Why is your butt cheek twitching? (+3 reasons)

In this article, we will discuss physical activities, disease conditions, and neurological conditions that may cause butt twitching.

Why is your butt cheek twitching?

Your butt cheek might be twitching due to involuntary muscular contractions or spasms. The cause of spasms can be your daily activities or an underlying neuromuscular disease. The most common cause of muscle twitching is vigorous exercise.

The cause of butt cheek twitching involves spontaneous depolarization of a single group of nerve cells which results in the synchronized contraction of the muscle fibre. You might also feel a tingling sensation, dull ache, pain, and numbness (1).

Butt cheek twitching is often harmless and goes away on its own when the underlying condition is treated or modified. It is important to consult your physiotherapist if the muscle twitching becomes unbearable.

Which lifestyle activities may cause butt cheek twitching?

Lifestyle, diet, and daily activities might impact the overall health of the patient. The physical and mental activities that might cause butt-cheek twitching include:

• Exercise: Extensive workout sessions may cause butt cheek twitching. Some forms of exercise, like squats, can increase the risk of twitching as compared to others.

Overworked muscle fibres and electrolyte imbalance during exercise can cause muscle twitching and cramping as a result of muscle exhaustion.

• Mineral deficiency: Calcium, Vitamin D, and magnesium deficiencies may cause butt cheek muscle twitching.

These minerals are required to keep the muscles and nerves healthy. Magnesium helps in the transfer of calcium across the cell membrane to provide support to muscles and nerves. Nerve cells need Vitamin D to rally the information from the brain to the muscles.

• Posture: Bad posture, too much pressure on the butt cheek, wallet in the back pocket, and prolonged sitting may lead to muscle spasms and twitching. 
• Stress: Excessive muscle tension may result from psychological stress or anxiety. This may result in muscle twitching, including the gluteal muscles.

Which medical conditions may cause butt cheek twitching?

Some medical conditions may cause butt cheek twitching, including:

• Paravertebral muscle spasm: It is a type of back spasm that might occur due to arthritis or a ruptured spinal disc. 

Lower back pain can either be acute, causing mild butt cheek twitching, or chronic. Chronic paravertebral muscle spasms might produce significant back pain to the point of immobility in the patient.

• Bilateral gluteal dyskinesia: In one of the rare reports, a female patient reported abnormal buttock muscle movement. 

The patient, previously diagnosed with pelvic endometriosis, reported involuntary movement and twitching in the left buttock cheek. The patient was obese, with a medical history of sleep apnea, and gastric bypass surgery (2).

• Myofascial pain syndrome: This can occur due to prolonged sitting, wrong posture, low-level inflammatory processes, or stress.

It is characterized by a local twitch response which might be elicited by rapid compression of the muscle fibres present in the butt cheek. The symptoms can worsen with time if not treated (3).

Which neuromuscular conditions cause butt cheek twitching?

Some neuromuscular diseases may cause butt cheek twitching, including:

• Piriformis muscles syndrome: It is a neuromuscular condition in which the piriformis muscle (located in the buttock region) presses on the sciatic nerve.

Piriformis syndrome causes intense pain, tingling sensation, numbness, and butt cheek twitching. Research suggests that 6-8% of sciatic nerve pain and associated butt cheek twitching is associated with piriformis muscle syndrome (4).

• Benign muscle fasciculation syndrome: It happens when twitching of the gluteal muscle might occur involuntarily.

Bening muscle fasciculation may cause irregular, localized, and temporal twitches of the buttock muscle. It might be triggered by strenuous exercise, stress, and abdominal muscle fasciculation (5).

• Deep gluteal syndrome: It is a non-discogenic sciatic nerve entrapment within the gluteal space. 

Deep gluteal syndrome is characterized by pain, and abnormal sensation in the butt cheeks due to damage of the peripheral nerves. This may cause gluteal muscle spasms and slight buttock twitching (6).

• Spinal cord injury: It may cause twitching, stiffening, and jerking of the butt cheek muscle.

Muscle spasms, or involuntary muscle contractions, may occur in the buttock muscles after a spinal cord injury. Muscle spasticity might cause jerky movements and muscle stiffening.

• Isaac Syndrome: It is an autoimmune peripheral nerve disorder that might cause involuntary butt cheek twitching (7).

How to manage butt cheek twitching?

Butt cheek twitching often goes away on its own. Sometimes it may require interventions by a physiotherapist. Possible treatment regimens include:

• Proper diet: The patient should improve their dietary intake and consume food rich in calcium, and magnesium.
• Sunlight: Sunlight is the best source of Vitamin D.

However, concomitant use of some drugs, such as antidepressants like sertraline, may reduce the level of Vitamin D in the body.

• Stretching: Various stretching exercises, such as unilateral hip medial rotation and forward sprint position can help relieve gluteal muscle twitching and spasm.
• Pain killer: Ibuprofen and naproxen can be administered in case of deep gluteal syndrome. 
• Phenytoin: It can be administered to the patient if the underlying condition causing butt cheek twitching is Isaac syndrome (7).
• Steroid medicine: In case of extreme spasms and twitching caused by piriformis syndrome, steroid injections may be given. This will reduce the inflammation around the nerve.

After a difficult hiking tract, I often feel gluteal muscle pain, and butt cheek twitching. However, the symptoms go away on their own after sometime. It is important to maintain your diet while doing vigorous walking or excercising.

Always consult your physioltherapist if the butt cheek twitching is persistant and compromsing the quality of life. There are various excercises for piriformis syndrome, benign fasciculation syndrome, and other gluteal muscle disorders.

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