Diagnosing Posterior Hip Pain

Posterior hip (or buttock) pain is a very common complaint in the active community especially with activities such as running or cycling. However, this can turn into quite a challenge to diagnose and ultimately feel better due to the multitude of body sites which cause this pain. Believe it or not, it is NOT just the hip which can cause pain back there! When it comes to posterior hip / buttock pain, there are four primary structures which could be causing your pain:

1.  Lumbar Spine
2.  Sciatic Nerve
3.  Sacroiliac Joint
4.  Hip Muscles

How to screen your body to better understand the source of your pain

It can be very beneficial to have a working knowledge of how to screen your body for each of these sites in order to know where to go next to feel better! Below we will show a brief “screening test” for each body part which can be easily reproduced at home for you to better understand the source of your pain.

Lumbar Spine

To rule in the lumbar spine as a source of your pain you can use the “quadrant test.” This involves standing and sliding your hand down the back of your leg thereby extending, bending, and rotating your back. This should be performed toward the painful side. If this maneuver reproduces your buttock pain, then your spine may the cause of the problem.

Sciatic Nerve

If your buttock pain consists of a burning sensation or tingling especially into the back of the leg than the sciatic nerve could also be in involved. In order to check this, you can utilize the “slump test.” In this test, you would sit with your back rounded (slumped) and head tucked down to your chest. Extend the limb that hurts as far as you can while pulling your foot back toward you. Reproducing of your pain with this maneuver may implicate sciatic nerve involvement.

Sacroiliac Joint

Finally, a less common cause of your buttock pain may be from your sacroiliac joint. This joint can be tested utilizing “Patrick’s Test.” This consists of you placing your ankle on your opposite knee and allowing your knee to relax and fall down toward the table. A positive sacroiliac joint pain test is EXACT reproduction of your buttock pain.

Hip Muscle

Lastly, if none of the above tests are positive, hip muscle is likely to be the culprit. This will commonly be painful when you press into it or stretch your leg into certain angles or positions.

In orthopedics, no one special test is perfect for diagnosing a pathology however the above maneuvers can work as a good jumping off point to figuring out where your pain is coming from! Knowing which body part is potentially the cause can be very helpful in deciding where to ultimately seek treatment and feel better.

Meet Kyle KolkmanN, PT, DPT, OCS

This blog was sourced from orthopedic expert and physical therapist, Kyle Kolkmann from our Ballantyne location. Kyle is a Certified Orthopedic Clinical Specialist (OCS) with the

American Physical Therapy Association.

This information is provided as an educational service and is not intended to serve as medical advice. If you are seeking specific orthopedic advice or assistance, please consult with your OrthoCarolina physician or locate one in your area through OrthoCarolina’s website at www.OrthoCarolina.com.