PAIN IN THE PELVIC AND SACROILIAC JOINTS: CAUSES, DIAGNOSIS AND TREATMENT

Pain in the pelvic and sacroiliac joint area is not uncommon, especially in active people and athletes. This type of pain can originate in the joints that connect the spine to the pelvis, in muscle insertions, or in nearby nerves, causing localized or radiating discomfort. An accurate diagnosis and appropriate treatment are key to regaining mobility and well-being.

01.- Main Causes of Pain in the Pelvis and Sacroiliac Joints

1.1. Sacroiliac Dysfunction Syndrome (Sacroiliitis)

The sacroiliac jointsThe sacrum and iliac bones, located between the sacrum and the iliac bones, can become inflamed or blocked, causing pain that can radiate to the buttocks or thighs.

Causes:

  • Postural imbalances or gait disturbances.
  • Trauma or falls on the pelvis.
  • Inflammatory arthritis, such as ankylosing spondylitis.
  • Pregnancy and childbirthdue to hormonal changes and pelvic mobility.

Symptoms:

  • Pain in the lower back and buttocks.
  • Discomfort when climbing stairs or standing for long periods.
  • Pain when turning over in bed or walking.

Diagnosis and Treatment:

  • Diagnosis: Clinical examination, imaging tests (magnetic resonance imaging) and, in some cases, diagnostic infiltrations.
  • Treatment: Stabilization exercises, physiotherapy, anti-inflammatory medication and, if the pain is persistent, corticosteroid injections.

1.2. Pubic Osteopathy

Also known as pubalgia, osteitis pubis is common among athletes, especially soccer players, runners, and rugby players. It is characterized by persistent pain in the front of the pelvis.

Causes:

  • Repetitive strain on the adductor and abdominal muscles.
  • Muscle imbalances between the core and adductors.
  • Repeated changes of direction and explosive movements during the sport.

Symptoms:

  • Pain in the pubic region and groin.
  • Feeling of stiffness in the front of the pelvis.
  • Difficulty performing activities such as running, kicking a ball, or getting up from a chair.

Diagnosis and Treatment:

  • Diagnosis: Clinical examination, ultrasound and magnetic resonance imaging.
  • Treatment: Relative rest, specific physiotherapy to strengthen the core and adductors, shock waves in chronic cases and, sometimes, surgery to reinforce the affected area.

1.3. Muscle Insertions in Athletes

In athletes, muscle insertions can suffer overload or microtrauma due to repetitive effort. This includes:

  • Insertions on the ischium (hamstrings): The muscles of the back of the thigh originate from the ischium, and overuse can cause tendinopathies or partial tears.
  • Insertions on the anterior inferior iliac spine: The thigh and rectus femoris muscles can cause pain if they are subjected to repetitive loads, especially in jumping sports or explosive running.

Symptoms:

  • Pain focused on the insertion area, which worsens with activity.
  • Morning stiffness or stiffness after exercise.
  • Sensitivity to touch in the affected region.

Diagnosis and Treatment:

  • Diagnosis: Clinical examination and imaging tests (ultrasound or magnetic resonance imaging).
  • Treatment: Physiotherapy to relieve the affected area, progressive strengthening work, shock waves and, in severe cases, local injections.

1.4. Meralgia Paresthetica

Although it is not a joint pathology, meralgia paresthetica causes discomfort in the pelvis due to compression of the lateral femoral cutaneous nerve, which passes near the anterior superior iliac spine.

Causes:

  • Wearing tight clothing or tight belts.
  • Obesity or pregnancy, which increase pressure in the area.
  • Repetitive movements that compress the nerve.

Symptoms:

  • Pain, burning or tingling sensation on the outside of the thigh.
  • Increased discomfort when walking or standing.
  • Reduced sensitivity in the skin of the affected area.

Diagnosis and Treatment:

  • Diagnosis: Medical history and physical examination. Sometimes, nerve conduction tests are used to confirm the involvement.
  • Treatment: Adjustment of clothing or sports equipment, physiotherapy, local injections and, in extreme cases, surgical treatment to release the nerve.

02.- A Comprehensive Approach to Pelvic Pain

At our clinic, we specialize in the diagnosis and treatment of pelvic pathologies, especially those related to sports activity. Our approach includes:

  • Complete clinical evaluation to identify the source of the pain.
  • Advanced imaging tests such as ultrasound or magnetic resonance imaging.
  • Personalized treatments, from physiotherapy and specific exercises to injections or advanced therapies such as shock waves.

Dr. Narváez Clinic’s Approach

If you experience pain in your pelvis or sacroiliac joints, we can help you recover and return to your daily activities without discomfort.. Book your appointment and find out how we can help you!