Introduction
The human pelvis consists of the two hip bones (again, each consisting of the ilium, pubic bone and ischium) and the sacrum between them. The sacrum is connected to the two hip bones via the sacroiliac joint (ISG). In addition, the head of the femur in its acetabulum is attached to the hip bone.
The pelvis is anatomically divided into two sections – the great and small pelvis. The large pelvis is the space between the two iliac bone blades, the small pelvis is the area below. However, the pelvis can also cause problems and pain for various reasons.
Often pain in this area cannot be clearly localised. They can be caused by the bony pelvis on the one hand, and by the organs in the large or small pelvis on the other. Possible causes for pelvic pain and their treatment are listed below.
Causes
Pelvic pain can originate from the bony pelvis. The most common cause of bony pain is traumatic events such as bruising or fractures. Fractures occur particularly quickly in the context of osteoporosis, where bone density is reduced.
Elderly people in particular are often affected by osteoporosis and therefore fractures occur quickly when they fall. Very often, pain in the pelvic-gluteal region is a blockage of the sacroiliac joint, which is located on both sides between the hip and sacrum. Slight shifts of the bones against each other or entanglement of the stabilizing ligaments can cause unpleasant pain in this area, which can also radiate over the whole buttocks to the lower back.
Poor posture and congenital malpositioning of the skeleton are also among the most common causes of pelvic pain. A pelvic obliquity, for example due to a difference in length of the legs, can therefore lead to painful tension in the pelvic region. Malignant diseases can also settle in the pelvic bone.
These can be metastases from a tumour, but there are also cancers that develop directly in the bone, such as osteosarcoma or Ewing’s sarcoma. Soft tissue injuries in the buttock or hip area can also radiate and feel as if they originated in the bone. On the other hand, pelvic pain can also radiate from the organs located in the great or small pelvis.
Diseases of the gastro-intestinal tract, the female and male genital organs, the bladder or even mental tension can manifest themselves through pain in the pelvic area. Pelvic pain can also occur during pregnancy, especially when the child grows up and presses on the organs and ligament connections in the pelvic area. Contractions also cause pain in the abdomen, which may not be recognised as such if it is mild.
Pelvic pain on the right
Right-sided pelvic pain can have different causes. For example, a pelvic obliquity can lead to right-sided pain in the pelvic area because the body shifts more weight to one side. This leads to incorrect posture of the entire body and to unpleasant tensions. Bruises, fractures and other obvious injuries can also cause right-sided pelvic pain.
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