What causes iliac crest pain after a cesarean section (C-section)?

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Last updated: March 10, 2025 • View editorial policy

Differential Diagnosis for Iliac Crest Pain Post C-Section

  • Single Most Likely Diagnosis + Musculoskeletal strain: This is the most likely diagnosis due to the physical strain and trauma associated with childbirth, particularly with a C-section. The iliac crest is a common site for muscle attachment, and strain or injury to these muscles during delivery or postoperative recovery could lead to pain.
  • Other Likely Diagnoses + Postoperative hematoma or seroma: Fluid collections or hematomas at the surgical site can cause pain and discomfort, including referred pain to the iliac crest area. + Incisional hernia: Although less common, an incisional hernia could cause pain, especially if it involves the iliac crest region. + Nerve entrapment or injury: Nerves in the abdominal or pelvic region could be irritated or damaged during surgery, leading to pain that might be perceived in the iliac crest area.
  • Do Not Miss Diagnoses + Osteomyelitis or pelvic osteitis: Infection of the bone or pelvic structures is a serious condition that requires prompt diagnosis and treatment. While less common, it could present with iliac crest pain post-C-section. + Deep vein thrombosis (DVT) or pulmonary embolism (PE): Although DVT and PE are more commonly associated with leg pain or shortness of breath, respectively, they are critical conditions that could indirectly cause or contribute to iliac crest pain due to the proximity of major vessels.
  • Rare Diagnoses + Stress fracture: Although rare, stress fractures could occur in the iliac crest, especially in individuals with risk factors such as osteoporosis or those who have experienced significant physical stress. + Metastatic disease or primary bone tumor: In patients with a history of cancer or those at high risk, metastatic disease or a primary bone tumor could present with iliac crest pain, though this would be extremely rare in the context of post-C-section pain.

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