Pelvic girdle pain, pelvic instability and symphysis pubis dysfunction are really all very similar problems all affecting the pelvis.
I see a lot of pregnant woman in my clinic who have this pain, and it can vary from being a little niggle to quite debilitating in that walking and moving around is quite painful. There are definitely some ways you can help yourself if you have pain in this area, so please don't put up with it and put it down to being pregnant!
I did my dissertation on this condition so it's a subject very close to my heart. There really isn't a lot of research to be found on it, but I had 10 women I treated with the condition and I found that all but 1 of them had improved pain symptoms, mobility, and quality of life whilst receiving massages and treatment from me.
What is it?
PGP or pelvic girdle pain is pain in the pelvis area. It can be felt it different places and to varying degrees but it is often caused by the same problem. Approximately 30% of all pregnant women experience it and it usually starts around 20 weeks. The symptoms are caused by the inflammation of one of the pelvic joints, either the symphysis pubis or pubic bone at the front of our pelvis or the SI or sacroiliac joints at the back. Some women also feel pain at the side of their hip when walking or lying down on the side, causing difficulty turning over. The pain can be stabbing, a dull ache, shooting pain or a burning sensation.
What causes it?
There is no conclusive evidence as to what may cause this condition, although it has been suggested it could be down to hormonal changes, pelvis misalignments, genetics or degenerative implications. Research states possible 'mutilfactorial conditions during pregnancy' (Kankaris et al 2011:2). Possible causes are:
- production of Relaxin and its effect on posture and stability
- An injury/accident affecting the joints
- Pelvic alignment
- Size and weight of the baby
- PGP in previous pregnancy
What can be done?
Symptoms tend to occur around 20 weeks, often earlier in subsequent pregnancies. I would urge women to get help as soon as they realise the pain is different from just back pain. I assess each person and try and assess what may be causing their pain. Often there is some tilting or rotating of the pelvis which is causing the discomfort, or it could be some muscular weakness, or posture causing it. Once assessed I can treat and then give homework to help hold the treatment, which is often stretching an area and strengthening another. I also sometimes refer clients to a McTimmoney chiropractor if I feel they need manipulation which I cannot give. Sometimes wearing a SI belt would be helpful, but each person is treated individually and helped as such!
Things to avoid
Keeping mobile and moving is important. As mentioned every woman is different and pain is felt in different places but on the whole things to avoid are:
- try and avoid standing on one leg for example putting on socks, or leaning on one leg whilst standing
- Avoid wearing high heels as this will throw the posture forward
- When getting out of a car try and turn pelvis round slightly rather than dragging one leg away from the other
- If struggling with rolling over in bed try using a satin sheet or lie on a silk scarf so you glide over rather then drag your hips over
Can I still exercise?
Again each mum is different, but on the whole yes, absolutely, movement helps keep mobile! If anything starts or aggravates the pain ease off and take it slightly slower or more carefully. The classes I run cater for PGP as more than ever mums with this need to keep strong, and exercise is good for mum and baby.
Will it go away after birth?
Generally the pain goes away, although some women do still suffer with discomfort, especially around times of menstruation or when breastfeeding, due to the hormonal changes.
I highly recommend being assessed once a mum is recovered from birth and definitely before falling pregnant again or taking up heavy exercise.
If you are concerned you may have the condition or have had the condition and want to become pregnant again, please contact me so we can discuss a way forward, or book an appointment for an assessment.