Iliac Crest Pain Syndrome and Integrative Care: Understanding Causes and Treatments

Introduction

Chronic low back pain affects millions of people worldwide and is one of the most common reasons for seeking medical attention. Among the many causes of back pain is a lesser-known but significant condition called iliac crest pain syndrome (ICPS). This syndrome originates from the iliac crest—the top border of the pelvic bone—and often involves injury to the iliolumbar ligament, which stabilizes the connection between the lumbar spine and the pelvis. Pain in this region can radiate to the hips, abdomen, or thighs, making daily activities such as walking, lifting, or even sitting uncomfortable.

Back muscle spasms can worsen iliac crest pain by creating imbalances, instability, or further strain on nearby ligaments. Over time, this can lead to a cycle of pain and dysfunction that requires more than just pain medication to manage.

Chiropractic care, combined with integrative therapies such as massage, acupuncture, and targeted exercise, offers an effective approach to managing and relieving iliac crest pain syndrome. This article will break down the condition, its causes, and how comprehensive treatment can help individuals return to optimal function while preventing long-term complications.

What Is Iliac Crest Pain Syndrome?

The iliac crest is the curved ridge at the top of the pelvis that many people can feel when placing their hands on their hips. Iliac crest pain syndrome occurs when there is irritation or injury around this area, often linked to problems with the iliolumbar ligament. The iliolumbar ligament plays a key role in stabilizing the lower back, connecting the spine to the pelvis. When it becomes strained or damaged, chronic pain can develop along the iliac crest, sometimes radiating into the buttocks or groin 【Verywell Health, 2023†source】.

Many cases of iliac crest pain are related to overuse injuries, poor posture, repetitive lifting, or trauma. Athletes, workers with physically demanding jobs, and individuals recovering from motor vehicle accidents are especially at risk 【Medical News Today, 2018†source】.

Causes of Iliac Crest Pain

There are several underlying factors that contribute to iliac crest pain syndrome:

Iliolumbar ligament strain or tear – Injuries to this ligament can destabilize the spine-pelvis connection 【Physio-Pedia, 2024†source】.
Back muscle spasms – Tightening of the quadratus lumborum or surrounding muscles can pull unevenly on the pelvis, worsening pain 【PMC, 2024†source】.
Sacroiliac joint dysfunction – Misalignment or irritation of the SI joint can cause pain that radiates along the iliac crest 【Spinal Backrack, 2023†source】.
Overuse or repetitive strain – Lifting, twisting, or poor ergonomics can cause chronic stress on the ligament and surrounding structures 【WebMD, 2022†source】.
Pregnancy and childbirth – Hormonal changes and pelvic stress can increase susceptibility to iliac crest pain 【WebMD, 2022†source】.

Patients often report tenderness when pressure is applied along the iliac crest, especially near the posterior iliac spine. This symptom is one of the hallmarks of ICPS 【Aesthetics and Medical Lasers, 2023†source】.

The Role of Back Muscle Spasms

Muscle spasms in the lumbar spine and hips often accompany iliac crest pain. Spasms are involuntary contractions of muscles that can be triggered by injury, poor posture, or nerve irritation. In ICPS, spasms of the quadratus lumborum or surrounding muscles may:

Pull the pelvis out of alignment
Cause instability in the lower spine
Increase strain on the iliolumbar ligament
Create radiating pain into the hips, thighs, or abdomen

Studies suggest that muscle spasms not only contribute to pain but may also signal underlying spinal instability 【PMC, 2024†source】. These spasms can perpetuate the pain cycle if left untreated.

How Chiropractic Care Helps with Iliac Crest Pain

Chiropractic care is one of the most effective approaches for addressing iliac crest pain syndrome because it directly targets spinal and pelvic alignment. Chiropractors use specific adjustments to restore mobility in the lumbar spine and sacroiliac joint, reduce ligament strain, and improve overall biomechanics.

Benefits of Chiropractic Care:

Improved joint alignment – Correcting misalignments reduces pressure on the iliolumbar ligament 【Miami Chiropractors, 2023†source】.
Reduced muscle spasms – Adjustments calm overactive muscles, decreasing pain and stiffness 【Precision Pain Care, 2023†source】.
Enhanced range of motion – Patients often report greater mobility in the hips and lower back 【Miami Chiropractors, 2023†source】.
Stabilization of the SI joint – Adjustments can relieve sacroiliitis-related pain 【Gonstead Chiropractic Center, 2023†source】.

By restoring proper function, chiropractic treatment not only addresses current pain but also prevents future flare-ups 【Binns Family Chiropractic, 2023†source】.

Integrative Approaches for Iliac Crest Pain

A single treatment is rarely enough for chronic iliac crest pain. This is where integrative medicine—the combination of multiple evidence-based therapies—comes in.

Massage Therapy

Massage helps reduce muscle tension, break up scar tissue, and improve circulation in the lower back and hips. This relaxation decreases pressure on the iliolumbar ligament and supports spinal stability.

Acupuncture

Research shows acupuncture may relieve SI joint and iliac crest pain by stimulating nerve pathways, reducing inflammation, and promoting healing 【Healthline, 2023†source】.

Targeted Exercise

Physical therapy and chiropractic-guided exercise focus on strengthening the core, gluteal, and back muscles, which support the pelvis and spine. These exercises reduce the likelihood of recurrent spasms 【Spinal Backrack, 2023†source】.

Complementary Therapies

Techniques such as prolotherapy and TENS (transcutaneous electrical nerve stimulation) can also play a role in managing stubborn iliac crest pain 【Dr. Justin Dean, 2023†source】.

Dr. Alexander Jimenez’s Clinical Insights

Dr. Alexander Jimenez, DC, APRN, FNP-BC, is a chiropractor and nurse practitioner in El Paso, Texas, who specializes in treating patients with work injuries, sports trauma, personal injuries, and motor vehicle accidents. His dual-scope practice allows him to diagnose conditions both from a chiropractic and medical perspective.

Diagnostic Approach

Dr. Jimenez emphasizes the importance of advanced imaging and functional assessments. These tools help identify not only ligament or joint injuries but also subtle biomechanical imbalances that contribute to iliac crest pain 【Dr. Alex Jimenez, 2025†source】.

Dual-Scope Skills

What sets Dr. Jimenez apart is his ability to:

Provide chiropractic adjustments to restore function
Order imaging studies to confirm ligament or disc damage
Develop rehabilitation plans combining exercise, massage, and integrative care
Handle medical-legal paperwork in personal injury cases, ensuring proper documentation for patients navigating both health and legal systems 【LinkedIn – Dr. Alex Jimenez, 2025†source】

Integrative Healing

By combining chiropractic with integrative therapies, Dr. Jimenez addresses the root causes of pain rather than simply masking symptoms. His patients benefit from natural healing approaches that reduce long-term reliance on pain medications and improve overall wellness.

Comprehensive Rehabilitation Strategy

An effective plan for managing iliac crest pain syndrome should:

Stabilize the spine and pelvis with chiropractic adjustments
Calm muscle spasms through massage, stretching, and modalities
Restore function with targeted strengthening of core and hip muscles
Reduce inflammation with acupuncture or complementary approaches
Document injuries for medical and legal purposes in personal injury contexts

This combination provides a whole-body recovery pathway, addressing physical, neurological, and structural components of iliac crest pain.

Conclusion

Iliac crest pain syndrome is a complex but treatable condition. Originating from the iliolumbar ligament and often worsened by muscle spasms or SI joint dysfunction, it requires a comprehensive and personalized approach to care. Chiropractic adjustments, integrative therapies, and guided exercise work together to relieve pain, restore mobility, and prevent chronic complications.

Clinicians like Dr. Alexander Jimenez demonstrate how dual-scope expertise in chiropractic and nurse practitioner care can make a profound difference for patients. By addressing both the medical and biomechanical aspects of injury—along with legal-medical documentation—patients receive the most complete care possible.

Ultimately, the strength of an integrative approach lies in combining therapies that address different aspects of neuromusculoskeletal health, giving patients the best chance at long-term recovery and improved quality of life.

References

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, and physical medicine, as well as wellness, sensitive health issues, and functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and the jurisdiction in which they are licensed to practice. We utilize functional health and wellness protocols to treat and support care for injuries or disorders affecting the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters and issues that relate to and directly or indirectly support our clinical scope of practice. Our office has made a reasonable attempt to provide supportive citations and identified relevant research studies that support our posts. We provide copies of supporting research studies upon request to regulatory boards and the public.
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Dr. Alex Jimenez, DC, MSACP, CCST, IFMCP, CIFM, ATN*
Email: coach@elpasofunctionalmedicine.com
Licensed in: Texas & New Mexico*

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