What is pelvic girdle pain?

Pelvic Girdle dysfunction 

The pelvic girdle is a ring of bones around the body at the base of spine. PGP is pain in the front and/or the back of the pelvis that can also affect other areas such as the hips or thighs. It can affect the sacroiliac 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, affecting 1 in 5 pregnant women, and can affect the mobility and quality of life. Pain when walking, climbing stairs and turning over in bed are common symptoms of PGP. However, early diagnosis and treatment can relieve the 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. As the baby grows in the womb, the extra weight and the change in the way you sit or stand will put more strain on pelvis. You are more likely to have PGP if you have had a back problem or have injured your pelvis in the past or have hypermobility syndrome, a condition in which your joints stretch more than normal.

Can PGP harm my baby?

No. Although PGP can be very painful, it will not harm the baby.

What are the symptoms of PGP?

PGP can be mild to severe but is treatable at any stage in pregnancy and the sooner it is treated, the more likely is 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 the knees apart, like getting in and out of the 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.

How is PGP diagnosed?

Tell the doctor about your pain. You should be offered an appointment with a physiotherapist who will make an assessment to diagnose PGP. This will involve looking at the posture and the back and hip movements and ruling out other causes of pelvic pain.

What can I do to help the symptoms?

The following simple measures may help:

  • keeping active but also getting plenty of rest
  • standing tall with your bump and bottom tucked in a little
  • changing the position frequently – try not to sit for more than 30 minutes at a time
  • sitting to get dressed and undressed
  • putting equal weight on each leg when standing
  • trying to keep the legs together when getting in and out of the car
  • lying on the less painful side while sleeping
  • keeping the knees together when turning over in bed
  • using a pillow under your bump and between your legs for extra support in bed.

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

  • lifting anything heavy, for example heavy shopping
  • going up and down the stairs too often
  • stooping, bending or twisting to lift or carry a toddler or baby on one hip
  • sitting on the floor, sitting twisted, or sitting or standing for long periods
  • standing on one leg or crossing your legs.

What are my treatment options?

The physiotherapist can suggest the right treatment.

This may include:

  • advice on avoiding movements that may be aggravating the pain. You will be given advice on the best positions for movement and rest and how to pace your activities to lessen the pain.
  • exercises that should help relieve the pain and allow you to move around more easily. They should also strengthen the abdominal and pelvic floor muscles to improve the balance and posture and make your spine more stable.
  • manual therapy (hands-on treatment) to the muscles and joints by a physiotherapist, osteopath or chiropractor who specialises in PGP in pregnancy. They will give you hands-on treatment to gently mobilise or move the joints to get them back into position, and help them move normally again. This should not be painful.
  • warm baths, or heat or ice packs
  • hydrotherapy
  • acupuncture
  • a support belt or crutches. For most women, early diagnosis and treatment should stop symptoms from getting worse, relieve your pain and help you continue with your normal everyday activities. It is therefore very important that you are referred for treatment early. PGP is not something you just have to ‘put up with’ until your baby is born.