I’m a physical therapist – here’s 11 reasons for your bum pain and when to see a doctor


PAIN in the bum is common.

Most of the time it’s harmless and rarely a sign of something serious like anal cancer.

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There are many different reasons as to why you might be experiencing pain in your bumCredit: Getty

It has many different causes, and the NHS says that the type of pain you are experiencing could give you a clue as to where the route of the discomfort lies.

Medics however say that when it comes to this area of the body, you should not self diagnose.

Pelvic physical therapist Amanda Shipley said the pain can sometimes lead to discomfort, inconveniences and stop you from doing everyday activities.

She said that the pain can be perceived in different ways, including as a tightness or a nagging ache.

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“Anus, rectum or tailbone-area pain can be felt as an itching, burning, searing pain or spasm that varies from mild to intense,” she told Huff Post.

Amanda said that talking about issues down below can be embarrassing, and explained what different types of bum pain could be down to.

1. Menstruation

Menstruation can be an uncomfortable time for many people who have periods and the pain in your bum could be down to this.

Dr Jennifer Roelands said that when the uterus contracts to expel menstrual tissue, it can cause adjacent nerves to activate and create pain in what most consider unusual areas.

In turn this can irritate the pelvic floor, causing spasms, leading to severe pain in the pelvis, including the rectum.

2. Fibroids

Fibroids are non-cancerous growths that can develop in or around the uterus.

Larger fibroids can cause bum pain as they press on the rectum or pelvic nerves.

3. Gluteal amnesia

This is also referred to as ‘dead bum syndrome’ and is usually caused by prolonged sitting.

Physical therapist Dallas Reynolds told Huff Post that when we are sat for a long time, our hip flexors get tight, resulting in our glute muscles getting weak and sleepy.

4. Sciatica

This is a condition whereby pain runs along the path of the sciatic and can often get to the glute area.

Dr Reynolds said that doing nerve and mobility exercises will help with this.

5. Proctalgia Fugax

Amanda explained that this is a term, which actually just means painful spasms in the anus and rectum.

She said it may be diagnosed after a careful history and a thorough examination has been performed to rule out more serious causes of rectal pain.

6. Levator Ani Syndrome

The Levator ani sits deep in the pelvic floor and the syndrome refers to when muscles are too tight and you have trouble contracting and relaxing them.

Amanda said that you can find relief from this condition by applying heat or ice to the area.

How to prevent and ease bum pain

If you find yourself in pain, there are some things you can do to relieve i.

The NHS suggests:

  • drink lots of fluid and eat plenty of fibre to keep your poo soft
  • exercise regularly
  • wipe your bottom with damp toilet paper
  • take paracetamol
  • take a warm bath to ease itching and pain
  • put an ice pack (or bag of frozen peas) in a towel on the painful area for up to 20 minutes every 2 to 3 hours

7. Anal abscesses

These are very painful and can be red and tender around the anus and if you have these, you might also present with a fever.

Experts at the American Society of Colon & Rectal Surgeons say you might also experience rectal bleeding and have trouble peeing.

8. Anal fissures

Fissures are small tears around the anus and usually happen if the anal opening is overstretched through passing a stool or sex.

This pain can feel severe, especially when passing bowel movements.

9. Haemorrhoids

Also known as piles, this happens when you get swollen blood vessels just inside your bottom which form lumps.

Doctors aren’t entirely sure why piles happen, but there are certain things that seem to put people at greater risk of getting it.

You may be more likely to get piles if:

  • You are constipated or dehydrated
  • You push too hard when you poo
  • You spend a lot of time sitting and don’t exercise
  • You do a lot of heavy lifting
  • You are pregnant

10. Piriformis Syndrome

Piriformis syndrome occurs when the muscle behind your glutes gets tight and irritated.

This can cause sciatica like symptoms which worsen with prolonged sitting.

11. Bursitis

This condition is mostly associated with overuse or repetitive or strenuous activity.

Experts say that this pain will usually cause discomfort in the glute area and will feel warm, tender and swollen, mostly on the outside part of the hip.

To stop the pain, you should modify the activity that is causing it and focus on pain management.

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The NHS adds that pain can also be caused by constipation.

“Less often, anal pain can be caused by something else like a sexually transmitted infection (STI) or fungal infection. Rarely, it can be a sign of something serious like anal cancer,” experts added.

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