What is it?
Pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD) refers to the pain pregnant women experience in one or more of their pelvic joints. It can start at any stage of pregnancy or affect women after the birth of the baby.
The chances of developing the condition is higher if the woman has suffered from lower back pain or sustained an injury to the lower back previously. Women carrying multiples, those who have had PGP in previous pregnancies and those working in hard, physical conditions may also be more at risk.
The hormone relaxin, which causes softening of the ligaments throughout the entire body during pregnancy, is often cited as the reason why muscles in the pelvic region may end up having to work harder to support the body, thus causing pain. Furthermore, changes in posture due to the growing baby as well as the weight on the pelvic floor muscles are said to be factors in pregnancy that contribute to pain in the pelvic area.
What are the symptoms?
- Pain in the pubic/lower back area
- Difficulty in getting up/sitting down, rolling over in bed or getting in and out of cars
- Clicking in the pelvis when walking
- Bladder dysfunction (temporary incontinence when changing positions)
- Pain in other areas of the body, including buttocks, down the leg and the knees
- Tightness in upper back
How is it diagnosed?
Diagnosis is usually made by clinical examination and takes into account previous pain history. GPs may provide a referral to see a physiotherapist who can examine the muscles in the back, pelvic and hip area as well as how joints move as you perform everyday activities.
What’s the treatment?
A physiotherapist specialising in women’s issues will help come up with a management plan including core stability exercises, taping or wearing a belt to support the lower back and pelvic area as well as pain relief medication.
Avoiding climbing stairs, heavy lifting (including toddlers), sitting on the floor or standing for long periods of time are also usually suggested.
Many women fear that the labour pain will be worse due to PGP, however with proper management, this is usually not the case. Normal vaginal delivery is usually recommended but certain positions like lying on your back to give birth is usually discouraged. Working on a birth plan to make the midwife and birth partner aware of uncomfortable positions can also help.
After birth, many women find that their symptoms improve markedly but for those with persisting problems, anti-inflammatory medication is prescribed. Further physiotherapist-recommended exercises can help improve strength in the pelvic area.
Facts verified by Dr. Gino Pecoraro. Dr. Pecoraro is a Brisbane-based obstetrician and gynaecologist.