Pregnancy and Pelvic Pain
It is common for women to develop pelvic pain in pregnancy. This is sometimes called pelvic girdle pain (PGP) for the general pelvic bowel (front and back) or pubic symphysis dysfunction (PSD) if the pain is more localised to the front of the pelvis. This blog is to help you recognise the symptoms and give you some information about things you can do to help with your pain.
What does it feel like?
PGP in pregnancy is a range of symptoms caused by stiffness and dysfunction of your pelvic joints at the back or front (or both!) of your pelvis. While there is no risk for your baby, it can cause severe pain around your pelvic area and make it hard to do normal activities. The types of symptoms and the severity can vary from person to person. Symptoms can include:
- pain over the pubic bone
- pain in your lower back
- pain that radiates to the lower back, lower belly, glutes, groin, hips, thighs, knees and legs
- clicking or grinding sensation in the pelvic area.
The pain can be most noticeable when you are:
- walking or exercising
- going up or downstairs
- standing on one leg (for example when you’re getting dressed)
- turning over in bed
- getting in or out of the car
Why do I have it?
It’s estimated that PGP in pregnancy can affect up to 1 in 5 pregnant women, and it can occur more commonly later in the pregnancy. PGP is thought to be linked to previous damage to the pelvis, the pelvic joints moving unevenly due to detraining of the muscles in the area or changes in the laxity of the ligaments in the area, the weight or position of the baby, and general change in the biomechanics of how women move when their body changes with pregnancy
Factors that may make a woman more likely to develop PGP include:
- a history of lower back or pelvic girdle pain
- previous injury to the pelvis, for example from a fall or accident
- having PGP in a previous pregnancy
- a physically demanding job
- increased body mass index or larger load being put on the body (eg. carrying multiple babies)
When to get help?
Early diagnosis can help reduce pain and avoid long-term discomfort during and after the pregnancy. Osteopathic treatment usually involves techniques applied to the muscles and joints in the area to get them moving better and education about the condition and at home exercises to help you manage the condition. This can help ease pain and discomfort in the short term and help with the condition’s long-term prognosis. Some women may have short episodes of pain where others can have pain lasting most of the pregnancy and can impact the mother’s ability to work, so it’s important to have a healthcare team helping you manage your pain and symptoms. Pain can occasionally persist after childbirth if your symptoms are not properly managed during or after pregnancy, and women generally have better long term outcomes when it’s managed by their healthcare team from as early on as possible.
Treatment aims to relieve or ease pain, improve muscle function and improve your pelvic joint position and stability, and may include:
- Osteopathy to make sure the joints and muscle of your pelvis, hip and spine are moving well and feeling good
- Exercises to strengthen your pelvic floor, stomach, back and glute muscles
- Clinical pilates
- Equipment if necessary, such as pelvic support belts or compression shorts or in the short term sports taping for support
Strategies to cope with PGP
Your Osteopath may recommend a pelvic support belt or compression shorts to help ease your pain. It can help to plan your day so that you avoid activities that cause you pain. Other strategies can include:
- Be as active as possible within your pain limits, and avoid activities that make the pain worse.
- Rest when you can.
- Get help with household chores from your partner, family and friends.
- Wear flat, supportive shoes.
- Sit down to get dressed and don’t stand on one leg when putting on pants.
- Keep your knees together when getting in and out of the car — a plastic bag on the seat can help you swivel.
- Sleep in a comfortable position, for example on your side with a pillow between your legs.
- Try different ways of turning over in bed, for example turning over with your knees together and squeezing your buttocks.
- Use an ice pack (gel pack, frozen peas, wrapped in a pillow slip) over the pelvic joints (front and back ‘dimples’) to reduce pelvic joint pain and inflammation. Use for 10 to 15 minutes only, several times a day.
You should also avoid until the symptoms and pain have decreased:
- standing on one leg
- bending and twisting to lift, or carrying a baby on one hip
- crossing your legs
- sitting on the floor, or sitting twisted
- sitting or standing for long periods (more than 30-60 mins)
- lifting heavy items, such as shopping bags, wet washing or a toddler
If you are suffering from pelvic pain and you are wondering if an Osteopath can help you, give us a call at Berwick Family Osteopathy and Spinal Clinic on (03) 9702 0094, or make an appointment online.
We can’t wait to see you in the clinic and help you with your health.
Blog written by Dr Amelia Sloan – Registered Osteopath.
Berwick Family Osteopathy & Spinal Clinic