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Pelvic Girdle Pain in Pregnancy

Published: 26 Sep 2019

Pregnancy is such an amazing time in a women’s life. Her body goes through so many changes in preparation for the delivery of her child.  Now, a woman’s body is physiologically made to make babies however, that doesn’t mean it’s a breeze. Unfortunately it is estimated that 1 in 5 pregnant women will experience pelvic girdle pain. For a woman who is already experiencing a whole lot of significant changes physically, mentally and emotionally – unexplained pain in the pelvic region – aka the region a baby is supposed to be pushed out of after 9 months can be pretty daunting.  

What exactly is pelvic girdle pain?

Pelvic girdle pain is defined as any pain located in any of the three joints of the pelvis. Generally the length of time that a woman is able to stand, walk and sit is reduced.

This is what your pelvis looks like. You can see that it includes the sacrum at the back and joins at the front at the pubic symphysis.

The pelvis is a complete ring made up of two innominate bones (the three fused bones of the pelvis, the ileum, ischium and pubis) and the sacrum/coccyx. Its function is to transfer loads between the trunk and legs.

The sacroiliac joints (aka SIJ) are the two joints at the back of the pelvis where the sacrum joins the innominate bone. The pubic symphysis is the articular cartilage that joins the two innominate bones together at the front of the pelvis.

Pelvic girdle pain may be located in one, two or all three of these joints. Pelvic girdle pain can cause significant disability and make it hard to perform even the simplest of daily tasks.

Symptoms of Pelvic Girdle Pain

• Pain located in any or all three of the pelvic joints
• Pain is sharp or stabbing
• Typically aggravated with turning in bed, first few steps, getting in and out of the car, stairs, dressing
• Pain can limit your walking and standing capacity
• Pain tends to ease with rest
• Can feel grinding or clicking sensations in the pelvic area
• Onset can be as early as 1st trimester, but more typically towards the 2nd and 3rd trimesters

Causes of Pelvic Girdle Pain

The cause of pelvic girdle pain in pregnancy is multifactorial and is related to many physical and hormonal changes that occur during pregnancy. As the pregnant belly grows and the pelvis adapts in preparation for a vaginal delivery, a women’s posture and supportive muscle system will be altered which can place more load through the pelvis. However, just because these changes are inevitable, it doesn’t mean you have to put up with the pain they may cause. 

Treatment Options

Early detection and intervention is important to ensure you are comfortable and able to do things you want and need to do, as your body inevitably gets bigger. 

Physiotherapy aims to provide pain relief and helps to maintain function as your pregnancy progresses. Techniques such as manual therapy and massage can help to restore normal muscle length and activation. Exercises to strengthen muscles that surround your belly and pelvis can be of assistance.  Your physiotherapist will also be able to provide advice on ways to self manage your pain such as:

• Avoiding activities that cause pain. Try to sit when getting dressed and when turning in bed avoid separating your leg, instead roll your whole body like a log.
• Try to stay active but modify what you need to by reducing intensity or taking increasingly frequent rest breaks.  Consider alternate exercise options if walking is uncomfortable, such as cycling or swimming (avoid breast stroke)
• Sleep in a comfortable position with a pillow between your knees
  
• If you find your pain is mainly in the first few steps after getting up you can try squeezing the tops of your hips together with your hands to see if this provides relief.
• Alternatively you may find a pelvic brace or taping helpful in reducing your pain. 

Important things to note:

Although the pain can be extremely daunting and inhibiting during pregnancy, in 93% of cases, it will resolve once postnatal.

Also if you do suffer pelvic girdle pain during pregnancy, you can still have a normal vaginal delivery. You can discuss possible birth positions to use and ones to avoid with your physiotherapist or midwife.

Remember you can get help – although it’s a common problem with pregnancy, it doesn’t mean you have to grin and bear it. 

Here at The Healthy Body Company we are able to perform a full assessment and then devise an appropriate management plan to ensure you have reduced pain and optimal function so you can actually enjoy your pregnancy!

For advice on exercising during pregnancy please see our blog: https://www.thehealthybodycompany.com.au/exercise-during-pregnancy/

Steph enjoying an active and healthy pregnancy 🙂