An iliolumbar ligament strain is a soft tissue injury to the ligament that connects the ilium (pelvic bone) to the lumbar spine. It often results in lower back pain, stiffness, and muscle spasms. It commonly occurs due to repetitive movements, heavy lifting, or physical therapy. Associated conditions include sacroiliac joint dysfunction, piriformis syndrome, and sciatica. Treatment focuses on pain management through injection therapy or physical therapy to reduce inflammation and improve mobility. Understanding the interconnectedness of these entities is crucial for effective patient care.