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Published on: 2/28/2026

Persistent Glute Pain? Why Your Glutes Are Failing & Medically Approved Next Steps

Persistent glute pain usually means your glutes are weak, irritated, or not firing properly due to issues like gluteal tendinopathy, prolonged sitting, piriformis irritation, SI joint dysfunction, sciatica, or muscle strain; most people improve with targeted strengthening, better daily movement habits, strategic heat or ice and appropriate medications, and guidance from a physical therapist with a gradual return to activity.

There are several factors to consider, including red flags that require urgent care; see below for specific exercises to start, what to pause, recovery timelines, and when to seek imaging, injections, or a medical evaluation so you can choose the right next steps.

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Explanation

Persistent Glute Pain? Why Your Glutes Are Failing & Medically Approved Next Steps

Persistent glute pain is more common than most people realize. If your glutes ache when you sit, feel weak when you walk, or burn during workouts, your body is trying to tell you something.

The glutes — made up of the gluteus maximus, gluteus medius, and gluteus minimus — are the largest and most powerful muscles in your body. They stabilize your hips, protect your lower back, and help you stand, walk, climb stairs, and lift objects. When your glutes "fail" (become weak, tight, inflamed, or injured), other muscles compensate. That compensation often leads to ongoing pain.

Let's break down why this happens and what medically approved steps can help.


What Does "Glute Failure" Really Mean?

"Glute failure" doesn't mean your muscles have stopped working entirely. It usually refers to:

  • Glute weakness (poor activation or underuse)
  • Muscle imbalance
  • Tendon irritation (tendinopathy)
  • Nerve irritation
  • Joint dysfunction in the hip or sacroiliac (SI) joint

When glutes don't fire properly, the lower back, hamstrings, or hip flexors take over. Over time, this overload leads to pain.


Common Causes of Persistent Glute Pain

1. Gluteal Tendinopathy (Very Common)

This occurs when the tendons connecting the glute muscles to the hip become irritated or degenerate from overuse. It's especially common in:

  • Women over 40
  • Runners
  • People who sit for long periods
  • Individuals with hip weakness

Symptoms:

  • Pain on the outside of the hip or deep in the glutes
  • Pain when lying on one side
  • Pain climbing stairs

2. Prolonged Sitting ("Dead Butt Syndrome")

Long hours sitting can inhibit glute activation. When you stand up, your glutes may not fire properly, leading to:

  • Tight hip flexors
  • Lower back strain
  • Aching glutes after activity

This is sometimes called gluteal amnesia.


3. Piriformis Syndrome

The piriformis is a small muscle deep in the glutes. If it tightens or spasms, it can irritate the sciatic nerve.

Symptoms:

  • Deep buttock pain
  • Tingling or numbness down the leg
  • Pain sitting for long periods

4. Sciatica (Nerve Compression)

If a spinal disc or bone compresses a nerve in your lower back, you may feel pain in your glutes.

Symptoms:

  • Sharp or shooting pain
  • Pain radiating down one leg
  • Weakness or numbness

5. Sacroiliac (SI) Joint Dysfunction

The SI joints connect your spine to your pelvis. When irritated, they can cause pain in one side of the glutes.


6. Muscle Strain

Overstretching or overloading your glutes during exercise can cause tears in muscle fibers.


Why Your Glutes Might Be "Failing"

Persistent glute pain usually comes down to one or more of these factors:

  • Weak gluteus medius (leads to hip instability)
  • Poor posture
  • Improper exercise form
  • Overtraining without recovery
  • Sudden increase in activity
  • Age-related tendon changes

If the underlying issue isn't addressed, pain can become chronic.


When Glute Pain Is More Serious

Most glute pain is musculoskeletal. However, you should seek urgent medical care immediately if you experience:

  • Loss of bladder or bowel control
  • Severe leg weakness
  • Fever with back or glute pain
  • History of cancer with new buttock pain
  • Recent major trauma

These could signal serious conditions like nerve compression emergencies or infection.

If you're unsure what's causing your pain, try using a free AI-powered Buttock pain symptom checker to get personalized insights into possible causes and help you have a more informed conversation with your healthcare provider.


Medically Approved Next Steps

The good news: Most persistent glute pain improves with proper care.

1. Stop Aggravating Activities (Temporarily)

Avoid:

  • Sitting for long stretches without breaks
  • Crossing legs
  • Sleeping on the painful side
  • Deep stretching if tendons are irritated

Pain is a signal. Don't push through it.


2. Start Targeted Glute Strengthening

Research consistently supports progressive strengthening as the first-line treatment for glute-related pain.

Focus on:

  • Clamshells
  • Side-lying leg lifts
  • Glute bridges
  • Monster walks with resistance bands
  • Step-ups

Key tip: Quality matters more than intensity. Slow, controlled movements help retrain activation.


3. Improve Daily Movement Habits

Small adjustments can make a big difference:

  • Stand up every 30–60 minutes
  • Keep feet flat and hips level when sitting
  • Avoid leaning to one side
  • Use supportive footwear

4. Consider Physical Therapy

A licensed physical therapist can:

  • Identify muscle imbalances
  • Assess gait and posture
  • Create a progressive strengthening plan
  • Use manual therapy when appropriate

Physical therapy is often more effective than rest alone.


5. Use Pain Relief Strategically

Short-term options may include:

  • Ice (for acute irritation)
  • Heat (for stiffness)
  • Over-the-counter anti-inflammatory medications (if medically appropriate)

Always speak to a healthcare provider before starting medication, especially if you have other health conditions.


6. Address Core and Hip Stability

Weak core muscles can overload the glutes. Incorporate:

  • Planks
  • Side planks
  • Bird dogs
  • Dead bugs

Balanced strength reduces recurrence.


7. Gradual Return to Activity

If you're a runner or athlete:

  • Reduce mileage temporarily
  • Avoid hills during flare-ups
  • Cross-train with low-impact activities (cycling, swimming)

Return gradually to avoid re-injury.


How Long Does Recovery Take?

Recovery depends on the cause:

  • Mild muscle strain: 2–6 weeks
  • Gluteal tendinopathy: 6–12 weeks
  • Chronic weakness patterns: several months of retraining

Consistency matters more than intensity.


What If Pain Doesn't Improve?

If pain persists beyond a few weeks despite conservative care, speak to a doctor. They may recommend:

  • Imaging (X-ray or MRI)
  • Prescription-strength anti-inflammatory medication
  • Corticosteroid injection (in selected cases)
  • Further evaluation for nerve compression

Persistent glute pain should not be ignored, especially if it interferes with walking, sleeping, or daily function.


The Bottom Line

Persistent glute pain usually means your glutes are weak, overloaded, or not firing correctly. The solution is rarely total rest. Instead, recovery typically requires:

  • Targeted strengthening
  • Better movement habits
  • Gradual activity progression
  • Professional guidance when needed

Don't panic — but don't ignore it either.

If you're unsure what's driving your symptoms, start with a free AI-powered Buttock pain symptom checker and then speak to a doctor to rule out anything serious or life-threatening. Early evaluation prevents small problems from becoming chronic ones.

Your glutes are powerful muscles. With the right approach, they can recover — and come back stronger.

(References)

  • * Fearon AM, Cook J, Scarvell JM, Smith PN. Greater Trochanteric Pain Syndrome: A Review of the Current Literature. PM&R. 2021 Jan;13(1):92-102. doi: 10.1002/pmrj.12458. Epub 2020 Oct 17. PMID: 33068989.

  • * Allison K, Vicenzino B, Grimaldi A. Gluteal tendinopathy: a narrative review of the pathology and management. Phys Ther Sport. 2021 Mar;48:119-127. doi: 10.1016/j.ptsp.2020.10.009. Epub 2020 Oct 26. PMID: 33139366.

  • * Cacchio A, Saraceni VM, Toselli F, De Filippis L, Foti C, Tarantino U. Abductor Tendinopathy of the Hip: A Clinical Review. J Sports Med Phys Fitness. 2018 Dec;58(12):1897-1906. doi: 10.3390/jcm10122718. Epub 2018 Oct 3. PMID: 30282662.

  • * Hicks BL, Varacallo M. Piriformis Syndrome. 2022 Jul 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 33649911.

  • * Coombes BK, Vicenzino B, Mellor R, Kelly BT, Grimaldi A. Greater Trochanteric Pain Syndrome: Management and Practical Tips. Curr Sports Med Rep. 2021 Aug 1;20(8):411-419. doi: 10.1249/JSR.0000000000000858. PMID: 34335440.

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