Doctors warn sedentary workers may be developing 'dead butt' syndrome linked to back, hip and knee pain

Millions of people who spend most of their workday sitting may have a condition clinicians call gluteal amnesia — colloquially known as "dead butt syndrome" — that can increase pressure on the lower back, legs and joints and raise the risk of painful conditions such as osteoarthritis and sciatica.

Specialists say the condition is caused when the gluteal muscles are used too little and the nervous system stops recruiting them effectively during movement, shifting workload to other muscles and to joints. In many cases the change produces no immediate pain in the buttocks and may remain unnoticed until secondary problems, including knee pain or hip and lower back complaints, develop.

"In recent years, we've seen a real increase in the number of patients suffering with this issue, which might be in large part due to the rise of working from home," said Dr. Jane Konidis, a specialist in physical medicine and rehabilitation at the Mayo Clinic. "Many people spend whole days sitting in front of a laptop, going from one Zoom meeting to the next, meaning they aren't using their glute muscles enough, which can impact the rest of the body."

The three gluteal muscles sit on the outside and back of the hips and serve to stabilise the hip, lift the leg and rotate the thigh. During walking or running they cushion impact, taking pressure off leg muscles and joints. When they are not recruited, other structures take on extra load, potentially leading to tendinopathy or joint degeneration.

Researchers and clinicians frequently link gluteal amnesia to gluteal tendinopathy, a condition in which the tendons on the outside of the hip become irritated or damaged. Studies have estimated that about 15 percent of women and 8 percent of men have gluteal tendinopathy, with occurrence most common between ages 40 and 60.

"The leading causes are a sedentary lifestyle, so sitting for long periods at a desk, or bad posture," said Dr. Chris Seenan, senior lecturer in physiotherapy at the University of Stirling. "Some speculate that the reason more women get this issue is because they are more likely to sit cross-legged, which can put extra strain on the tendons."

Seenan said that when tendons are inflamed the body may instinctively reduce gluteal contraction to protect the tissue, which leaves the legs, feet and ankles to pick up the extra work and can lead to secondary injuries. Konidis and other clinicians add that many people with gluteal amnesia do not feel direct pain in the buttocks and instead present with back or knee pain.

Clinicians recommend a simple at-home check to see whether the glutes are engaging. Stand on one leg while letting the other hang relaxed; feel the glute on the standing side and then switch legs and squeeze the cheek. If the muscle does not tense immediately when squeezed, that can indicate reduced glute activation. Patients may also notice stiffness in the glutes or an achy lower back, especially when bending forward.

Preventive advice centers on keeping the glute muscles active. Konidis recommends standing up briefly every 30 minutes during long periods of sitting to engage the muscles. Seenan advised people to try to keep weight evenly balanced between both legs, noting that habitually leaning on one hip can put extra strain on tendons.

Once weakness or reduced activation is identified, clinicians say a progressive exercise program can strengthen the glutes. Recommended movements include squats, lunges, side planks and single-leg glute bridges, performed with attention to form and gradual progression. Short walks during the day and other regular activity also help maintain muscle recruitment. Authoritative patient resources and exercise instructions are available from the National Health Service and from Versus Arthritis.

Doctors caution that persistent pain, worsening symptoms or concerns about tendon damage should prompt assessment by a health professional. Early recognition and a targeted strengthening and mobility plan can reduce the likelihood of secondary problems such as sciatica or joint degeneration, clinicians say.

As remote work and prolonged sitting remain common for many occupations, clinicians expect gluteal amnesia and related conditions to continue to be a concern for middle-aged and older adults. Keeping movement and muscle use part of the daily routine is the principal recommendation to reduce risk and preserve function.