Pain at the top of the pelvic bone is a common experience with various causes. The iliac crest, the upper edge of the ilium, serves as an attachment point for numerous muscles and ligaments.
Muscle and Ligament Strains
Muscle and ligament strains frequently cause pain at the top of the pelvic bone. The iliac crest is a significant attachment site for several core and hip muscles, including the abdominal obliques, hip flexors, latissimus dorsi, and gluteal muscles. Overuse, sudden movements, or poor posture can lead to microscopic tears or overstretching in these muscles, resulting in a strain.
Intense exercise, heavy lifting, or repetitive motions can place excessive stress on these attachments. Pelvic ligaments, such as the iliolumbar and sacroiliac joint ligaments, can also be sprained or inflamed. Symptoms include localized tenderness, pain worsening with movement, and stiffness in the affected area.
Bone and Joint Conditions
Bone and joint conditions can also cause pain at the top of the pelvic bone. Osteitis pubis is an inflammatory condition affecting the pubic symphysis, the joint where the two halves of the pelvis meet at the front. Pain often radiates to the groin, lower abdomen, or inner thigh, and can be aggravated by activities like running, kicking, or climbing stairs.
Stress fractures are tiny cracks in a bone, often occurring in the iliac crest or pubic ramus due to repetitive impact or overuse. These fractures cause a deep, aching pain that worsens with activity and improves with rest. Avulsion fractures, where a tendon or ligament pulls a small piece of bone away, can occur at sites like the anterior superior iliac spine (ASIS) or anterior inferior iliac spine (AIIS). Dysfunction of the sacroiliac (SI) joint, which connects the sacrum to the ilium, can refer pain to the hip, groin, or upper pelvis. Instability or inflammation in this joint can cause persistent or sharp pain.
Causes Related to Pregnancy
Pregnancy can contribute to pain at the top of the pelvic bone due to significant physiological changes. Hormonal shifts, particularly increased relaxin production, cause pelvic ligaments to become more relaxed and stretchy. This prepares the body for childbirth but can lead to increased joint mobility and instability, resulting in discomfort.
Round ligament pain is often felt as sharp, stabbing, or aching pain in the lower abdomen or groin, sometimes extending toward the top of the pelvic bone. This occurs as the round ligaments, which support the growing uterus, stretch and sometimes spasm, especially with sudden movements like coughing or turning. Pelvic Girdle Pain (PGP) involves pain and instability in the pelvic joints, particularly the pubic symphysis and sacroiliac joints. PGP can cause pain over the pubic bone, lower back, hips, and sometimes radiate to the thighs, often worsening with activities like walking, climbing stairs, or turning in bed.
When to Consult a Doctor
While many instances of pelvic bone pain resolve with rest and self-care, certain signs indicate the need for medical attention. It is advisable to consult a doctor if the pain is severe, sudden in onset, or rapidly worsening. Seek professional advice if the pain is accompanied by other concerning symptoms such as fever, chills, or unexplained weight loss.
Medical evaluation is warranted if the pain follows a significant injury or trauma. If the pain interferes with daily activities or sleep, or if it does not improve with rest and self-care within a few days to a week, a doctor should be consulted. Any pelvic pain combined with numbness, tingling, or weakness in the legs also requires prompt medical assessment.