The scourge of many a poor pregnant woman is pain – specifically pain in the pelvic girdle(PGP). This pain is differentiated from lower back pain (but can occur simultaneously) as it is below the big pelvic bones in the back to the fold below your buttock and can also be in the groin or pubic bone, in the front of the pelvis.  However, it is one of my favourite things to treat as many a mum to be has hobbled in on crutches and forgotten them on the way out!

Pelvic Girdle Pain develops in pregnancy due to a variety of factors like biomechanical and hormonal changes, trauma to the pelvis and a history of previous back pain. Symptoms occur from around the 18th week of pregnancy and peak between the 24th and 36th week.

For some lucky women the pain spontaneously disappears within 3 months but it can persist up to 6 months postpartum and unfortunately if you have a history of lower back pain, have pain front AND back or are very stressed the prognosis can be longer than that.

However, women who do high impact exercise have a lower risk to develop PGP so there is some good motivation to get active before you fall pregnant and stay active during. Interestingly, breastfeeding seems to have a small beneficial effect for recovery postpartum too.

There can be many symptoms and pain can be provoked by walking, sitting or standing. Some women feel a catching sensation in the upper leg or groin or in the sacro-iliac joint(below the lower back) whilst walking or standing for longer than half an hour.

Any activities with children, doing the housework, going up stairs or even turning over in bed can trigger pain and cause you to walk differently to avoid the discomfort – hence the crutches mentioned earlier! Post-partum running can be painful for a long time so getting treatment and resolving symptoms early is important.

PGP is easy to diagnose in clinic with a series of simple tests and outcomes are best when treatment includes hands on therapy, exercises and advice to offload where possible.  

Occasionally there can be some benefit found with a sacro-iliac support belt especially in people with hypermobility. I rarely treat a woman more than 3 times for this so there is no need for weeks and weeks of treatment provided there are no other complex factors involvedand of course, Physiotherapy is a drug free therapy that is safe for mum and for baby.

So, don’t suffer needlessly if you are pregnant – it should be a time of joy and wonder at the changes and abilities of your body. Creating and carrying another human being is such a miracle and there is much that can be done to support you through this.

Bergstrom et al 2017; Fur spine 2008 Jun;17(6):794-819PMCID:PMC2518998; European Guidelines for diagnosis and treatment of PGP; Louw 2017; PMID18259783

Elrina

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