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What Are the Different Causes of Posterior Pelvic Pain?

Rebecca Harkin
Rebecca Harkin

Pregnancy is the most common cause of posterior pelvic pain in women. Other causes of this lower back pain in both men and women include osteoarthritis in the back, a fracture in the lower back, and overuse or straining of the muscles or ligaments at the base of the back. Posterior pelvic pain may also be referred to as lumbar back pain, pelvic girdle pain, or, in pregnant women, pregnancy back pain.

The posterior pelvic area is composed of the lumbar or lower vertebrae, the upper part of the left and right side of the pelvis, known as the ileum, and the triangular shaped bone, called the sacrum and located at the base of the spine. This region also includes the two sacroiliac joints located on the left and right side of the body where the sacrum touches the ileum. The posterior pelvic area bears the weight of the upper body and is an anchoring foundation that allows walking, twisting, and lifting.

Many pregnant women experience posterior pelvic pain.
Many pregnant women experience posterior pelvic pain.

This pain is very common amid pregnancy for two reasons. First, as the fetus grows during pregnancy, the stomach muscles are elongated and distressed until they can no longer bear all the weight of the baby and the load is shifted onto the lower back. Second, some pregnancy hormones cause joints, including the sacroiliac joint, to slacken, allowing the pelvic region to widen in preparation for passage of the baby. This loosening of the pelvic joints makes the sacroiliac joint more prone to pulls and tears, which can produce significant posterior pelvic pain.

Posterior pelvic pain can sometimes be the result of a fracture to the sacrum.
Posterior pelvic pain can sometimes be the result of a fracture to the sacrum.

Another common cause of sacroiliac joint pain is osteoarthritis. Joints are blanketed with a soft rubbery substance known as cartilage. Osteoarthritis causes the cartilage cushioning the joints to wear away. The degeneration of the cartilage can cause a person afflicted with osteoarthritis to walk, twist, and lift at the hip differently to compensate for the lack of padding at the joints. Eventually this type of awkward movement can strain and damage the sacroiliac joint, causing swelling and radiating posterior pelvic pain.

Osteoarthritis in the back may cause posterior pelvic pain.
Osteoarthritis in the back may cause posterior pelvic pain.

As people age, the density of the bones and the flexibility of the joints decreases. As a result, the bones become frail and more apt to break, and the joints become stiff and function less effectively. Occasionally, the pain will be the result of a break in the ilium or the sacrum. Stiff joints can also tear more easily, causing significant lumbar back pain.

Osteoarthritis can cause cartilage cushioning and joints to wear away causing swelling and pain in the lower back.
Osteoarthritis can cause cartilage cushioning and joints to wear away causing swelling and pain in the lower back.

Overuse and straining to lift large amounts of weight can tear the sacroiliac joint or pull muscles in the lumbar region. Lifting and twisting at the waist while bearing a heavy weight are particularly stressful to the pelvic girdle. Tears of the sacroiliac joints and pulled muscle will often be the cause of posterior pelvic pain.

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    • Many pregnant women experience posterior pelvic pain.
      By: WavebreakmediaMicro
      Many pregnant women experience posterior pelvic pain.
    • Posterior pelvic pain can sometimes be the result of a fracture to the sacrum.
      By: Anatomical Design
      Posterior pelvic pain can sometimes be the result of a fracture to the sacrum.
    • Osteoarthritis in the back may cause posterior pelvic pain.
      By: WavebreakmediaMicro
      Osteoarthritis in the back may cause posterior pelvic pain.
    • Osteoarthritis can cause cartilage cushioning and joints to wear away causing swelling and pain in the lower back.
      By: aceshot
      Osteoarthritis can cause cartilage cushioning and joints to wear away causing swelling and pain in the lower back.
    • Lifting and twisting while carrying a heavy weight may cause stress to the pelvic region.
      By: ndoeljindoel
      Lifting and twisting while carrying a heavy weight may cause stress to the pelvic region.
    • Sacroiliac pain can radiate from the back, though the hips and to the knees, making everyday activities difficult.
      By: Monkey Business
      Sacroiliac pain can radiate from the back, though the hips and to the knees, making everyday activities difficult.
    • Performing gentle stretching exercises may help alleviate posterior pelvic pain during pregnancy.
      By: evgenyatamanenko
      Performing gentle stretching exercises may help alleviate posterior pelvic pain during pregnancy.
    • Long-distance driving may cause pelvic pain.
      By: Henryk Sadura
      Long-distance driving may cause pelvic pain.