The pelvis is a pair of bones located in the lower back of the spine between the rump (sacrum) and the thigh (femur). It is actually formed by the fusion of three bones called the ilium, ischium, and pubis . During childhood, three parts are separated from each other by cartilage tissue; After the age of 15-16, they fully fuse. The pelvis articulates with the femur and the hip, and the sacrum with the sacroiliac. In the front, the two pelvis bones articulate with each other, called the symphysis pubis. All of these joints have important functions and their disorders due to various reasons can lead to problems such as hip, low back and groin pain. The pelvis transfers the weight of the body to the legs, protects the organs in the groin, and provides support for the muscles to hold on.
The part of the pelvis closest to the skin that can be felt on both sides is called the iliac crest. We usually touch this part while resting our hands on our waist. The crista iliaca is the border between the abdominal cavity and the pelvis, called the pelvis. Abdominal muscles, thigh muscles (gluteus maximus muscle) and latissimus dorsi muscle, which is the largest muscle in our back, attach here. By pelvic pain, people can sometimes refer to pain in the iliac crest. This pain can sometimes be expressed as back pain or hip pain. Pain, spasm, swelling in the lower back, buttocks and hip muscles; It may be accompanied by difficulties in walking, bending and turning the trunk.
Causes of Pelvic Pain
Muscle weakness is one of the common causes of pelvic pain. Strong abdominal muscles are required to support the trunk. If the abdominal and lower back muscles are weak, muscle or ligament damage may occur in an activity such as a reverse movement or carrying a heavy load. Trigger points in the muscles can also cause pain. Although trigger points are mostly known to affect the muscles around the neck and shoulder blades, they can actually occur in any muscle.
Traumas such as falling and traffic accidents can cause injury to the pelvis. As a result of trauma, the iliolumbar ligament that connects the lumbar vertebrae to the pelvis can be torn. Pain that is exacerbated by rotation and bending of the waist may occur. This is called iliolumbar syndrome.
The joint between the pelvis and the sacrum is called the sacroiliac joint. Thus, the spine is connected to the pelvis. Conditions such as rheumatic diseases, calcification, and infection may affect the sacroiliac joint and cause pain and difficulty in movements. Pain may be felt in the buttocks slightly below the waist. It can be right or left unilateral or bilateral. In fact, it is estimated that 15-30% of all low back pain is caused by the sacroiliac joint. This joint makes a small amount of shock absorption and gliding motion. Too flexible or tight ligaments holding the joint and less or more movements than normal can cause a problem called sacroiliac joint dysfunction. Leg length difference, increased flexibility of ligaments during pregnancy and weight gain,
While bone development continues in children and young people, growth cartilages are found in the pelvis. With intense sports or physical activity, the muscles pulling the bone close to the growth cartilage too much can lead to cartilage damage or even separation. This is called ilium apophysitis. Blunt pain, tingling or swelling may occur around the hip and pelvis.
Another problem that can cause pain around the hip and pelvis is piriformis syndrome . Lumbar hernia is often confused with sciatic pain. The piriformis muscle is located deep in the hip. In some people, the sciatic nerve can pass through the muscle. Or the muscle may be too tight and tense.
Rarely, pelvic pain may occur due to a cancer involving the bone. In this case, the pain increases gradually, is not relieved by rest, has little relationship with movement, there may be additional symptoms such as weight loss, night sweats, and fever.
Pelvic Pain Treatment
If you have a complaint of pain around the pelvis, you can be examined by a physical therapy and rehabilitation (FTR) doctor. As we mentioned above, the problem may originate from muscle, bone, ligament, nerve fiber or spine. A preliminary diagnosis is formed in the mind of the doctor by questioning the medical complaints and physical examination. Other possible causes can be excluded and the preliminary diagnosis can be confirmed by examinations such as x-ray film, MRI, and blood examination. Treatment of muscle, connective tissue, sacroiliac joint and spine pain mostly includes exercise and physical therapy methods.