Buttock pain can be caused by prolonged sitting time, muscle strain, or a sports injury. Often, these are causes of common buttock pain, but it is important to know that in rare cases, persistent or unusual pain in the area can signal something serious. The potential relation of buttock pain and cancer is the initial step for diagnosis and treatment.

Common non-cancer reasons

A majority of buttock pain occurs due to benign musculoskeletal issues. These can be due to:

• Sciatica: Irritation or compression of the sciatic nerve can cause pain, tingling, or numbness down the leg.
• Muscle strain and sprain: Injuries to tendons and gluteal muscles due to overuse or improper lifting.
• Piriformis syndrome: A spasm of the piriformis muscle affects the sciatic nerve.
• Arthritis: It is a degenerative joint disease in the hip or lower back, causing buttock pain.
• Sacroiliac joint dysfunction: The inflammation of the joint that connects the pelvis and lower spine.

Cancer-related causes

Cancer associated with buttock pain is rare. The pain is due to a tumor growth in or near the structures of the pelvis or bones. The cancers causing buttock pain are

• Bone cancer (sarcoma): Tumors in the bones of the pelvis or sacrum can result in deep and continuous pelvic or bone pain.
• Soft tissue sarcoma: Tumors in muscles, fat, or fibrous tissue of the buttocks.
• Pelvic cancers: Cancer of reproductive or urinary organs that has spread to the nearby nerves or bone structures.
• Metastatic cancer: Cancer that has spread from another body part to the pelvic bones.

Warning signs

A strained muscle improves within a few days or weeks, but cancer-related pain has a few characteristic warning signs. The red flags of cancer symptoms resulting from buttock pain that need medical attention are: 

• Continuous or worsening pain: Pain that doesn’t go away with rest, over-the-counter pain relievers, or physical therapy.
• Night pain: Pain that worsens at night and remains unrelieved by changing position.
• Unexplained weight loss: Weight loss without any changes in diet or exercise.
• Swelling or lump: Noticeable lump or swelling in the buttock area.
• Neurological signs: New or increasing numbness, weakness, or loss of bowel and bladder control.
• Systemic signs: fevers, fatigue, or night sweats.

Medical evaluation and screening

Unusual buttock pain with the above signs requires medical evaluation. Doctors take a detailed medical history and physical examination with diagnostic testing. The screening includes:

• Blood tests: Checking markers of inflammation or particular tumor markers.
• Imaging: CT scans, MRI, or X-rays to visualize the bones and soft tissues.
• Biopsy: If imaging shows a tumor, a sample of the tissue can be sent for microscopic examination to confirm the diagnosis.

When should you seek help?

If the pain is mild and improving, monitor it for a week or two. Seek medical help if you notice any of the above red flags, particularly continuous or progressive pain. Many cases of buttock pain are benign, but pay attention to the character and time period of your symptoms. If you notice any persistent pain warning signs, consult a medical professional immediately. They ensure proper diagnosis, whether it is due to a simple strain or, in rare cases, a serious condition that needs intervention.