Definition
The iliac crest is one of the bone points of the hip bone that can be palpated from the outside and represents the upper edge of the iliac bone scoops. It serves as a starting point for various ligaments of the hip joint and is located in the immediate vicinity of a variety of structures and organs of the pelvis. Due to these narrow conditions, an exact localization of the pain is therefore very important to distinguish pain of the iliac crest from pain of the pelvic or abdominal cavity.
Causes
Pain in the region of the iliac crest can have a number of possible causes. If the pain emanates directly from the bone, it can be caused by inflammation, injuries resulting from an accident, or wear and tear due to incorrect or excessive strain. In a similar way, the muscles and their tendon attachments can also be damaged, thus causing the pain.
Another possibility are diseases of the internal organs, which can lead to pain transmission to the external structures of the pelvis. An exact diagnosis and localization of the pain is therefore indispensable for complaints in this area. In case of a pelvic obliquity, the pelvis is crooked in its position.
As a consequence, the back tries to compensate for the malposition. Without treatment, the malposition can lead to a (more severe) curvature of the spine, scoliosis, and worsening of the pelvic obliquity. A pelvic obliquity can be asymptomatic at the beginning and can lead to pain in the course of time.
With increasing wear and tear, the pain can become stronger, especially after long periods of standing or sitting. A pelvic obliquity is often accompanied by back pain. Pelvic pain while sitting is often the result of a muscular problem.
Often the muscles are tense or even shortened, which in turn leads to a tilted pelvis. As a result, when sitting, more weight is placed on one side of the pelvis than on the other. This incorrect load finally triggers the pain.
Typical for such tensions as triggers for the pain are the improvement of the complaints under movement as well as under heat treatment or massage. Furthermore, an incipient arthrosis in the hip joint can also be the cause of pelvic pain. A typical symptom of this disease is pain, which occurs especially after lying or sitting for a long time and improves or disappears after a few minutes of movement.
Similar to the complaints caused by jogging, pain that occurs during normal walking can also be the result of incorrect or excessive strain on the muscles attached to the pelvis or the bony structures. Another cause is a more advanced arthrosis in the hip joint. Over time, this often leads to limited mobility in the hip joint.
This also leads to an incorrect loading of the structures mentioned above and, as a consequence, to significant discomfort and pain in the region of the iliac crest. If the pain occurs mainly when jogging, a frequent cause is a pulled muscle. This occurs mainly as a result of incorrect or excessive strain, e.g. too intensive or unusual training.
In order to prevent further damage to the muscles, a doctor should be consulted if such a strain is suspected and the muscles should be spared. Another possible consequence of overloading is the slightest injury to the bone. These can, if there is insufficient time for healing, result in very painful inflammation of the affected bone or periosteum.
If the pain is preceded by trauma, such as a severe fall, larger injuries to the pelvic bone, such as fractures, can also be a possible cause of the pain. If this is suspected, it is best to check this with an X-ray. Unilateral complaints in the region of the iliac crest are usually the result of incorrect posture or incorrect weight bearing.
This can lead to muscular tension or strongly irritate the tendons or the bones at tendon attachment points. These complaints usually improve after sufficient protection. However, a precise analysis of the posture and load on the pelvis when walking is recommended in order to eliminate the causes and prevent the pain from recurring.
A frequent cause of unilateral incorrect loading of the pelvis is, for example, a difference in leg length. This can usually be compensated with a simple measure, such as special insoles in the shoes. As a result, the pelvis is no longer loaded unilaterally but evenly and the complaints decrease.If one unconsciously shifts the weight to the other side by injuring a foot or leg, this can lead to pain on the loaded side in the long run.
At the same time, bad habits (carrying a heavy handbag always over the same shoulder) can also be associated with one-sided pelvic strain. The shift to one side is noticeable in the pelvic and hip area. A permanent one-sided load can lead to a pelvic obliquity.
After removal of bone material from the iliac crest, many patients complain of pain at the removal site. This is due to the fact that the so-called periosteum, which is very sensitive to pain, is injured during the procedure. The pain makes it particularly difficult to walk and get out of bed in the first days after the operation. However, the pain can be reduced well with the usual painkillers, and if the patient is sufficiently relieved, it often subsides significantly after a few days.
