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The iliac crest is the most prominent part of the ilium, the largest of the three bones that make up the bony pelvis or hip bone.
It is the curved part at the top of the hop that sits close to the skin and forms the wing-like part of the pelvis on which a person will sometimes rest their hands.
Pain in the iliac crest can also radiate to other areas of the body, including the back, abdomen, and groin. The location where it is felt depends on what is causing the pain.
The hip bone or bony pelvis provides strength, stability, and support for the spine and organs. It is made up of three bones, including the ilium, ischium, and pubis.
The iliac crest is the most prominent part of the ilium, the largest of the three big bones.
As well as dividing the pelvis and the abdomen, the iliac crest is connected to many important muscles. These muscles include:
- the gluteus maximus of the hip itself
- the main abdominals
- the latissimus dorsi or largest muscle in the back
Iliac crest pain tends to make normal movement difficult. The type of pain experienced can vary.
Pain may also be felt in areas other than the hip, as so many muscles and nerves are connected to the pelvis.
Exactly where the pain is felt will depend on its underlying cause, but the most common symptom is lower back pain.
The pain may spread down the leg, through the buttocks, and into the groin. In some people, it can lead to dull aches in the back or buttocks or sharp muscle spams. Others may experience pain when walking, while bending or twisting may make it worse.
Tenderness and swelling can also be signs of iliac crest problems, particularly if caused by trauma.
There are a number of causes of iliac crest pain. These can include:
Strong core muscles are needed to support the joints and to move properly. If the abdominal muscles or lower back muscles are weak, hip pain can occur.
The iliac crest can be damaged during a trauma, such as a fall or a car accident. This can result in tenderness and pain in the hip area, and sometimes in the lower back.
If a serious fall occurs, and the person lands on the front and upper part of the iliac crest, it is called a hip pointer.
Sacroiliac joint dysfunction
Pain in the lower back, abdomen, or groin may be caused by damage to or inflammation of the sacroiliac joint.
This joint, which is in the pelvis and connects the iliac to the lower part of the spine, can be damaged by arthritis, aging, or exercise, such as jogging.
The pain usually starts in one side of the lower back and buttocks and can reach up to the lower hip, groin, and upper thigh.
People may also feel numbness, tingling, or weakness in their leg. The symptoms may get worse when sitting, sleeping, or walking up and down stairs.
An apophysis is a type of growth plate and the point on a bone where muscles are attached. It is the area of bone that the rest of the bone grows from, and so is the last area of bone to fully harden. As such, it is relatively soft in children and teenagers.
If the muscles are repeatedly pulled from the growth plate—during sports, for example—this can cause it to become irritated and inflamed, or it may even be pulled off the bone. The condition will resolve itself once growth has finished, and the bone has fully hardened.
Ilium apophysitis occurs in children and adolescents, is caused by overuse, and results in a dull pain at the front of the hip. The area can sometimes be swollen, is usually tender, and the pain tends to get worse with activity.
Iliac crest pain syndrome, also known as iliolumbar syndrome, occurs when the iliolumbar ligament tears. This can happen if it undergoes repeated twisting or bending motions and actions. It can also result from trauma, such as a car accident or fall.
Common symptoms of iliolumbar syndrome include persistent bouts of severe pain in the lower back that can spread to the hip and groin. This pain may get worse when a person bends or twists.
Piriformis syndrome is usually caused by muscles becoming too tight, often as a result of wear and tear. This puts pressure on the sciatic nerve, causing pain to spread through the hip and buttocks.
This syndrome can also be caused by working out in worn gym shoes, leading to pain in the pelvic region of the body.
Gluteus medius pain
A problem with the gluteus medius muscle can lead to pain near the iliac crest. This can mean reduced blood flow, flexibility, and range of motion, and less nerve and muscle function.
Cancer of the bone
In rare cases, iliac crest pain can be caused by cancer of the bone.
However, in the overwhelming majority of cases of iliac crest pain, the cause will be one of the other conditions that are listed above.
The first step to managing most types of iliac crest pain is RICE, an acronym standing for:
If someone experiences iliac crest pain, they should ensure they rest after activities that put a strain on their lower back or hipbone.
After resting, they should apply ice to the affected area as a compress to reduce inflammation and pain. Ice should be wrapped in a towel and applied for 15 minutes about three times per day.
A person can use a cold compress instead of ice. Cold compresses are available for purchase online.
If possible, wrapping the area in a compression bandage can reduce swelling, as can elevating the injured area above the heart. Compression bandages are available online.
In most cases of iliolumbar syndrome, the best remedy is resting the back. Ice and over-the-counter pain medications can be used to manage pain and swelling. Steroid injections may also be used if the pain is particularly bad.
In cases of ilium apophysitis, if RICE does not ease the pain, a doctor may recommend anti-inflammatory medication.
Some people also find that physical therapy can help with the pain and discomfort from iliac crest pain.
A number of exercises and stretches have been shown to both treat and prevent iliac crest pain.
Hip flexor stretch
- Kneel on one knee with the other bent in front of you and your hands on your hips.
- Keeping your back straight, thrust your hips forward.
- Hold for up to 30 seconds before switching legs.
Hip abduction stretch
- Stand up straight with your hips, knees, and feet pointing forward.
- Lift your left leg out to the side and hold for a few seconds.
- Repeat on the other side.
- Take a big step back, keeping the back heel off the floor.
- Lower yourself until both legs form a 90° angle with the floor.
- Be sure to keep the back straight and make sure your front knee does not move forward past the ankle.
- Repeat as many times as you are able then switch sides.
- Hold on to something at waist height, such as the back of a chair.
- Extend one leg out behind you, keeping your back straight, and hold.
- Repeat on both sides.
People trying these stretches and exercises should only do them as many times as they feel comfortable. Trying to do more than is comfortable can lead to further injury.
It is a good idea to talk to a doctor before starting a new exercise regime.
Wearing good quality shoes while exercising and increasing muscle strength can help prevent iliac crest pain.
Exercises may also help, such as lunges, hip extensions, hip flexor exercises, and hip abductions. These exercises all strengthen the muscles in the iliac crest area.
Most causes of iliac crest pain are treatable by following the RICE procedure and taking over-the-counter pain medications.
If iliac crest pain does not go away with these home treatments, a person should speak to a doctor about other ways to manage the pain.