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. Pain can occur due to wear, tear, and trauma. Exercises, stretches, and other home remedies may provide relief.
The iliac crest is the curved part at the top of the hip. It forms the wing-like part of the pelvis on which a person will sometimes rest their hands.
Muscles, ligaments, and fascia (a thin casing of connective tissue) attach to the iliac crest, and pain is caused when these are pulled or strained. The pain can also radiate to other body areas, including the back, abdomen, and groin.
This article explores the causes of iliac crest pain, what it feels like, treatments, and exercises that may help to prevent and relieve pain.
The hip bone or bony pelvis provides strength, stability, and support for the spine and organs. It comprises
The iliac crest is the most prominent part of the ilium, the largest of the three big bones.
In addition to dividing the pelvis and the abdomen, the iliac crest connects to many important muscles. These muscles include:
- the gluteal muscles of the hip itself
- the main abdominals
- the latissimus dorsi or largest muscle in the back
Iliac crest pain tends to make movement difficult. The type of pain experienced may vary.
Pain can also be felt in other body areas, as many muscles and nerves are connected to the pelvis. The location of the pain depends on its underlying cause, but the
The pain may spread down the leg, through the buttocks, and groin. It can lead to dull aches in the groin or hip or sharp muscle spasms in some people.
Others may experience pain when walking, while bending or twisting may make it worse.
Tenderness and swelling can also indicate iliac crest problems, particularly if caused by trauma.
There are several causes of iliac crest pain. These can include:
Weak muscles
Strong core muscles are needed to support the joints and to move properly. Hip pain can occur if the abdominal muscles or lower back muscles are weak.
Learn more about exercises to strengthen the core muscles here.
Trauma
Trauma can damage the iliac crest, such as a fall or car accident. This can result in muscle pulling away from the bone, causing tenderness and pain in the hip area and sometimes in the lower back.
This type of injury
Ilium apophysitis
An apophysis is a 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 with rest, improving flexibility, or once growth has finished and the bone has fully hardened.
Iliac apophysitis occurs in children and adolescents. Overuse causes the condition and results in a dull pain in the front of the hip. The area can sometimes swell and is usually tender, and the pain tends to worsen with activity.
Iliolumbar syndrome
Iliac crest pain syndrome, also known as iliolumbar syndrome, occurs when the iliolumbar ligament is inflamed or tears. This can happen if it undergoes repeated twisting or bending motions and actions.
It can also
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.
Gluteus medius pain
A problem with the
This can mean reduced blood flow, flexibility, range of motion, and less nerve and muscle function.
Bone cancer
In rare cases, bone cancer
However, in most cases of iliac crest pain, the cause will be one of the other conditions listed above rather than bone cancer.
Sacroiliac joint dysfunction
Damage or inflammation of the sacroiliac joint can cause pain in the lower back, abdomen, or groin.
This joint sits in the pelvis and connects the iliac to the lower part of the spine. Arthritis, aging, or exercise, such as jogging, can all damage the sacroiliac joint.
The pain usually starts in one side of the lower back and buttocks and
People may also feel numbness, tingling, or weakness in their legs. The symptoms may worsen when sitting, sleeping, or walking up and down stairs.
A person with iliac crest pain will be asked to provide their medical history. If the pain is a result of injury, then details of how the trauma occurred must be specified.
A healthcare professional will then examine the hip area for signs of bruising, swelling, tenderness, and pain.
The first step to managing most types of iliac crest pain is RICE, an acronym standing for:
- rest
- ice
- compression
- elevation
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 20 minutes about three times per day. A person can use a cold compress instead of ice.
Traditionally, elevation can also help with healing but in this instance it is difficult for a person to elevate their back or hip above heart level. Therefore, they should focus on the first three items in the RICE method.
Pain medications available over-the-counter or online, such as acetaminophen and ibuprofen, may also help reduce pain and inflammation.
In most cases of iliolumbar syndrome, the best remedy is resting the back. Ice and over-the-counter (OTC) pain medications
In cases of ilium apophysitis, a doctor may recommend anti-inflammatory medication if RICE does not ease the pain.
Some people also find that physical therapy can help with the pain and discomfort from iliac crest pain.
An orthopedic surgeon may be consulted on rare occasions where a fracture occurs or the pain is continuous and severe.
Although some causes of iliac crest pain cannot be avoided, such as during pregnancy, there are some things a person can do to try and prevent hip pain.
The UK’s National Health Service (NHS) advises people to try the following:
- Maintaining a moderate weight: Keeping a healthy weight will help reduce pressure on the hips.
- Wearing good shoes: Wearing comfortable, shock-absorbing shoes with a soft sole.
- Avoiding strain: Trying to avoid putting too much strain on the hip. It’s always good to keep moving but a person should avoid overdoing it.
- Exercising: Trying gentle hip stretching exercises.
Some risk factors for iliac crest pain include:
- running
- sitting for long periods
- aging
- arthritis
Several exercises and stretches may help to 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.
- Keep your back straight and 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.
Hip extensions
- 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.
Talk with your doctor before starting a new exercise regime.
Why would my iliac crest hurt?
A person’s iliac crest could be hurting due to several reasons, such as:
- muscle weakness
- trauma (like a fall or accident)
- inflammation of the sacroiliac joint
- overuse injuries (like in sports)
- iliolumbar syndrome (tears in the iliolumbar ligament)
- conditions like bone cancer, although this is rare
How do you fix iliac pain?
To alleviate iliac crest pain, a person should rest, use pain relievers as needed, perform physical therapy exercises for strength and flexibility, and, if necessary, consult a healthcare professional for further treatment options.
Why does the top of my pelvis bone hurt?
The top of a person’s pelvis bone may hurt due to issues such as muscle strain, ligament sprain, trauma, inflammation of joints like the sacroiliac joint, or less commonly, conditions like bone cancer.
What is the pain at the top of the hip bone on the side?
The pain at the top of the hip bone on the side typically originates from the iliac crest, which is the prominent ridge of the pelvic bone.
This area can experience discomfort due to various reasons, such as muscle weakness, trauma, or inflammatory conditions affecting the surrounding structures.
Iliac crest pain can stem from a variety of factors, including muscle weakness, trauma, sacroiliac joint dysfunction, growth plate inflammation, ligament tears, muscle issues, and, in rare cases, bone cancer.
Preventing iliac crest pain can be achieved by wearing high quality footwear during exercise and improving muscle strength.
Effective exercises include lunges, hip extensions, hip flexor exercises, and hip abductions, all targeting muscles around the iliac crest.
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.