Upper Glute Pain: What Sits at the Top of the Buttock

Upper glute pain is the ache you feel at the top of the buttock, just under the rim of your pelvis, close to where your back seems to end. Many people assume it is the muscle there and nothing else. But this small patch of the body is crowded, and pain felt here often starts somewhere else.

Here is the key idea in one sentence. The spot that hurts tells you less than what changes it. Sitting, walking, standing on that leg and bending forward each can point toward a different source.

What sits at the top of the buttock

Put your hand on the back of your hip, then slide it up until you feel a bony ridge. That ridge is the top edge of your pelvis, called the iliac crest. Upper glute pain is usually felt just below it. Four things share that area.

The outer glute muscles. The gluteus medius is a fan shaped muscle on the outer surface of the pelvis, just under the rim. It steadies your pelvis each time you stand on one leg. The upper part of the gluteus maximus, the big surface muscle, also begins near here. If you want more on how this muscle behaves, see our guide to glute med pain.

The SI joint. The sacroiliac joint is where the base of the spine, the sacrum, meets each side of the pelvis. It moves only a little, but it carries your weight from the spine to the legs. Many people have a small dimple low on the back, just above the buttock, and the joint lies deep beneath and a little inside it.

The cluneal nerves. These are small nerves that supply the skin of the upper buttock. They come from the low back and cross the rim of the pelvis on the way down. In some people they get squeezed or irritated there. The result can be a burning or sharp patch of pain, sometimes near one spot you can cover with a fingertip. How common this is, and how reliably it can be told apart from other causes, is still debated.

The low back. Joints, discs and nerves in the lower spine can send pain to the buttock. Doctors call this referred pain: the signal comes from one structure, yet you feel it somewhere nearby. It is one reason pain in the upper glute and lower back so often arrive together.

How upper glute muscle pain tends to feel

Muscle pain is usually the easiest to recognise. It is a deep ache or a tender patch in the soft part of the buttock. Pressing on it hurts, and it often flares when the muscle is working. Going up stairs, walking a long way, or standing on the sore leg to put on a sock are the usual moments.

It can also build quietly. Long sitting on a hard seat, or standing with your weight parked on one leg, loads the same muscle for hours. By evening it complains. Many people notice that the pain eases when they change position often, and that gentle walking helps more than long rest.

This may be part of the picture in upper glute pain on one side. We tend to favour one leg without knowing it, and the muscle on that side may simply have more to do.

Upper glute pain, the SI joint and the nerves

The other three sources have their own habits, though they overlap and nobody can sort them out perfectly from a description.

• SI joint. Pain tends to sit lower and closer to the spine, often on one side. It may show up when you turn over in bed, climb out of a car, or stand up after sitting. Standing on one leg can bring it on.
• Cluneal nerves. Pain may be sharp, burning or sore to light touch on the skin. It may sit right along the rim of the pelvis. Bending forward or twisting can make it worse.
• Low back referral. Pain tends to change with spine movements, such as bending forward, arching back or sitting for a long time. It may come with an ache in the back itself, and it may travel a short way into the buttock or thigh.

Two of our neighbouring pages go further. One looks at how to relieve buttock muscle pain, and another covers lower back and glute pain together. If your pain travels down the leg, or your back is stiff in the mornings, see also the causes of sciatic nerve pain and the SI joint in ankylosing spondylitis.

Why not simply name the source? For the large majority of people with low back pain, no single structure can be named as the cause. The WHO reports that about nine in ten cases are non specific (WHO, 2023). Pain felt in the buttock can be part of that picture. So a confident label on the spot alone is rarely reliable. Watching how the pain behaves is more useful.

When upper glute pain needs a clinician

Most aches here are ordinary and change with position. Some are not, and these need someone to look.

A few signs cannot wait, so call emergency services or get to an emergency department for any of them. They are a numb area between your legs or around your bottom, sexual feeling that has changed, difficulty starting to pee, lost control of your bladder or bowels, both legs feeling weak, numb or sore, or one leg that gives way suddenly or loses strength fast. These can mean the nerves at the base of the spine are being squeezed. Do the same if you fall and then cannot put weight on the leg, or after a serious accident.

Get same day medical care if the pain began after a fall or a blow, if you have a fever or feel generally unwell, or if severe pain starts suddenly or gets worse quickly. See a doctor soon if it wakes you at night whatever position you take, if it keeps getting stronger, if you have lost weight without trying, if tingling spreads down a leg, or if buttock pain comes on each time you walk and eases when you stop. Back and buttock pain that began gradually, with long morning stiffness that eases as you move, is worth mentioning too, because a doctor may want to look for an inflammatory cause. Our Feldypedia article on sciatica and nerve related back pain explains the nerve side in more detail.

Clinical care, from a doctor or a physiotherapist, sits alongside everything on this page. Movement methods such as yoga, Pilates or strength training work through a different route, and can be good in their own right.

Sensing the hip and leg that carry you

In the Feldenkrais Method®, we are less interested in naming the exact tissue than in noticing how you use yourself. A sore upper buttock often goes with a habit: one favourite leg, a pelvis that tips, a back that holds still while the hip does all the work. Slow lessons ask you to feel how weight moves through each leg, and where you hold your breath or brace. Feldy offers short audio lessons in that spirit. Our knee proprioception exercises lesson is a gentle place to begin, since it trains the sensing of how your leg and hip carry you.

One thing to notice

Stand at a counter with a hand resting on it. Slowly shift your weight onto the sore side, and then take the other foot a little off the floor. Does the pain appear as the weight arrives, or only once you are fully on that leg? Does it stay, or fade as you settle? Try the other side too. Then notice what else changes it: sitting, a step, a bend. There is nothing to change, and you can stop at any point. This small piece of information can help a clinician narrow down where the pain starts.

Common Questions about upper glute pain (FAQ)

Is it safe to move gently when I have upper glute pain, and who should be careful?

For an ordinary ache that changes with position, slow movement kept well inside comfort is usually fine. Be careful, and get checked first, if the pain began after a fall, if a leg feels weak or numb, if you have a fever, or if the pain wakes you and does not ease in any position. If you lose feeling around your bottom or genitals, cannot pass urine as usual, or lose control of your bladder or bowels, phone emergency services or go to an emergency department.

What is the difference between upper glute muscle pain and SI joint pain?

Muscle pain tends to sit in the soft part of the buttock and feels tender when pressed. It often flares when the muscle works, as when you climb stairs or stand on one leg. SI joint pain is usually felt lower and closer to the dimple just above the buttock, and it often shows up when you turn over in bed or stand up from a chair. The two can overlap, and a clinician can tell them apart far better than you can alone.

Why do I have pain in the upper glute and lower back at the same time?

The two areas share nerves and work as one unit, so a stiff or irritated low back can send pain into the top of the buttock. The reverse can also happen, with a sore buttock making the back guard. Often no serious cause is found for either. If the pain runs down the leg, or the leg feels weak or numb, have it checked.

Why do I get upper glute pain on one side only?

Most of us lean on one side without noticing: a favourite leg to stand on, a bag on one shoulder, a leg crossed the same way each time. That side's glute and pelvis joint may then do more of the work. One sided pain is common, and it does not by itself point to anything serious. It is a reason to be curious about which side you favour.

How long does upper glute pain usually last?

It varies a lot with the cause. A muscle that was worked hard often settles over days to a few weeks. Pain from the SI joint or a nerve can take longer and can come and go. If it has not changed after several weeks, or it keeps getting stronger, it is time to see a clinician and not simply wait.

How is this different from sciatica?

Sciatica is pain that follows the sciatic nerve, usually running from the low back or buttock along the back of the leg, and often bringing tingling or numbness. Upper glute pain mostly stays in the top of the buttock, or travels only a short way. When it does start to run down the leg, treat it as a different story and have it looked at.

When should I see a professional about upper glute pain?

See someone if the ache is still there after a few weeks, disturbs your sleep, arrives with weight loss you cannot explain, or brings tingling that spreads. Get seen the same day if it follows a fall or a blow, or comes with a fever. Numb skin near the genitals or bottom, new difficulty peeing, lost bladder or bowel control, two weak legs, or one leg that suddenly weakens all mean calling emergency services or going to an emergency department.