Iliac Crest Pain: Guide to Causes Treatment And Precautions


Do you have pain on your right side on the top circle of the hip joint?

Are you unable to sleep on the right side or travel for long hours?

If yes, then you might be suffering from iliac crest pain. (1)

I have grappled with the same pain two years back. It went on days, weeks, months and then, it seemed like it’ll last forever.

I couldn’t afford to wear heels, couldn’t go for a long time shopping and couldn’t roam around in malls. And the reason was my illness.

I have suffered a lot with the same stigma but I don’t want you to suffer. In this article, we will discuss the causes and treatment of Iliac crest pain, and also the necessary precautions that should be taken.

Taking wise advice is always better than fighting with the illness.

Then, Let’s start working!

Do You Want To Know The Reasons Behind Iliac crest Pain? Come With Me, I Will Explain You!

Before I give you any analysis, you should know about your illness in depth.

What actually are you suffering from?

Iliac crest pain is the common illness among the population. It starts with the back pain (2), extending through the hips, thighs, back of the knee to the sole of the foot.

Are you suffering from the same symptom?

If yes, then read further to know more about it and to treat yourself.

Remember: Though it is commonly found in elderly people and athletes that doesn’t mean that younger adults cannot experience this pain.

Iliac Crest Syndrome Symptoms:

Individuals who have Iliac Crest Syndrome may experience pain in the following regions:

  • Lower abdomen
  • Buttocks
  • Groin
  • Down the leg
  • Hip
  • Sacroiliac Joint
  • Lower Back

Causes Behind Iliac Crest Pain:

1. Sacroiliac Joint Dysfunction:

Sacroiliac Joint Dysfunction (3) refers to pain caused by the sacroiliac joint that, this joint connects the iliac bone and sacrum.

Sacroiliac joint pain is thought to occur as a result of hypomobility or hypermobility at the joint.

What causes Sacroiliac Joint Dysfunction?

  • Muscle tightness
  • Pregnancy
  • Trauma
  • Arthritis (4)
  • Difference in leg length


  • Extreme pain in the lower back drawn towards the hip and the lower extremities.
  • The pain gets worse when you sleep on the troubled side.
  • You feel relaxed when you stretch your legs.
  • Intolerable pain on standing for a long time.
  • Pain gets relieved on sitting cross legged.


Hot Fermentation:
  • Hot fermentation is always a good option when there is severe pain.
Remember: Moist heat is always preferred as it penetrates well into the tissues and heels quickly.

How to perform:
Fill a bucket with hot water. Dip the towel in hot water by holding from the sides. Wrung by holding it from the sides, then apply hot to the affected area.

Caution: Don’t give hot fermentation on the swelled region.

Ice Pack
  • Give Ice pack if there is swelling. With the ice pack, the swelling will vanish and pain will be relieved.
Exercise and physical therapy
  • Exercise and physical therapy (5) is the best treatment method because it treats you from the roots.
  • Seek the help of Physiotherapist.

2. Trauma: Hip Pointer Injury

Iliac crest contusion is also known as ‘Hip pointer’ (6). As a result of this injury, the blood vessels get damaged and bleeds into the surrounding tissue.

This causes the skin to turn blue and black in color i.e. leads to bruising.

Causes of Hip pointer:

  • Direct blow in the pelvic area
  • A grave fall at an iliac crest
  • A collision during sport
You Should Know: This is generally not a serious condition. It goes away within some days if adequately treated.


  • Pain, tenderness, and swelling along the iliac crest area.
  • Difficulty in walking, running, and sitting.
  • Pain worsens with long-standing tasks.
  • Difficulty in climbing stairs.
  • Muscle cramps, bruising under the skin, muscle spasm.


  • Your doctor is going to treat you best for this because this condition is a bit complicated one.
  • Painkillers can be taken for immediate relief.
  • Ice packs are also beneficial.
  • Take proper rest.
  • For long term relief, seek the help of your doctor.

3. Piriformis Syndrome

The spasm of the piriformis muscle causes Piriformis syndrome (7). This can also lead to the irritation of the sciatic nerve which will induce a pain similar to that of sciatic pain.

You Should Know: Piriformis muscle: This muscle is situated in the buttock area.


  • Pain at the back of the thigh, calf muscles and foot.
  • Decreased hip joint range of motion.
  • Intense pain after prolonged sitting.
  • Dull pain in the buttock.
  • Pain worsens on climbing stairs.


  • Ice massage is best for treating this illness.
  • Stretching is a boon if you have piriformis syndrome.
  • Electrotherapy also stands beneficial.
  • Physical therapy: Deep massage is beneficial.
  • Regular stretching exercises are best for you.

4. Gluteus Medius Pain

Gluteus muscle (8) attaches to the iliac bone.

Tightness in the muscle can lead to pain and discomfort beneath the iliac crest.


  • The Increase of pressure in the gluteus medius area.
  • Numbness around the gluteus medius area.
  • Reduced range of motion and reduced flexibility of the hip joint.
  • Severe pain.


  • Ice massage when there is severe pain and swelling.
  • Take rest when you feel you can’t bear it anymore.
  • Place pillows below your hip joint while you sleep supine.
  • Keep the cushion in between your legs in side lying position.

5.Iliolumbar syndrome

Iliolumbar ligament (9) is a ligament which extends from the spinal area to the iliac crest region.

This syndrome involves an injury or inflammation of the concerned ligament.

The Cause of Iliolumbar Syndrome:

Repeated twisting and bending motion irritates this ligament and leads to inflammation.


  • Pain in hip, pelvis and the iliac crest area.
  • Lower back pain.
  • Pain gets worse on prolonged sitting and prolonged standing.
  • Pain in the groin or hip area.
  • You can’t even lift your suitcase.


  • Medications
  • Seek the help of physiotherapist to treat this illness.

6. Ilium Apophysitis

Ilium Apophysitis (10) leads to pain and inflammation along the iliac crest.

Abdominal muscles get attached in this region and thus, regular heavy exercise can cause temporary muscle inflammation and weakness.


  • Worsening of pain during sports sessions, exercise etc.
  • Tenderness
  • Swelling
  • Raised temperature in this area.
  • Dull pain around the hip area.
  • Throbbing around the hip area.
  • Swelling at the frontal region of the hip.


  • Rest is best for you, it’s because when you take rest, your muscles get relaxed and you feel better.
  • Ice massage is best to treat swelling, ice massage relieves swelling quickly.
  • Painkillers can be taken to relieve pain. Painkillers will give you momentarily relief.
  • Seek the help of your physiotherapist.

7. Iliotibial band syndrome

The inflammation of Iliotibial band leads to Iliotibial band syndrome (11). This injury is commonly found in runners.

You Should Know: Iliotibial band: It is a ligament that extends down the thigh from the hip to the front of the leg below the knee.


  • Severe pain in the knee joint and around the knee joint.
  • Reduced knee range of motion.
  • Inflammation in the knee joint.
  • Swelling around the knee joint.


  • Ultrasonic therapy is best for you if you are suffering from the syndrome. As ultrasound penetrates well into the tissues and heels well.

Other causes and risk factors

  1. Osteoarthritis.
  2. Arthritis: Juvenile rheumatoid arthritis.
  3. Rheumatoid arthritis.
  4. Septic arthritis.
  5. Psoriatic arthritis.
  6. Dislocation.
  7. Injuries: Bursitis.
  8. Sprains and strains.
  9. Inguinal hernia.
  10. Tendinitis.
  11. Pelvis fracture.
  12. Hip fracture.
  13. Hip labral tear.
  14. Nerve compressions:
    • Meralgia paresthetica.
    • Sciatica.
    • Spinal stenosis.
    • Sacroiliitis.
  15. Metastatic cancer that has reached the bones:
    • Leukemia.
    • Bone cancer.

Other problems:

  1. Osteomyelitis.
  2. Osteoporosis.
  3. Osteomalacia.
  4. Paget’s disease of bone.
  5. Synovitis.
  6. Legg-Calve-Perthes disease.
  7. Avascular necrosis.
  8. Rickets.

Precautions that you need to take if you have iliac crest pain syndrome

You need to follow lots of precautions if you want to treat iliac crest pain.

I know you must have tried every possible method to get rid of this pain, but this time you are gonna meet the miracle.

As it is said, “ Precaution is better than treatment.”

Believe me, if you show your trust in me, you will sit on the edge of the hill but if you don’t, then you are already into the pit of the pain.

(Just trying to convince you! Because I have suffered a lot. Ok! Come with me)

Let’s swim in for more details

  • See your feet: It’s for you ladies! Don’t stand on your toes if you are suffering from iliac crest pain. I mean don’t wear heels, It’s actually not good for you. Wear flat sports shoes with gel soles.
  • Don’t lift it on: Do not lift heavy object when you are suffering from iliac crest pain. It’s because when you lift something heavy, it creates pressure on your hip joint and pain may get worse.
  • No long standing: You have to avoid prolonged standing. As hip is a weight bearing joint and when you stand for a long time, it creates a pressure on hip muscles and hence pain aggravates.
  • Avoid prolonged sitting: Avoid prolonged sitting as prolonged sitting in not a comfortable posture for your body. Avoid prolonged sitting to avoid a backache.

Food that you need to avoid:

  • Limit sugar: Increased sugar levels can lead to some other conditions like insulin disturbance (12). When insulin levels get disturbed, pain gets aggravated. Eat fresh fruits with natural sugars.
  • Less caffeine: Caffeine makes chemical changes in your body, you cannot have appropriate sleep if you consume caffeine because it keeps you awake. Hence, Less rest to the body and brain.
  • Avoid nightshade vegetables: Nightshade vegetables (13) are tomatoes, potatoes, eggplant. These vegetables may aggravate pain. So, it’s better to avoid these.
  • 10 miles away from junk: Yeah! It sounds weird? Yes, you have to stay away from junk as they contribute to weight gain, irritate muscles, disrupt sleep, and compromise your immunity. So, it’s better to avoid them.
  • Say no to additives: Food additives like “Monosodium Glutamate” (MSG) (14) can get troublesome for the patients experiencing extreme pain. MSG is a neurotransmitter and may stimulate pain receptors. Better to say no to them.

Treatment That You Are Looking for to Relieve Iliac Crest Pain

1. Medications: Anti-inflammatory medicines (15) are best to reduce inflammation.

  • NSAIDs, analgesics, and aspirins will help reduce pain and inflammation at the injury site.
  • Surgery may be required in acute cases of injury.
  • OTC drugs such as NSAIDs (Ibuprofen), Acetaminophen (Tylenol) may provide symptomatic relief if the pain is caused due to osteoarthritis and strained tendon or muscle.
Caution: But don’t try them yourself. Consult your doctor.

2. Stretching and regular exercise: Stretching and regular exercises are best for you. Stretching is a boon for patients with iliac crest pain. Perform daily stretching regime from head to toe. It is good for your muscles and maintains tensile strength of your body. Do regular stretching at home.

You Should Know: Cardiovascular exercises will increase blood circulation to your spinal area and body. Thus, in turn, will fasten the healing process in the back.

3. Home treatment: Home treatment can be practiced like Hot water fermentation, Ice massage, Exercises, Massage. Hot fermentation stands best but it should be avoided in a case of swelling. If swelling is there, apply an ice pack.

4. Physiotherapy: Physiotherapy or physical therapy proves really beneficial. Your physiotherapist will give you the perfect treatment regimen. Follow his /her instructions. You will be fine soon. Seek for best physiotherapist around your habitat.

5. Ultrasonic therapy: Ultrasound therapy is also the better one, as ultrasonic waves penetrate into the deeper tissues and heal well. Ultrasonic waves repair torn tissues. It relieves pain.

6. Electrotherapy: Electrotherapy also helps a lot to relieve symptoms like pain, swelling, and tenderness. This may include TENS, IFT, SWD, etc.

Concluding Words

When we start we have to end as well. My aim is to guide you in the right direction. I don’t want you to struggle because I have struggled so much. I used to withdraw my outing plans just because of this pain.

I had a feeling of becoming old though I am young enough!

So, I know how it feels.

But you don’t have to worry much, believe me, if you are going to follow my guidelines, you will feel the difference.

First of all, make a mindset, don’t scroll here and there. Make yourself psychologically strong, don’t think that your illness cannot be treated.

It can be treated but only when you do it sparingly.

Do Meditation, make your mind strong and go through it.

It is just a small battle, you have got to win a long race in life.

Go for it!

I am suffering from pain around the hip area. I have swelling as well. What to do?

If you want to deal with swelling and pain then Ice massage is best for you. Cold fermentation helps treat swelling.

What exercises should I perform to deal with iliac crest pain?

Well, daily stretching is best for you. Perform head to toe stretching exercises.

Can I start gymming? I have iliac crest pain.

No, you cannot even think of the gym. First of all, see your doctor, treat your syndrome, then with the permission of your doctor, go to the gym.

Does electrotherapy help to treat iliac crest pain?

Yes, electrotherapy treats your syndrome well. Ultrasonic therapy is best among electrotherapy. Seek the help of your physiotherapist.


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