Iliac Crest Pain: Causes, Symptoms, and Effective Treatments

What is the Iliac Crest?

The iliac crest is the largest and most prominent part of the ilium, the uppermost bone of your pelvis. It forms the curved, wing-like part of your hip that you can feel just under the skin. The iliac crest serves as an attachment point for several important muscles, including the gluteus maximus, latissimus dorsi, and main abdominals².

Pain in the iliac crest can radiate to the back, abdomen, and groin, depending on the underlying cause¹. The iliac crest provides stability for the spine and organs, and its health is crucial for normal movement and posture.

The front tip of the iliac crest is called the anterior superior iliac spine. The ilium, ischium, and pubis together form the pelvis.

How Does Iliac Crest Pain Feel?

Iliac crest pain can make movement difficult and may present in several ways. The most common symptom is lower back discomfort, but you may also feel:

• Soreness in the buttocks, groin, or down the leg
• Dull or sharp pain
• Muscle spasms
• Pain when walking, bending, or twisting
• Tenderness and swelling if caused by trauma²

Causes of Iliac Crest Pain

Iliac crest pain can result from a variety of causes, including:

Muscle Atrophy

Weak core, lower back, or abdominal muscles can lead to poor support for the iliac crest, resulting in pain and instability. This is a common cause of hip pain.

Trauma

Falls, car accidents, or direct blows can injure the iliac crest, causing tenderness and pain. A “hip pointer” injury occurs when the front and top of the iliac crest are impacted.

Sacroiliac Joint Dysfunction

Dysfunction in the sacroiliac joint, which connects the lower back, belly, and groin, can cause pain that radiates from the buttocks to the lower back, hip, groin, and upper thigh. Arthritis, aging, and repetitive activities like running are common causes³. Gluteus Medius Pain at the iliac crest is also common among runners.

Apophysitis of the Ilium

In children and adolescents, overuse can inflame the growth plate (apophysis) where muscles attach to the ilium. This causes pain, swelling, and tenderness, especially during movement⁴.

Iliolumbar Syndrome

Repeated twisting or trauma can tear the iliolumbar ligament, leading to chronic lower back pain that radiates to the hips and groin.

Piriformis Syndrome

Tightness in the piriformis muscle can compress the sciatic nerve, causing pain in the lower back, hips, and pelvic area⁵.

Gluteus Medius Pain

Dysfunction or injury to the gluteus medius muscle can cause pain around the iliac crest, sometimes affecting blood flow and nerve function⁶.

Bone Cancer

Rarely, bone cancer can cause iliac crest pain. Most cases are due to other, less serious causes.

Treatment of Iliac Crest Pain

Prolotherapy

In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat Iliac Crest Pain.
Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with Iliac Crest Pain.
As prolotherapy is helping to treat the root cause of Iliac Crest Pain, it is deemed to be a permanent fix, preventing the symptoms from returning.

RICE (Rest, Ice, Compression, Elevation)

RICE is the first step for most cases of iliac crest pain. Rest after strenuous activity, apply ice for 15 minutes every 3-4 hours, use compression bandages, and elevate the area to reduce swelling. NSAIDs like ibuprofen can help with pain and inflammation. Physical therapy and regular stretching can strengthen the muscles supporting the pelvis and lower back⁷.

For iliolumbar syndrome, rest, ice, and over-the-counter pain relief are usually effective. Severe cases may require steroid injections. For apophysitis, anti-inflammatory medication may be used if RICE does not help.

Frequently Asked Questions

What can cause pain in the iliac crest?

Common causes include overuse injuries, trauma, childbirth, pregnancy, iliotibial band weakness, piriformis syndrome, sexual activity, and weak core or hip muscles.

What does iliac crest pain feel like?

It often presents as chronic low back pain, hip or pelvic pain, tenderness, or swelling around the iliac crest. Some people experience numbness, tingling, or weakness in the legs.

How should I sleep with iliac crest pain?

Sleeping on your side with a pillow between your legs or under your hips can help keep the hip in alignment and reduce pain.

How do you fix iliac crest pain?

• Rest and avoid aggravating activities
• Apply ice packs and compression
• Use topical ointments or creams
• Exercise and stretch daily
• Elevate the affected area
• Consult a physical therapist

What causes inflammation of the iliac crest?

Inflammation is often due to iliolumbar ligament strain, weak core or hip muscles, or overuse. Iliopsoas bursitis can also cause pain in the hip or groin region.

Where is the iliac crest?

The iliac crest is the uppermost, curved part of the pelvis. Pain often starts in the lower back or hip and can radiate to the thigh or groin.

Contact ProHealth Clinic Today for Your FREE 15-Minute Discovery Call

Don’t let Iliac Crest Pain control your life any longer. Join the thousands of patients who have found lasting relief through prolotherapy at ProHealth Clinic.

Get in Touch

• Phone: +44 1234 380345
• Email: info@prohealthclinic.co.uk

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• London: 104 Harley Street, Marylebone, W1G 7JD
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All clinics offer the same award-winning prolotherapy treatment with convenient appointment times, including evenings and weekends.

Author Bio

Having performed over 10,000 procedures, Mr Eaton is one of the UK’s leading practitioners in the field of treating Iliac Crest Pain, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with Iliac Crest Pain and providing effective treatment options to alleviate them.
He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
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References

1. Heary RF, Schlenk RP, Sacchieri TA, Barone D, Brotea C. Persistent iliac crest donor site pain: independent outcome assessment. Neurosurgery. 2002;50(3):510–7.
2. Eggleton JS, Cunha B. Anatomy, Abdomen and Pelvis, Pelvic Outlet. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2021 Dec 7]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK557602/
3. Kim DH, Rhim R, Li L, Martha J, Swaim BH, Banco RJ, et al. Prospective study of iliac crest bone graft harvest site pain and morbidity. The Spine Journal. 2009;9(11):886–92.
4. Fox IM. Iliac apophysitis in teenage distance runners. Journal of the American Podiatric Medical Association. 1986;76(5):294–6.
5. Parziale JR, Hudgins TH, Fishman LM. The piriformis syndrome. American journal of orthopaedics (Belle Mead, NJ). 1996;25(12):819–23.
6. Shah A, Bordoni B. Anatomy, Bony Pelvis and Lower Limb, Gluteus Medius Muscle. StatPearls [Internet]. 2021;
7. Collee G, Dijkmans BA, Vandenbroucke JP, Cats A. Iliac crest pain syndrome in low back pain. A double-blind, randomized study of local injection therapy. The Journal of rheumatology. DOI 1991;18(7):1060–3.