8 Common Causes of Buttock Pain After Hip Replacement

by Riley Thompson

With around 95% success rate, hip replacement in the USA is a first-rate surgery with positive results. However, in some cases, many individuals experience buttock pain during the recovery phase. Wondering what exactly are the causes of buttock pain after hip replacement surgery? Several factors can contribute to it from weak muscles to improper positioning of joint implants. Understanding those possible causes is important for early management and prevention. This blog will help explore all the contributing factors to buttock pain and how to effectively manage it. 

8 Causes of Buttock Pain After Hip Replacement

The following are the common causes of buttock pain after hip replacement:

1. Muscle Weakness or Imbalance

  • Muscles around the buttocks and hip get weak because of limited movement during the recovery phase.

  • This causes pain or discomfort in the buttocks, especially while standing or walking. 

2. Nerve Irritation or Injury

  • Nerves around the hip (e.g. a sciatic nerve) might get irritated during the surgery or recovery process.

  • This consequently can cause referred nerve pain in the area of the buttock that can even move down the leg.

3. Trochanteric Bursitis

  • This condition is marked by the inflammation of the bursa called the greater trochanter which covers the bony point of the thigh bone.

  • The inflamed bursa leads to pain in the buttocks and outer hip, particularly while moving. 

4. Changes in Gait or Posture

  • Changes in the gait (a person’s way of walking) can occur after the surgery due to altered mobility, reduced pain, or the adaptation of the body to the new hip joint.

  • These adjustments can cause additional strain on the tendons, ligaments, and muscles in the buttocks, causing pain.

5. Infection or Inflammation

  • Although rare, sometimes infections can occur in or around the treated area, putting more pressure on the hip area and thus, causing pain and swelling.

  • Moreover, inflammation in the surrounding tissue or hip joint can also contribute to pain. 

6. Implant-related Complications

  • Research says that improper positioning or even hip implant loosening might also lead to pain or discomfort in the buttock and hip area.

  • Unalignment of the hip implants might put excessive stress on the joints and surrounding muscles, resulting in discomfort or pain.

7. Scar Tissue Formation

  • Scar tissue may form around the treated site that can sometimes limit the movement or press nearby muscles, nerves, or other soft tissues.

  • This can contribute to pain in the hip and buttock which may decrease slowly after the body recovers well. 

8. Excess Physical Therapy Intensity

  • Excessive physical therapy to improve flexibility or strength can also lead to strain or overuse of muscles around the buttocks and hip.

  • This might cause discomfort and pain in the buttocks, particularly when engaging in too many physical activities.

By identifying and addressing all these potential causes with the help of doctors, you can manage and reduce buttock pain post-hip replacement surgery. 

When to See a Doctor?

In case of a buttock pain after the hip replacement, consult the doctor if there is :

  • intense and persistent pain

  • worsening pain despite the physical therapy

  • redness or swelling

  • limited mobility

  • numbness or tingling sensations in the buttocks or leg

  • fever or chills

  • unusual discharge from the surgical site

The healthcare providers look for the underlying causes and personalize the treatment accordingly. 

Treatment Options for Buttock Pain Post Hip Replacement Surgery

Here are the effective treatment options for buttock pain:

Physical Therapy

  • Uses exercises to strengthen the hip flexors, gluteal muscles, and core muscles to reduce strain and improve stability.

  • Aims on mobility & flexibility exercises to increase the range of motion as well as prevent muscle tightness. 

Pain Management

  • Uses pain medications such as acetaminophen or ibuprofen as prescribed by the doctors to relieve inflammation and pain.

  • Apply an ice pack or heating pad to the affected area to temporarily relieve pain and swelling and relax muscles.

Massage and Myofascial Release Therapy

  • Myofascial release or professional massage therapy to improve blood flow and ease muscle tightness.

  • Also, a gentle massage around the buttock and hip area can also prevent muscle tension. 

Nerve Pain Treatment

  • In case sciatic nerve irritation is the cause, the doctors might prescribe medications such as amitriptyline or gabapentin to soothe nerve pain.

  • Nerve mobilization techniques may also help prevent compression and irritation in the sciatic nerve.

Steroid Injections

  • If trochanteric bursitis is present, the providers might suggest corticosteroid injections to relieve pain and reduce swelling.

  • These injections help reduce swelling or inflammation in the surrounding muscles, especially in the piriformis muscle (the common source of buttock pan).

Physical Activity Adjustments

  • Change everyday activities to prevent additional pressure on the buttocks and hips, especially high-intense physical activities that can increase the pain.

  • Use supportive devices such as crutches or walking aids (suggested by the doctor) to avoid strain on the new hip joint.

Gait & Posture Correction

  • Seek help from physical therapists to fix posture or gait issues that can be the contributing factors to buttock pain.

  • This ensures the correct mechanism of the body while walking, sitting, and even standing to reduce further discomfort.

Revision Surgery

  • In cases where the buttock pain continues and shows no response to other treatments, there might be implant-related issues that might be causing pain.

  • The healthcare providers may recommend revision surgery to fix incorrectly positioned or loose hip implants. 

By using these different treatments, the providers can help manage buttock pain and support complete recovery. 

Tips To Manage Hip Pain After Arthroplasty

Though the treatments are beneficial, prevention is also crucial to reduce the further complications:


Carefully follow rehabilitation guidelines (e.g. strengthening and range of motion exercises 3 times per day) to improve flexibility and strengthen muscles. 

Increase daily activity levels slowly to reduce the risk of overstrain on the hip muscle.


Work on proper standing and walking strategies to prevent the chances of strain on the buttocks.

Focus on strengthening core muscles, hip flexors, as well as glutes to avoid muscle imbalances.

Manage a healthy body weight to reduce excessive pressure on the new hip joint and other surrounding muscles.


Lift or move things correctly and cautiously to avoid strain on the muscle or joint.


Return to normal activities gradually to prevent the overloading of joints and muscles of the hip. 

Final Thoughts

Understanding the causes of buttock pain after hip replacement is crucial to managing and preventing the discomfort. If the pain continues and worsens, see a doctor to find out the possible underlying pain-causing factors and the right treatment.

Remember that, a regular follow-up and sticking to rehabilitation guidelines can ease recovery and reduce the risk of persistent buttock pain.

Also Read 8 Causes of Hip Pain

Frequently Asked Questions

Is it normal to have buttock pain after hip replacement?

Yes, it’s normal to experience buttock pain post-surgery as it is a part of the recovery process.

How long does it take for muscles to stop hurting after hip replacement?

It can take around 10-12 weeks to return to normal activities. However, a full recovery will take approximately 6-12 months.

Can you overdo walking after hip replacement?

No, avoid it. Instead, slowly increase the walking distance and duration to avoid additional strain on the new hip joint.

Can hip replacement surgery always reduce pain completely?

No, it’s not a guaranteed solution and hence, patients need to understand the factors impacting its success.

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