He stressed the attacks are often brought on by physical exercise involving bending and twisting of the lumbar spine. The patient complains of pain at the posterior portion of one iliac crest.
Some patients complain of pain across the iliolumbar area bilaterally.
Some complain of pain only after prolonged sitting or standing or for a brief period in the morning after getting out of bed. Pain can be referred to the groin with an increase in discomfort after prolonged siting or standing. Usually the painful iliac crest is the higher one. Forward bending sometimes is slightly limited. The most typical sign is tenderness on palpation of the iliac crest on the involved side.