The iliac crest is the area where arching bones sit on either side of your pelvis. They look somewhat like wings and extend to your hips and lower back. The iliac crest bones are attached to your oblique muscles. Pain in your iliac crest can radiate to other locations, and you may not always be aware that it’s actually iliac crest pain.

The most common type of iliac crest pain is associated with chronic low back pain. You may also have tenderness around the iliac crest. This pain can also feel like hip pain or pelvic pain.

Iliac crest pain can also increase with movement. Movements that might cause or increase iliac crest pain include:

  • raising your leg
  • moving your hips
  • movement of your lumbar spine

Pelvic pain near the iliac crest can have many variables. The pain can be constant or may appear only during certain movements or activities. It can be a sharp or dull pain. This pain can also include your lower back, thighs, or buttocks.

Iliac crest pain can be caused by many factors. This type of pain is common in older adults, people who are active in sports, and people who have chronic lower back pain. Some of the possible causes of iliac crest pain include:

  • iliolumbar ligament inflammation
  • muscles used in movement being weak, including hip flexors, abdominal muscles, low back muscles, and other core muscles
  • iliotibial band weakness or injury
  • piriformis syndrome
  • pregnancy and childbirth
  • sexual activity
  • any injury, medical condition, or activity that puts extra pressure on the pelvic area, including the iliac crest
  • falls or accidents

Some exercises and stretches can be helpful in preventing and treating iliac crest pain. However, you should always talk to your doctor before starting any new exercise routine. This is especially true if you’re pregnant.

Some common exercises that may help prevent or treat iliac crest pain include:

Lunges

To do this exercise:

  1. Stand up straight.
  2. Step one foot forward until your knee is at a 90-degree angle.
  3. Be sure your knee does not extend beyond your toes.
  4. Shift your weight to your heel.
  5. Return to your start position.
  6. Switch sides. Repeat 10 times or as many as is comfortable.

Hip extensions

To do this exercise:

  1. Stand straight while holding onto the back of a chair or another sturdy object.
  2. Raise one leg behind you while keeping your back straight. Hold for a few seconds.
  3. Lower your leg.
  4. Switch sides. Repeat 10 times on each side.

Hip flexor exercises

To do this exercise:

  1. Kneel on one knee with the other leg bent in front, foot planted on the ground.
  2. Push your hips forward with your back straight. Hold for 30 seconds.
  3. Switch sides. Repeat 10 times on each side.

Hip abductions

To do this exercise:

  1. While standing straight, lift one leg slowly to the side.
  2. Hold it briefly, then lower it again.
  3. Switch sides. Repeat 10 times on each side.

When performing these exercises, only do as many repetitions as you feel comfortable doing. Don’t push yourself to the point of pain. You’ll gradually be able to increase your repetitions as you increase your strength. Pushing yourself may cause injury or slow your recovery time.

The treatment options for iliac crest pain vary based on the cause and severity of the pain. Initial treatment at home usually includes some of the following:

  • Rest: Stop activities that increase or cause the pain. This may only be needed for a few days if the cause of pain is minor.
  • Ice: Applying an ice pack to the painful area can help reduce inflammation and ease the pain. Be sure to use a cloth between your skin and the ice pack.
  • Stretching: Once the pain has subsided, gently stretch the muscles surrounding the iliac crest using the exercises above.

If the pain is sudden and severe or continues for more than a few days, you should contact a medical professional. Some possible medical treatment options include:

  • anti-inflammatory medication
  • lidocaine injection
  • physical therapy, especially when the pains is caused by the iliotibial band
  • corticosteroid injection to reduce inflammation when other treatments have not worked

Physical therapy can also correct any issues in your running gait to treat the pain.

It can be difficult to prevent iliac crest pain in some cases, like during pregnancy. However, you can talk to your doctor about stretches and exercises you can start doing to help lessen your chances of iliac crest pain.

If you have sports-induced iliac crest pain, there are some measures that you can take to try to prevent iliac crest pain. Try these tips:

  • Wear good shoes: Replace your running or athletic shoes when they start to show wear.
  • Avoid uneven surfaces: When you run or participate in other sports, be sure that the surface you use is level and in good condition.
  • Increase your muscle strength: Performing exercises that strengthen the muscles surrounding your iliac crest will help protect you from pain and injury.
  • Stretch: Stretching the ligaments and muscles surrounding your iliac crest and pelvis can prevent some injuries and pain.

The main complications of iliac crest pain are pain and a loss of mobility. This may include not being able to participate in your normal athletic activities or exercise routine. However, because a variety of things can cause iliac crest pain, it’s important to seek medical attention if the pain does not clear up after a few days of rest.

With proper treatment, many people have a complete recovery from iliac crest pain due to injury. If you have chronic pain that can’t be quickly resolved, your doctor will discuss treatments to help manage your pain and improve your mobility and quality of life.