Buttock pain is one of the most common yet clinically challenging presentations in musculoskeletal practice. With overlapping contributions from the lumbar spine, sacroiliac joint, hip, proximal hamstring, and peripheral nerves, clinicians are often faced with diagnostic uncertainty and inconsistent treatment outcomes.

This lecture provides a clear, evidence-informed framework to systematically assess and manage buttock pain. Attendees will learn how to move beyond structure-based thinking and instead apply a mechanism-driven approach, integrating load tolerance, neural sensitivity, and movement behaviour into clinical decision-making.

Through a combination of practical demonstration, case-based reasoning, and clinical pearls, this session will equip clinicians with the tools to confidently differentiate between key pain generators including lumbar referral, SIJ dysfunction, hip joint pathology (including FAI and dysplasia), proximal hamstring disorders, deep gluteal syndrome, cluneal nerve entrapment, pudendal neuralgia, and less common conditions such as ischiofemoral impingement.

Learning Outcomes
By the end of this lecture, participants will be able to:

• Apply a structured framework to classify buttock pain
• Differentiate between lumbar, SIJ, hip, tendon, and neural drivers
• Identify red flags and non-mechanical presentations
• Perform a targeted, high-value clinical examination
• Interpret key findings to guide accurate diagnosis and referral
• Implement mechanism-based rehabilitation strategies