A deep ache in the buttock that shoots or burns down the back of your leg is often called sciatica. Sometimes the cause is a nerve being irritated in the lower back. Other times, tight muscles deep in the buttock, such as the piriformis, may be adding to the problem.

What is the sciatic nerve?

The sciatic nerve is the largest nerve in the body. It runs from the lower back, through the buttock and down the back of each leg. In most people it passes just underneath the piriformis, a small muscle that helps rotate the hip.

Common signs

• Deep pain in one buttock
• Pain, burning or tingling down the back of the thigh
• Pain that gets worse with sitting, especially on hard seats or when driving
• Tightness when crossing your legs or turning your hip inwards
• Relief when walking or changing position
• Sharp, electric or shooting pain that can travel down the side or front of the lower leg, into the shin or top of the foot

Disc or muscle?

True sciatica is usually caused by a disc or joint in the lower back pressing on a nerve root. Piriformis syndrome, where the muscle may irritate the nerve, is less common and can be hard to tell apart. That's why an assessment matters, and why we'll refer you on if your symptoms point to the spine.

Other muscles can mimic sciatica too. Trigger points in the gluteus minimus can refer pain through the buttock and down the back or side of the leg, sometimes as far as the ankle. Trigger points in the gluteus medius can add to pain in the buttock, lower back and outer hip.

How remedial massage can help

After an assessment of your back, hips and leg movement, treatment may include:

• Releasing the piriformis and other deep hip rotators
• Massage of the gluteals, hamstrings and lower back
• Trigger point therapy for referred buttock and leg pain
• Gentle hip mobility work
• Stretches and advice on sitting, driving and sleeping positions
• Trigger point therapy for the gluteus minimus and gluteus medius
• Dry needling, where appropriate following assessment

Many clients find their buttock and leg pain eases as the surrounding muscles relax. Results vary from person to person, and we'll talk with you about what to expect.

When to see your GP first

See your GP or seek urgent care if leg pain comes with numbness around the groin or buttocks, changes to bladder or bowel control, weakness in your leg or foot, pain in both legs, or follows a fall or accident. Also see your GP if the pain is severe or getting worse.

Related treatments: Trigger Point Release and Dry Needling.