A pinched nerve in your buttocks could cause relatively mild pain like a muscle cramp or a sharp, shooting pain that makes you wince. A doctor can confirm the cause and determine the best treatment.

The pain might be kept completely in your buttocks, but it may also shoot down your legs or into your hips and groin. Either way, the nerve won’t let you forget that something’s not right.

Once a medical professional determines which nerve is under pressure, you can learn how to manage the pain and go about your daily activities.

A likely and common culprit for that nerve pain in your buttocks and legs — along with numbness, tingling or even weakness — is a condition called sciatica. You may develop this pain when part of the sciatic nerve near your spinal canal is pinched.

The most common cause of sciatica is a herniated disc, which is also called a slipped disc.

Your spine comprises a series of individual bones called vertebrae. A rubbery pad called a disc sits between every set of vertebrae. If some of the jelly-like filling of one of those discs pushes through a rip in the outer covering, it’s called a herniated disc.

It can put pressure on nearby nerves and cause weakness, tingling, and pain. If the herniated disc is low enough, it can lead to pain in your buttocks that can shoot down your legs, too.

The chances of experiencing a herniated disc increase as you age, as the discs tend to break down, or degenerate, over time.

A few other conditions can cause sciatica. Here are the most common:

  • Spinal stenosis: This is when your spinal canal gradually narrows, putting pressure on the spinal cord and nerve roots inside. A number of conditions can cause spinal stenosis, including osteoarthritis.
  • Piriformis syndrome: You have a muscle that runs from your lower spine to the top of your femur, which is the large bone in your thigh. If this piriformis muscle pushes down on your sciatic nerve, which traces a path from your spinal cord down your buttocks and the back of each leg, it can cause pain and numbness. This is known as piriformis syndrome.
  • Spondylolisthesis: Spondylolisthesis can cause intense pain. A stress fracture to one of the vertebrae causes it to slip out of its position in the spine. It can press on the sciatic nerve or another nerve at a different level of the spine.
  • Deep gluteal syndrome (DGS): Pain felt deep in the buttocks can be the result of what’s called entrapment of the sciatic nerve in the gluteal space. Your muscles, blood vessels, and skin are pushing on your nerves and causing severe pain, as well as possibly some tingling or numbness.
  • Infection: Inflammation from an infection may impinge a lumbar or sacral nerve root, causing sciatic symptoms.
  • Malignancy: Malignancy is the presence of cancerous cells that have the potential to spread to other parts of the body. These cells can form tumors that can press on a nerve and cause sciatic symptoms.

Sciatica and the associated nerve pain can present with different symptoms, such as:

  • tingling, or a “pins and needles” sensation
  • numbness in your buttocks that may run down the back of your legs
  • weakness in your legs
  • a deep pain in your buttocks
  • pain that radiates down your legs

Some people find that their pain gets worse when they sit, especially for long periods of time. Walking or other types of exercise can exacerbate the pain, too.

You may not be able to tell for certain if the pain in your buttocks is originating in your hip or in your lower back. A nerve that’s gotten pinched in your hip might cause pain in your groin or your leg. So the pain you’re experiencing in your buttocks could have started in another part of your body.

An examination by a medical professional is the best way to determine where the pain is coming from. A doctor may also take imaging tests, such as an MRI scan, to determine which nerve is being pressed.

Pain is your body’s signal to you that something is wrong. Don’t ignore a nagging pain or an intense pain in your buttocks. If the pain is getting worse, or you’re having trouble controlling your legs and feet or even your bowels, contact a medical professional.

Or if you’re unable to go about the activities that you do on a daily basis, see a medical professional. Some type of treatment should be able to help reduce the pain.

If you have cancer and experience these symptoms, seek immediate medical attention.

You’re probably eager to find some relief from the pain that your pinched nerve has been causing you, as well as improve your mobility. The most common first-line treatments include:

  • Heat and ice: Treating pain with heat and cold packs can help relieve nerve pain. Ice tends to help swelling and inflammation, so it may be more effective when the pain is sharp. Once that initial pain ebbs, you can try applying a heat pack to relax the muscles and perhaps reduce the compression on the nerve that’s causing the pain.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter pain relievers, like ibuprofen (Advil), naproxen (Aleve), and aspirin can relieve moderate pain.
  • Muscle relaxants: A doctor might consider prescribing a muscle relaxant medication that relaxes your muscles, such as cyclobenzaprine.
  • Other prescription medications for nerve pain: Doctors sometimes prescribe antidepressants and anticonvulsants to treat symptoms.
  • Physical therapy: Physical therapy is commonly recommended for people experiencing sciatic nerve pain. A physical therapist will work with you and teach you certain exercises that decrease the pressure on the nerve, which should reduce the pain.

If these treatments are not effective, your medical care professional may recommend:

Spinal injections

An epidural steroid injection can address the inflammation of the nerve and the pain that it’s causing you. Your doctor will inject a corticosteroid or a pain medication into the area around your spinal cord.

The anti-inflammatory effects of the steroid will begin working within a couple of days. The injection is more invasive than an oral medication, but its considered relatively safe and effective, with rare side effects.

Surgery

If your symptoms remain or get worse, your doctor may recommend a surgical treatment. The type of surgery will depend on your specific situation, but a couple of common types of surgery include

  • microdiscectomy, which removes fragments of a disc that’s herniated
  • laminectomy, which removes part of the lamina bone that covers the spinal cord, and tissue that may be pushing down on your sciatic nerve

Complementary therapies are another possibility. Consider whether one of these options might be right for you:

Yoga

If you’re looking for a nonmedical, noninvasive way to address your sciatic nerve pain, you might unroll a yoga mat and ease yourself into child’s pose. A 2024 study found that yoga and physical therapy were able to help reduce chronic back pain, and some participants even needed less pain medication.

Acupuncture

Experts sometimes suggest giving acupuncture a try, along with stretching exercises and other treatments, to see if it will relieve pain. A study from 2023 showed that acupuncture could be an effective treatment for nerve pain caused by sciatica and piriformis syndrome.

Massage

You can massage the painful areas yourself, or you can seek a professional massage therapist. There are benefits to both deep tissue and soft tissue massage. A 2023 study suggests that deep tissue massage helps with lower back pain and can be a good option for people who don’t want to take NSAIDs.

Nerve pain in your buttocks can usually be treated. But it’s best to find out what’s causing it so you can address it. Sciatica is a very common cause of pain in the buttocks. But you might want to see a medical professional to rule out other causes.

A medical professional will be able to examine you and find the underlying cause. Then, you can figure out the treatments that will be the most appropriate for you.