthcare professional can often make an initial diagnosis based on your symptoms, medical history and physical examination.

An MRI or ultrasound may be recommended if the diagnosis remains uncertain or other conditions need to be ruled out.

When Should You Seek Medical Attention?

If pain around your lower buttock persists, worsens or significantly affects your ability to sit, walk or perform everyday activities, consult a qualified healthcare professional.

Seek prompt medical attention if you experience severe pain following an injury, significant swelling, redness, fever or new numbness or weakness in your legs.

Medical References

[1] Cleveland Clinic: Ischial Bursitis – Causes, Symptoms and Treatment. Read the Cleveland Clinic medical resource

[2] Johnson DB, Varacallo M: Ischial Bursitis. StatPearls, National Library of Medicine. Read the medical reference