Iliac Crest Pain

Iliac Crest Pain

The development of pain in the iliac crest is common in older people, athletes or those that suffer from lower back pain. Iliac crest pain may also be a symptom of inflammation in the iliolumbar ligament. This pain can be felt throughout the hip, lower back or core. Properly addressing this pain as soon as it develops will help to ensure an adequate recovery.

Causes of Iliac Crest Pain
Most who experience iliac crest pain describe this sensation as an aching or bruising feeling that develops along the hips.

Weak Muscles
There are many muscles that attach above and below iliac crest that are essential to movement of the body. The hip flexor muscles as well as back and abdominal or core muscles are all active in this area. If these muscles are weak then running or other repetitive motions can irritate these attachment points and cause pain.

Iliotibial Band Syndrome
The iliotibial band is located along the outer thigh and moves to the outer side of the knee joint. Runners and other athletes will often experience hip pain that is centralized to this area. The iliotibial band is responsible for stabilizing the pelvis, so it can be irritated by an imbalance between legs. Putting too much strain on one side of the body can cause discomfort in this area.

Piriformis Syndrome
Piriformis syndrome is typically caused by the luteal muscles becoming too tight and putting pressure on the sciatic nerve, which can radiate throughout the hip and buttocks as the pelvis is caused additional wear and tear. Working out in worn out shoes, inflexibility, length discrepancies of the legs and muscle imbalances can contribute to this condition.

Iliolumbar Syndrome
Iliac crest pain can often be caused by inflammation of the iliolumbar ligaments.This inflammation can put pressure on the muscles within the pelvis or the lower back.

Gluteus Medius Pain
Aggravation in the gluteus medius can cause pain below the iliac crest which can lead to reduced elasticity, reduced flexibility, reduced range of motion, an increase of pressure, reduce nerve or muscle function or reduced circulation to the area.

Home Remedies for Iliac Crest Pain
Rest
Rest completely for a few days to give your body time to address your symptoms. Gently work your way back into your training schedule to avoid putting too much pressure on the damaged muscles.

Apply Ice
Placing an ice pack on the sore or injured area of the iliac crest every night will help to reduce swelling and this discomfort. Do not apply ice directly to the skin as this can result in damage to these cells.

Gentle Stretch
Gently stretching the core and hip muscles will help you to build strength that will help to prevent injuries in the future. Stretch hamstrings, iliotibial band, hip flexors and quadriceps before each run to make sure the body is ready to take on this workout.

Medical Treatments for Iliac Crest Pain
Anti-inflammatory Medications
You can use anti-inflammatory medications to reduce swelling and limit your discomfort as you begin to treat your iliac crest pain.

Injections
Corticosteroids may be injected into the affected area to help take down inflammation of the iliac crest. This is often provided for those that have had limited success with other treatment methods such as ice, physical therapy and rest.

Physical Therapies
Those that are experiencing pain in the iliotibial band may see the most success with physical therapy. Your doctor may evaluate your running style to determine if you an underlying cause may be contributing to this inflammation. Gait analysis, muscle strength and muscle flexibility tests can be used in order to determine how best to avoid causing such damage in the future.

Preventions for Iliac Crest Pain
Replace Worn-out Shoes
Over time your shoes will wear out and will fail to provide adequate support for the feet. Take the time to replace them with something sturdier that will help to provide the necessary shock absorption and stability for your legs.

Avoid Uneven Road
Avoid constantly running on surfaces that are uneven or in areas that are uphill or downhill as these put excessive pressures on the legs.

Strengthen Muscles
Pain that develops on the side of the iliac crest may be caused by irritation to your core muscles or the tensor fascia. While stretching and applying ice you will need to improve hip and core strength as strength deficits can cause you to develop an abnormal gait. This will cause the hip to drop on your non-weight bearing leg that can Stress the muscles on the affected side of the pelvis.

Additional reference material can be found here:

Iliac Crest Pain

Iliac Crest Pain






Ileum is the largest bone of the pelvic girdle and iliac crest is located on the superior corner (margin) of the ileum. It lies on the upper hip region and it is the place where we rest our hands on the hip. At the anterior side the crest takes the shape of pointed bone which is known as ASIS (anterior superior iliac spine). This curved structure is designed to protect the parts of the pelvic region and is closely attached to the muscles, fascia and aponeurosis present nearby.

The large portion of the iliac crest is found at L4 vertebra and iliac tubercle is found at L5 vertebra. Iliac crest is the region present in the superior edge of the ileum and extends till the superolateral corner of pelvic region. Iliac crest is largely used for bone grafting and spinal fusion. Iliac crest contusion is also known as hip pointer. Top curved region of the pelvis undergo injury and bruise can develop on this bone structure. Since many abdominal muscles are fused in the point of iliac crest any injury on this point would cause severe pain. Hip pointer largely occurs in sports persons when the ball hits the hip region with high impact.

Iliac Crest Pain Causes :

Any forceful blow or direct injury to the iliac crest can cause contusion. Iliac crest contusion occurs due to bleeding of abdominal muscles and swelling. This can cause excruciating pain when the person tries to move his hip region. Bleeding can occur on the periosteum region of the bone resulting in inflammation and the muscles of the iliac crest would develop spasms.

The pain may reduce if the person walks backwards and he should be given rest along with ice compression quickly. If possible the hip region should be covered with foam padding to arrest the movement. Iliac apophysitis is another condition in which the person would develop subtle pain due to chronic irritation. Here the anterior superior iliac spine is largely affected.

Risk Factors :

Sports persons are at high risk of developing iliac crest contusion. Direct blow is quite common in contact sports like hockey and football. Bike accident is another factor that increases the risk of iliac crest contusion. The bone can get damaged when the person hits the ground with force in the hip region.

Iliac Crest Pain Symptoms :

Severe pain in the upper hip region, tenderness, swelling and Bone Bruises are the common signs of iliac crest contusion. Muscle spasms can occur due to inflammation. Normal movement can become difficult due to such injury. Iliolumbar syndrome is a condition that causes inflammation and wear and tear of ligaments of iliac crest. Pain can be felt on the pelvic region, hip and groin also. Bending the body forward and twisting movements can aggravate the pain further.

Diagnosis :

It would be easy for the doctor to diagnose iliac crest contusion based on symptoms. He may request for imaging tests of X-rays or computerized topography scan to know the extent of damage clearly. In case of ossification he may order for radiography tests further.

Iliac Crest Pain Treatment :

Complete rest is the first line treatment for iliac crest contusion. Ice packs can be compressed on the affected hip region to control swelling of muscles. OTC anti-inflammatory medications can be given to manage pain before reaching the clinic. Muscle spasms can be managed by doing mild stretching exercise. Based on the results of the diagnosis and intensity of damage done to the iliac crest, the doctor will decide further course of treatment.

For severe pain, electrical stimulation is given in mild doses to give relief from the symptoms. He may also give a shot of steroid injection directly on the affected bone. The patient should take complete rest and avoid any kind of activities. Giving sports massage is highly effective in reducing swelling. This would also help in preventing the formation of scar tissue and loosen the muscle fibers inside. If required, your doctor would recommend you to physiotherapist. Doing mild stretching exercises and hip pointer exercises would speed up recovery. Complete recovery can take several weeks or even months. It depends on the extent of internal damage and general health of the patient.