PELVIC GIRDLE PAIN
Written by Dr Elizabeth Dwyer
Pelvic Girdle Pain is a collection of musculoskeletal symptoms which can occur at the back of the pelvis (sacroiliac joints), buttocks, hips and pubic region (pubic symphysis).
It is a common complaint during pregnancy and can occur at any stage gestation, however is more common in the later stages of pregnancy.
What causes PGP?
PGP is multifactorial and impacted by biomechanical, hormonal, genetic, degenerative changes – either pre-existing or during pregnancy.
During pregnancy, a hormone called relaxin is released, which has the effect of causing laxity in ligaments throughout the body – especially around the pelvis. This is a great thing, as we want a subtle pelvis for childbirth, however sometimes it can come with problems.
A woman’s lumbar spine and pelvis also has increasing load as it supports a growing uterus, which is accompanied by a change in centre of gravity and further stress on the pelvis.
Not all pregnant women experience PGP though. It can be more common in those with previous pelvic or lower back pain (+/- during pregnancy), multiparity (eg twins), increased body mass index, physically demanding work, emotional distress and smoking also increase a woman’s risk.
What are some of the symptoms of PGP?
Symptoms vary from mild discomfort to severe and debilitating pain that can hinder mobility.
Pain in and around the pelvic girdle, hips, low back and/or down the legs
Instability when walking, getting dressed, going up and down stairs etc
Pain bending forward or twisting
Pain walking, rolling over in bed or after long sitting
Pain during intercourse
What can help PGP?
Try doing the following:
Keeping active with controlled exercises such as pre-natal pilates or yoga
Wearing supported shoes, not heels!
Neutral and supported posture while sitting and standing (an osteopath can help with an assessment)
Place a pillow between legs when sleeping
External support like: taping, pelvic support belt, support tights or crutches in severe cases
Heat on painful areas
Avoid:
Long sitting, long standing, walking long distances
High heels
Heavy lifting
Carrying uneven loads such as a shoulder bag or toddler on the hips!
Uneven weight distribution: avoid lunges, avoid standing on one leg (sit down to put pants/socks/shoes on)
Getting in and out of a car onto one leg (think getting out of a car like a Princess)
Crossing legs on the floor or when seated
What can osteopathy do to help?
Osteopaths are trained to assess the body holistically and will aim to improve restrictions in the spine, hips and lower limb to ease pain in the pelvis. It is also common that despite the ‘laxity’ of these ligaments, there can still be imbalances and restrictions through the pelvis which can potentially lead to this pain.
An osteopath can identify any such imbalances and offer gentle treatment, or suggest strengthening exercises, specific stretches and ergonomic advice to assist in easing the pain.
A symmetrical and mobile pelvis offers a space for the baby to grow and develop without any restriction. It is ideal to see your practitioner early on, and aim for support during the growth of your baby and changes to your pelvis.
The other important aspect of PGP is ensuring the muscles which surround the pelvis assist in supporting the ligamentous structures. Doing specific strengthening exercises or pre-natal pilates is an excellent way to not only treat, but also prevent PGP from coming about.
Will PGP affect my birth plan?
There is no indication that PGP is associated with the incidence of labour interventions, pain or complications.
How long does PGP last?
Most cases of pelvic girdle pain resolve after giving birth. The decrease in load on the pelvis is often enough to relieve the pain almost immediately.
This is not, however, the case for all. So definitely seek help if it continues after birth.
It is worth remembering that prevention is better than a cure and if you think you might have another baby that it would be worth resuming a strengthening/pilates programme and get some post-natal osteo treatment also.
All of our Osteopaths have experience in treating pregnant women, and love being apart of your journey!