Pelvic Girdle Pain

Pelvic Girdle Pain and Pregnancy

 

What is pelvic girdle pain? (PGP)

 

The pelvic girdle is a ring of bones around your body at the base of your spine. PGP is pain in the front and/or the back of your pelvis that can also affect other areas such as the hips or the thighs.It can affect the sacroliac joints at the back and/or the symphysis pubis joint at the front. PGP used to be known as symphysis pubis dysfunction (SPD)

PGP is common, but not normal. It is found in 1 in 5 pregnancies and can affect your mobility and quality of life. Pain when you are walking,climbing stairs and turning over in bed are the most common symptoms of PGP.

However, early diagnosis and treatment can relieve your pain.

Treatment is safe at any stage during or after pregnancy.

 

What causes PGP?

 

The three joints in the pelvis work together and normally move slightly. PGP is usually caused by the joints moving unevenly, which can lead to the pelvic girdle becoming less stable and therefore painful. You are are more likely to have PGP if you have had a previous back/pelvic problem or have hypermobility syndrome, a condition in which your joints stretch more than normal.Also PGP in previous pregnancy

 

Symptoms of PGP

 

PGP can be mild to severe but is treatable at any stage of pregnancy and the sooner it is treated, the more likely you are to feel better. It is more common later in pregnancy. Symptoms include:

  • Pain in the pubic region,lower back,hips,groin,thighs,or knees

  • Clicking or grinding in the pelvic area

  • Pain made worse by movement,for example:

  • Walking on uneven surfaces/rough ground or for long distances

  • Moving your legs apart, like getting in and out of a car

  • Standing on one leg, like climbing the stairs,dressing or getting in or out of the bath

  • Rolling over in bed

  • During sexual intercourse

 

Can PGP harm my baby?

 

No. Although PGP can be very painful for you, it will not harm your baby.

 

 

How is PGP diagnosed?

 

Tell you midwife or doctor about your pain. You should be offered and appointment with a physiotherapist who will make an assessment to diagnose

PGP. This will involve looking at your posture and your back and hip movements.

 

What can I do to help my symptoms?

  • Keeping active but also getting plenty of rest

  • Standing tall with your bump and bottom tucked in a little

  • Changing your position frequently-try not to sit for more than 30mins at a time

  • Sitting to get dressed and undressed

  • Putting equal weight on each leg when you stand

  • Trying to keep your legs together when getting in and out of a car

  • Lying on the less painful side while sleeping

  • Keeping your knees together when turning over-try wearing silky nightwear to help with moving

  • Using a pillow under your bump and between your legs for extra support

You should avoid anything that makes your symptoms worse, such as:

  • Lifting anything heavy,for example heavy shopping

  • Going up and down stairs too often



Treatment from your physio may include:

  • Advice on the following

  • back care

  • lifting

  • Exercises to retrain and strengthen you stomach, back,pelvic floor and hip muscles

  • Manual therapy

  • Other types of pain relief such as acupuncture or TENS

  • Exercises in water

  • Provision of equipment( if necessary after individual assessment) such as crutches, pelvic girdle supports belts, wheelchairs.

 

Will I need to have labour started off (be induced) early?

 

Going into labour naturally is better for you and your baby. Most women with PGP do not need to have labour started off. Being induced carries risks to you and your baby, particularly if it is before your due date. Your midwife or obstrician will talk to you about the risks and your options.

 

Please inform the midwife who is caring for you in labour that you have PGP. 

Informed choice may include discussion on:

  • Pain relief

  • Water birth

  • Mode of delivery

  • Birth positions ie all 4s , supported kneeling, side lying or standing

What happens after the birth of my baby?

 

PGP usually improves after birth although 1 in 10 will have ongoing pain. If this is the case, it is important that you continue to receive treatment from your physio and take regular pain relief. If you have been given aids to help get around, keep using them until the pain settles down.

If you have severe PGP, you should take extra care when you move about.Ask for a room where you are near to toilet facilities, or an en-suite room if available.Aim to become more mobile. If your pain persists after 6mths seek advice from your GP, who may refer you to another specialist to exclude other causes such as hip problems or hyper mobility syndrome.

 

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Thanks go to a lovely local Midwife who spent time putting this article together for you.