Massage for Hip and Glute Pain (Including Piriformis)

This is general guidance, not medical advice. If you have hip pain after a fall, a hot or swollen joint, or pain with a fever, get medical help first. Your GP's or physiotherapist's advice always comes before anything here.

Hip and buttock pain is often muscular, and massage may help with that part of it. It is most useful for tight, achy glutes and a stiff feeling around the side or back of the hip. It is less useful when the pain comes from inside the joint itself, such as arthritis.

TL;DR: if your pain sits in the buttock or the side of the hip, gets worse after sitting or running, and eases when you move, a remedial or deep tissue massage is a reasonable thing to try alongside exercise. NHS advice says most hip pain improves within two to six weeks. If yours has not eased after two weeks of self-care, see your GP or a physio.

Where your pain sits tells you a lot

"Hip pain" covers several different problems. Where you feel it is the first clue to whether massage is a good fit.

• Deep in the buttock. Often the glute muscles or the piriformis, a small muscle under them. This is the area massage suits best.
• On the outside of the hip. Often the tendons of the glute muscles where they attach to the bony point of your hip. Lying on that side at night usually hurts.
• At the front, in the groin. This is more often the hip joint itself, or a strained hip flexor. Joint pain here needs assessing before massage.
• Pain that runs down the leg. This may be a nerve, not a muscle. Our guide on whether massage helps sciatica covers that pattern in detail.

You do not need to work out the cause yourself. A good therapist will ask where it hurts, what makes it worse and how long it has been going on. If what you describe sounds like more than muscle tension, they should send you to a GP or physio.

Piriformis pain: what it is and what helps

The piriformis runs from the base of your spine to the top of your thigh bone. The sciatic nerve passes right beside it. When the muscle is tight or irritated, it can cause a deep ache in one buttock, and sometimes tingling down the back of the thigh.

People often call this piriformis syndrome. It is worth knowing that doctors still debate how often the muscle is truly the cause. Back problems can produce very similar pain, which is why a proper assessment matters if it keeps coming back.

Where the piriformis is the problem, it tends to feel worse after long periods of sitting, driving or climbing stairs. Massage on the glutes and the piriformis area may ease that tightness for a while. Runners' clubs often suggest weekly sessions while it is bad, then monthly ones to keep it settled.

Massage works best as one part of a plan, not the whole plan. Stretches, strengthening your glutes and changing how long you sit for usually do more over time. The massage just makes those easier to start.

What a hip and glute massage involves

The glutes are big, thick muscles, so the work is often firm. Expect the therapist to use their forearm or elbow on some areas, as hands alone may not reach deep enough.

You will usually lie face down, sometimes on your side. The therapist works through the buttock with a towel covering you, and will check you are comfortable before working there. You can keep your underwear on, and you can say no to any area at any time.

A typical session also covers the muscles around the hip, because they work as a team:

• the lower back, which often tightens up alongside the glutes
• the hip flexors at the front, which get short from sitting
• the outer thigh and the small muscle at the front of the hip
• the hamstrings at the back of the thigh

Some pressure on a tight spot can feel intense, a "good hurt". Sharp pain, or pain that shoots down your leg, is not that. Say so straight away and the therapist should ease off.

Why side-of-hip pain gets gentler treatment

If your pain is on the outside of the hip, deep pressure right on the bony point can make it worse. NHS physio leaflets on this kind of pain focus on exercise and education, and say over 90% of people recover without surgery. Massage on the muscles around it may feel good, but strengthening is what usually settles it.

How many sessions should you expect?

If massage is going to help, you should notice some change within two or three sessions. That might be easier sitting, less stiffness in the morning, or a smaller area of pain.

A common pattern is weekly for two to four weeks while it is sore, then every three to six weeks once it settles. Our guide on how often to get a massage explains how to space sessions out.

If nothing has changed after three sessions, stop booking more of the same. That is a sign the cause is something massage cannot reach, and a physio assessment is a better use of your money.

Between sessions, these help:

• get up and move every 30 to 45 minutes if you sit for work
• use a tennis ball against a wall on the buttock for a minute or two, gently
• try a figure-four stretch, ankle on the opposite knee, holding for 30 seconds
• avoid low chairs and sleeping on the painful side for a while

What it costs, and who to book

In the UK, a 60-minute remedial, sports or deep tissue massage usually costs £45 to £70. London and city centres often run higher. A 30-minute session focused on the hips and glutes alone is often £30 to £45.

For hip and glute pain, look for a therapist with a Level 4 or Level 5 qualification in remedial or sports massage. These courses cover assessment, so the therapist can tell muscle pain from something that needs referring on. If you run or play sport, a sports massage therapist will also understand how training load feeds into it.

When to see a GP or physio instead

NHS advice is to see your GP if hip pain stops you doing normal things, keeps coming back, or has not improved after two weeks of home treatment. Many areas also let you refer yourself to NHS physiotherapy.

Get urgent help from your GP or NHS 111 if you have:

• sudden, severe hip pain with no fall or injury
• a hot, swollen or red hip
• hip pain with a high temperature or feeling generally unwell
• morning stiffness that lasts more than half an hour, especially in other joints too

Go to A&E or call 999 after a serious fall, if your leg looks deformed, or if you cannot move your hip or put weight on it.

Back pain with numbness around your bottom or genitals, or new problems controlling your bladder or bowels, needs A&E straight away. These are signs of a rare but serious nerve problem.

If the pain started in your lower back and spread down, our guide to the best massage for lower back pain is a good next read. When you are ready, search our directory of qualified massage therapists for a remedial or sports therapist near you.