Left side lower back pain above the buttocks: causes, treatments, and exercises

People experience all different types of back pain, but many notice that their pain seems concentrated in a specific spot. “About half of the time patients come to me with low back pain, it’s on one specific side,” says Emily Davis, PT, DPT, a physical therapist at Hinge Health. For example, it’s common to feel lower back pain on your left side, right above your buttocks. 

Pain in this area can make everyday activities like sitting, standing, or sleeping more difficult, Dr. Davis notes. But most of the time, lower back pain above the left buttock isn’t related to a serious condition, and it can be managed effectively with simple strategies such as targeted exercises and physical therapy. 

Read on to learn about what might cause lower back pain on the left side above your buttocks, along with tips on how to address it — including exercises recommended by Hinge Health physical therapists.

Causes of left-sided lower back pain above the buttocks 

There are many reasons you might feel pain in your lower back just above your buttocks — especially on one side. Overworked muscles, repetitive movements, nerve irritation, and joint issues can all play a role. Everyday activities, whether physical work, long periods of sitting, or caring for a child, can all contribute. Here are some of the top causes: 

• Muscle imbalances. Lower back pain on one side often results from muscle imbalances that develop over time. “Frequently carrying a child, bag, or other heavy object on one side — or doing repetitive movements or heavy lifting — can strain the muscles on one side of your lower back,” says Dr. Davis. Sedentary jobs can also contribute, especially if you tend to lean or twist to one side while sitting, which increases the risk of discomfort above your buttocks.

• Sciatica or nerve issues. Sciatica is pain and other symptoms caused by irritation of the sciatic nerve, which runs from the base of your spine down each leg. “If the sciatic nerve on your left side is affected, you might feel sharp or aching pain in your lower back, just above the left buttock. Sometimes this pain can travel down your leg, too,” explains Dr. Davis. 

• Disc issues. Changes in the discs between your spinal vertebrae — such as bulging or shifting — can put pressure on nearby nerves. If a disc presses on a nerve on your left side, it can cause pain that radiates from your lower back down into your buttock.

• Sacroiliac joint issues. This condition affects one or both of the sacroiliac joints, where the lower spine meets the pelvis. If one of these joints becomes irritated, it can cause pain on one side of your lower back and buttock. Sacroiliac joint dysfunction accounts for about a quarter of lower back pain cases. “We often see this during pregnancy, due to an expanding belly and hormonal changes that affect the joints,” says Dr. Davis.

• Spinal stenosis. Lower back pain on your left side can sometimes be related to spinal stenosis, which happens when the small joints in your spine (facet joints) become narrower and put pressure on nearby nerves. 

• Referred pain. Conditions and issues like constipation, endometriosis, and kidney stones can cause irritation or inflammation in your body, which may be felt as pain in the lower left side of your back, notes Dr. Davis.

What about back pain on the right side above the buttocks?

Lower back pain on the right side above the buttocks is often caused by the same factors as left-sided pain, including muscle strain, joint irritation, and nerve issues. Sometimes, pain on the right side can also be related to conditions that affect organs on that side, like the appendix or gallbladder. If you suspect pain is coming from an organ, see your primary healthcare provider. 

Daily habits can also create more stress on your right side — such as regularly carrying a bag or child on your right hip. In general, the same strategies for managing left-sided back pain also apply to right-sided discomfort.

Movement is one of the most effective ways to manage and reduce lower back pain, including pain on the side above your buttocks. The above exercises, recommended by Hinge Health physical therapists, are designed to strengthen and stretch the muscles that support your lower back and core. By improving mobility, flexibility, and balance, these movements help relieve tension, address muscle imbalances, and prevent future discomfort. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for left side back pain above buttocks

Treatment for lower back pain on the left side above the buttocks should include staying active and using targeted exercises to address muscle or nerve issues. Other helpful strategies may include using heat or ice, pain-relieving therapies like TENS, and, in some cases, medication or injections. Here are the treatments Hinge Health physical therapists recommend: 

• Targeted exercises and physical therapy. Targeted exercises and physical therapy can help manage lower back pain on the left side above the buttocks. Exercise therapy not only helps reduce pain, but also improves strength, mobility, and flexibility. You can do these exercises at home, or work with a physical therapist who can guide you through movements tailored to your needs. “A physical therapist can develop a personalized exercise plan to address muscle or nerve-related pain, so you can get back moving comfortably,” says Dr. Davis. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Staying active. If you have left-sided back pain above your buttocks, you might be hesitant to move, but staying active is important for recovery. “Movement is medicine. Using your muscles increases blood flow to your tissues to help treat and prevent injury,” says Dr. Davis. Gentle activities like walking, swimming, or yoga can be excellent ways to stay active without putting too much strain on your back. As you start to feel better, you can gradually return to your usual activities.

• Ice or heat. Applying heat often helps relieve left lower back pain above the buttocks, especially if it’s from muscle strain or injury, says Dr. Davis. However, some people find ice more soothing, particularly for reducing inflammation. You can try both and use whichever provides the most relief for your symptoms.

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can perform your targeted exercises and stay active when you have lower back pain above your buttock. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

• Fluids and fiber. Constipation can worsen lower back pain, says Dr. Davis. To help prevent this, aim for about 35 grams of fiber per day from foods like fruits, vegetables, beans, and whole grains. Staying well-hydrated also helps with constipation. Aim to drink half your body weight in ounces of water each day. 

• TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce lower back pain. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

• Steroid injections. In some cases, your healthcare provider may recommend steroid injections to help manage persistent lower back pain. These injections work by reducing inflammation around irritated nerves or joints, providing relief when other treatments haven’t been effective. Steroid injections are usually only considered if pain interferes with your daily activities and other treatments haven’t provided enough relief.

• Consider lifestyle modifications. Factors like sleep, stress, nutrition, and certain activities can all play a role in how you feel. In fact, many people are surprised to learn that pain isn’t just about what’s happening physically — your daily habits and overall well-being can have a real impact, too. Staying curious about how your routines affect your muscles and joints can help you identify where small changes might help reduce pain. For example, you might notice your pain is less noticeable on low-stress days.

When to see a doctor

Lower back pain above your buttocks often improves on its own with conservative treatments. But if your pain is severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. It’s also a good idea to get care if you have:

• Weakness in one or both legs

• Loss of bowel or bladder control 

• Fever 

• Unexplained weight loss

• Pain and weakness in your lower leg

PT tip: Look at the whole picture 

When managing lower back pain on the left side above the buttocks, it’s important to consider your overall lifestyle. Factors like stress, sleep, and nutrition can all play a role in your pain and recovery, explains Dr. Davis. “While these factors may not be the main cause of lower left back pain above the buttocks, they can contribute to it and affect your recovery,” she says. Taking steps to manage stress, improve your sleep habits, and maintain a balanced diet can help support your body’s healing process and reduce pain.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Ferreira, M. L., Katie de Luca, Haile, L. M., Steinmetz, J. D., Culbreth, G. T., Cross, M., Kopec, J. A., Ferreira, P. H., Blyth, F. M., Buchbinder, R., Hartvigsen, J., Wu, A.-M., Saeid Safiri, Woolf, A., Collins, G. S., Ong, K. L., Stein Emil Vollset, Smith, A. E., Cruz, J. A., & Kai Glenn Fukutaki. (2023). Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. The Lancet Rheumatology, 5(6), e316–e329. doi:10.1016/s2665-9913(23)00098-x

2. Wald, A. (2026, February). Patient education: Constipation in adults (Beyond the Basics). UptoDate. Retrieved from https://www.uptodate.com/contents/constipation-in-adults-beyond-the-basics#H5

3. Wang, D.-C., Peng, X.-F., Chen, W.-X., & Yu, M. (2025). The Association of Moisture Intake and Constipation among Us adults: Evidence from NHANES 2005–2010. BMC Public Health, 25(1). doi:10.1186/s12889-025-21346-x

4. Newman, D. P., & Soto, A. T. (2022). Sacroiliac Joint Dysfunction: Diagnosis and Treatment. American Family Physician, 105(3), 239–245. 

5. Chou, R. (2024, August). Patient education: Low back pain in adults (Beyond the Basics). UptoDate. Retrieved from https://www.uptodate.com/contents/low-back-pain-in-adults-beyond-the-basics 

6. Davis, D., & Vasudevan, A. (2020, November 15). Sciatica. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK507908/