ischial bursitis
Bursitis

Ischial Bursitis: Causes, Symptoms, and How to Find Relief

August 5, 2025 /

If you’ve ever felt a deep ache or sharp pain in your buttocks—especially when sitting for long periods—you might be dealing with ischial bursitis. Also known as weaver’s bottom or tailor’s bottom, this condition can be frustrating and painful, but it’s also very treatable once you know what you’re dealing with.

What Is Ischial Bursitis?

The ischial bursa is a small fluid-filled sac that sits between your ischial tuberosity (the bony part of your pelvis you sit on) and the hamstring tendons. Its job is to reduce friction and cushion pressure when you sit. When this bursa becomes inflamed, it leads to ischial bursitis.

Common Causes

Ischial bursitis usually results from:

  • Prolonged sitting on hard surfaces (especially without enough padding)
  • Direct trauma or falls onto the buttocks
  • Repetitive activities like cycling or rowing
  • Overuse injuries from sports or exercise
  • Hamstring strains or tightness, which increase stress on the bursa
  • Poor posture or spinal issues that alter sitting mechanics

Symptoms to Watch For

  • Pain in the lower buttock that may radiate down the back of the thigh
  • Discomfort worsens when sitting, especially on hard surfaces
  • Pain may improve when standing or lying down
  • Tenderness over the ischial tuberosity
  • Possible swelling or warmth in severe cases

How Is It Diagnosed?

Your doctor will often diagnose ischial bursitis through:

  • Physical exam and a review of symptoms
  • Palpation of the ischial tuberosity
  • In some cases, imaging tests like ultrasound or MRI can help rule out other conditions, such as hamstring tears or sciatica

Treatment Options

The good news: most cases of ischial bursitis respond well to conservative care.

1. Rest and Activity Modification

Avoid sitting for long periods or using hard chairs. Take frequent breaks and try using a padded cushion or donut seat.

2. Ice and Anti-Inflammatories

Apply ice packs for 15–20 minutes a few times a day and use over-the-counter NSAIDs (like ibuprofen) to reduce pain and inflammation.

3. Stretching and Strengthening

Tight hamstrings and weak glutes can worsen the problem. A physical therapist can guide you through gentle stretches and core/glute strengthening exercises.

4. Posture and Ergonomics

Improving how you sit, especially with lumbar support and hip alignment, can reduce pressure on the bursa.

5. Injections

If conservative treatments fail, a corticosteroid injection into the bursa can offer significant relief.

6. Surgical Intervention

Very rarely, chronic or severe cases may require surgical removal of the bursa, but this is usually a last resort.

Is It the Same as Sciatica?

Many people confuse ischial bursitis with sciatica, since both can cause buttock pain. However, sciatica typically includes sharp, shooting pain down the leg and may be caused by spinal issues. Ischial bursitis is usually more localized to the sitting bones and triggered by pressure.

Prevention Tips

  • Use cushioned seating if you sit for long hours
  • Take frequent standing or stretching breaks
  • Maintain flexibility in your hamstrings and strength in your hips and glutes
  • Avoid repetitive strain from sports without cross-training or proper form

Bottom Line

Ischial bursitis can be a literal pain in the butt—but it’s one that’s very manageable. By addressing the root causes and making a few lifestyle adjustments, most people experience significant relief. If your symptoms don’t improve, it’s worth seeing a healthcare provider for a personalized treatment plan.