Pelvic pain in pregnancy

Pelvic pain in pregnancy

Pregnancy is a new and amazing experience. But how do you know the additional body pains you are feeling are normal or if they are more than the usual aches and pains?

Pelvic girdle pain (PGP) in pregnancy occurs in about 20% of women and can happen at any stage of pregnancy. It might involve the sacroiliac joint at the back or pubic symphysis pain at the front. It also can occasionally present as low back pain, referred leg pain or lower abdominal pain. This should be a new onset pain, & should not a recurrence of a pre-existing lower back or pelvic pain.However, on a more positive note, 90 percent of women fully recover from PGP within 3-12 months after delivery.

Causes of PGP

PGP generally starts around the 18th week and peaks between 24-26 weeks, however it might start earlier or later. The exact reason is unknown; however, it’s thought to be due to the changes in hormone levels plus biomechanical factors such as a decreased ability to transfer load through the pelvis, altered posture, altered centre of gravity, changes in pelvic support (muscular force) and changes in everyday activity.

Risk factors for developing PGP

  • Previous history of lower back pain or SIJ pain
  • Previous trauma to the pelvis or lower back
  • High/strenuous workload
  • Position of baby e.g. if the baby is sitting posteriorly it can potentially increase lower back pain
  • Just because you had PGP in your first pregnancy, doesn’t automatically mean you’ll have it in your second or third pregnancies!

Symptoms

  • Pain in the pelvis (at the back), lower back pain or groin pain
  • Pain at the pubic symphysis bone (at the front)
  • Pain with taking long strides when walking or running
  • Pain with single leg movements such as climbing stairs, standing on 1 leg
  • Pain with transitional movement such as getting in/out of the car or rolling over in bed
  • Pain with prolonged stationary positions e.g. standing >45 minutes
  • Pain during or after intercourse

 

Treatment

  • Modification of activities e.g. walking speed
  • Exercise education and changes. Exercise can help for pain relief (if doing the correct modes of exercise e.g. swimming and Pilates)
  • Advice regarding postures (including sleeping)
  • Manual therapy which includes massage, joint mobilisations, dry needling etc
  • Using supportive garments such a SIJ belts
  • Ice/heat for pain relief
  • Correcting ergonomics

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