What Is Ischial Bursitis?

Written by Matt McMillen
Medically Reviewed by Zilpah Sheikh, MD on June 25, 2025
7 min read

Ischial bursitis is a condition that causes pain and inflammation (swelling) in your sit bones. 

“Not everyone describes the pain in the same way, but in general, it’s a deep ache in the buttock,” says Andrew Bach, DO, a physiatrist at Cedars-Sinai Orthopaedics in Los Angeles. “Some people will describe it as a burning type of pain.”

Ischial bursitis isn’t a common condition, but it can affect people of all ages. It often affects people who sit on hard surfaces for long periods, but there are other causes too. Most of the time, it will get better without medical treatment.

Bursitis is the inflammation of bursae. Bursae are small fluid-filled sacs located between your muscles and bones in some areas of your body. Their job is to cushion the space between your muscles, bones, tendons, and joints.‌

Your ischium is the lower part of your hip bone. It includes the ischial tuberosities, otherwise known as your sit bones, which attach to your hamstring muscle. This bears most of your weight when you sit down. Ischial bursitis happens when the bursae that cushion these bones become Bike and inflamed due to irritation.

Ischial bursitis is also known as “weaver’s bottom.” That’s because, years ago, weavers sat on hard seats for most of the day to do their work. In some places, it’s known as “tailor’s bottom.”

Your highest risk of ischial bursitis comes from sitting for too long, especially on a hard surface, says physical therapist Craig Hensley, an associate professor at Northwestern Feinberg School of Medicine in Chicago.

Sitting for a long time, like not getting up from your desk all day, can cause your bursae to become irritated and inflamed. Staying in your seat while on a long flight can also cause ischial bursitis.

You can also get ischial bursitis if you overwork the muscles around your sit bones for too long, too hard, or repeatedly. A very long bike ride, for example, could cause it, as could lots of stair climbing.

Other risk factors include:

  • Driving
  • Canoeing
  • Going for long hikes

Trauma to your backside, such as falling very hard on your bottom, can also cause ischial bursitis. Certain activities, like horseback riding, can also be to blame.

“Horseback riding is something that classically can contribute to ischial bursitis because of the horse kind of hitting your butt over and over as it’s galloping,” Bach says.

Some inflammatory and autoimmune conditions can also cause ischial bursitis. These include:

  • Rheumatoid arthritis
  • Lupus
  • Scleroderma
  • Spondyloarthritis
  • Gout

Rarely, infections such as tuberculosis and septic arthritis can cause ischial bursitis.

Once you have ischial bursitis, certain activities, such as climbing stairs, can worsen your pain.

“If you’re using a lot of your hip extensor muscles, such as your hamstrings and your glutes, that can aggravate your ischial bursitis,” says Hensley.

Who’s at risk for ischial bursitis?

Because repetitive activities or motions cause ischial bursitis, some groups of people are more at risk than others.

They include those who:

  • Bike frequently
  • Run regularly
  • Exercise often or incorrectly
  • Sit for long periods
  • Jump or kick repetitively

Symptoms of ischial bursitis include:

  • Tenderness in your upper thigh and lower buttock
  • Swelling in the lower buttock and hip area
  • Pain when stretching your hip or buttock
  • Pain that gets worse when you sit down
  • Not being able to extend your hip
  • Pain that travels from your buttock down through your leg

Usually, getting a diagnosis for ischial bursitis is a pretty straightforward process. Your doctor will ask you about your symptoms and what types of activities trigger or worsen them. They may also ask you to do specific movements to see if they increase pain or discomfort. These movements often involve your glutes or hamstring muscles, such as bringing your knee toward your chest.

Your doctor might gently press on the area to check for pain or tenderness. “It’s almost always tender when you push on it,” Bach says. “That’s the most important thing.”

Your doctor may feel what’s called a lobulated lesion. This is a bundle of tissue that can be about the size of a peanut or walnut. But these don’t always happen with ischial bursitis.

Your doctor will also try to rule out other possible causes of your discomfort. For example, ischial bursitis can cause pain that radiates down your leg. That kind of pain could also result from a pinched sciatic nerve, which travels from your lower back down each of your legs. Hamstring tendonitis also causes discomfort in the same general area as ischial bursitis.

If your symptoms don’t quite match those of ischial bursitis, imaging tests such as an ultrasound or MRI can paint a clearer picture.

You’ll get a blood test if your doctor thinks an infection could be causing your symptoms.

Most of the time, managing ischial bursitis involves avoiding whatever caused your ischial bursitis. You might need to make some changes to your routine to keep it from getting worse. “If you have bursitis and you don’t make any changes, it’s probably not going to get any better,” says Bach, who often recommends physical therapy to address common causes, such as sitting for long periods or overworking nearby muscles.

In most cases, your priority will be to sit for shorter periods. For people whose jobs involve lots of sitting, Hensley often recommends a standing desk. An inflatable donut-shaped cushion (often called a hemorrhoid cushion) can help too.

Medical treatment for ischial bursitis

More serious ischial bursitis cases could take about six weeks to heal. Your doctor might prescribe prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids to ease the pain and inflammation.

If your pain is serious, your doctor might recommend a corticosteroid shot directly into the inflamed bursa to help with swelling. But it’s usually not the first option. That’s because this spot is near important blood vessels and nerves, and too many shots over time can cause damage. So, doctors use corticosteroid shots carefully.

If they think complications such as infection could be at play, they might order a blood test and prescribe antibiotics.

During the healing process, avoid any activities that worsen your discomfort. For example:

  • Limit stair climbing. Take an elevator where possible.
  • If it hurts when you walk or run, take smaller steps.
  • Stay off your bike.
  • Don’t stretch the muscles around your ischium, such as your hamstrings.

If your ischial bursitis was caused by a fall, you can treat your pain with rest, ice, and over-the-counter anti-inflammatory painkillers. Also, avoid sitting.

Keep in mind that these are only temporary measures. You can go back to your normal activities once your ischial bursitis clears up, which usually takes a week or two.

Complications are rare, but they can happen. The bursae can become infected and could eventually limit your range of motion in the affected bones and other tissues.

Bacterial skin infection (cellulitis) and bacterial joint infection (septic joints) are other possible complications.

You may get bursitis again from time to time. Take care of yourself to avoid pain and any potential complications. Try these tips to prevent discomfort and flare-ups in the future:

Bend your knees when lifting an object. If you keep your legs straight, you can put extra pressure on your hips.

Use cushions to relieve pressure. A cushioned seat or kneeling pad can help keep you comfortable and distribute pressure evenly.

Take breaks. Don’t do one repetitive activity for too long. Space it out and give your body time to rest in between.

Warm-up. Warming up before exercise increases blood flow to your joints and prevents injury.

Ischial bursitis can be uncomfortable, but it often takes only a few weeks to heal if you follow your doctor’s advice. That usually means avoiding sitting for long periods, which is the most common cause of ischial bursitis. You may have to avoid some activities, such as biking and climbing stairs. In the long term, try to sit less. For example, if you usually sit at your desk, use a standing desk. That will help prevent ischial bursitis from coming back.

Here are some commonly asked questions about ischial bursitis. 

What mimics ischial bursitis?

A few conditions can cause symptoms similar to those of ischial bursitis. They include hamstring tendonitis, hamstring tendinopathy, and sciatica.

What’s the difference between sciatica and ischial bursitis?

Sciatica is a painful condition caused by an injury or irritation to your sciatic nerve, which runs from your lower back down both your legs. Ischial bursitis is inflammation or swelling of the bursae (fluid-filled sacs that provide cushioning) around your sit bones, also called ischial tuberosities.

Is walking bad for ischial bursitis?

Usually, walking won’t worsen your ischial bursitis. If you do feel pain while walking, it may help if you take shorter steps.

Does ischial bursitis ever go away?

If you follow your treatment plan, you should feel better within a couple of weeks. More serious cases of ischial bursitis could take about six weeks to heal.

What is the fastest way to cure bursitis?

The fastest way to heal from ischial bursitis is to avoid doing what caused it. This means not sitting for long periods to avoid putting pressure on your inflamed bursae. Your doctor or physical therapist may also tell you to avoid activities that can make your condition worse, such as biking and stair climbing.