Posterior pelvic pain is common in pregnancy due to strain on stomach muscles and loosening of pelvic joints. Other causes include osteoarthritis, fractures, and overuse/strain. The pelvic area supports the body and is prone to tears and strains from heavy lifting and twisting.
Pregnancy is the most common cause of posterior pelvic pain in women. Other causes of this back pain in both men and women include osteoarthritis in the back, a fracture in the lower back, and overuse or strain on the muscles or ligaments in the lower back. Posterior pelvic pain may also be referred to as low back pain, pelvic girdle pain, or, in pregnant women, pregnancy back pain.
The posterior pelvic area is made up of the lumbar or lower vertebrae, the upper left and right sides of the pelvis, known as the ilium, and the triangular-shaped bone, called the sacrum, 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 ilium. The posterior pelvic area supports the weight of the upper body and is an anchor base for walking, twisting and lifting.
This pain is very common during pregnancy for two reasons. First, as the fetus grows during pregnancy, the stomach muscles stretch and strain until they can no longer support the full weight of the baby and the load is shifted to the lower back. Second, some pregnancy hormones cause joints, including the SI joint, to loosen up, allowing the pelvic region to widen in preparation for the baby to pass. This loosening of the pelvic joints makes the SI joint more prone to strains and pulls, which can produce significant posterior pelvic pain.
Another common cause of SI joint pain is osteoarthritis. Joints are covered in a soft rubbery substance known as cartilage. Osteoarthritis causes the wear and tear of the cartilage that cushions the joints. Cartilage degeneration can cause a person with osteoarthritis to walk, twist, and lift the hip differently to compensate for the lack of padding in the joints. Eventually this type of awkward movement can strain and damage the SI joint, causing swelling and radiating posterior pelvic pain.
As people age, bone density and joint flexibility decrease. As a result, bones become brittle and more likely to break, and joints become stiff and function less effectively. Occasionally, the pain will be the result of a rupture of the ilium or sacrum. Stiff joints can also tear more easily, causing significant lower back pain.
Overuse and straining to lift large amounts of weight can tear the SI joint or pull the muscles in the lower back. Lifting and twisting at the waist while supporting a heavy weight are particularly stressful on the pelvic girdle. Tears of the sacroiliac joints and muscle strain are often the cause of posterior pelvic pain.
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