Pelvic Girdle Pain | Symptoms and Treatment

It’s a fact that when you become pregnant, your ability to move is affected.

Most often, women develop pelvic girdle pain (PGP) during pregnancy.

This can be quite debilitating and can affect the quality of your life, especially in the third trimester.

Some women aren’t affected too much, while others find it impossible to carry on with normal life.

Chances are, if you’re reading this, you suspect you might be suffering from pregnancy-related pelvic girdle pain (PGP).

Around 20% of pregnant women will experience PGP. Let’s look more into this pregnancy condition, its causes, and how it is treated.

Pelvic girdle pain (PGP) in pregnancy

Ask yourself the following questions:

• Do you have low back pain or leg pain?
• Do you find it difficult to get dressed because of the pain?
• Does it feel painful when you take a bath?
• Or when you hop in the car and move your legs apart?

If your answer is yes, read on for more information to help you find treatment and relief from pelvic pain in pregnancy.

SPD in pregnancy

Physiotherapists once used the term symphysis pubis dysfunction for pelvic girdle pain.

Today, you might see it written either way. Symphysis pubis dysfunction (SPD) and pelvic girdle pain (PGP) are one and the same condition, and you can use the terms interchangeably.

SPD or PGP is a group of symptoms that cause discomfort in the pelvic region, particularly in pregnancy.

What causes pelvic girdle pain in pregnancy?

The pelvic floor muscles support the uterus (womb). During pregnancy, your body is producing larger amounts of a hormone called relaxin.

This hormone softens your ligaments to loosen up your joints, in preparation for the birth of your baby. The flexibility in your pelvis allows your baby to pass through during birth.

This loosening of the joints in pregnant women is the cause of pregnancy-related pelvic girdle pain.

Other causes could be the change in your center of gravity and your posture. The extra weight of your baby and uterus can cause you to alter how you sit and stand.

You might also have a pre-existing pelvis problem that has been exacerbated during pregnancy.

Some mothers might be experiencing pelvic pain in pregnancy quite early. Others are luckier and don’t encounter any difficulties until the last few weeks or days.

What does pelvic girdle pain in pregnancy feel like?

Women experiencing PGP in pregnancy describe the condition as:

• Hip pain
• Back pain
• Lower back pain
• Pelvic pain
• Shooting pains down one leg, or in both thighs, legs, and buttocks.

Pregnancy-related pelvic girdle pain might cause one of these symptoms, or you might be unlucky enough to suffer them all.

The pain is worsened by a whole host of everyday activities, including getting dressed, lying down, sitting, or standing.

Basically, anything that causes an imbalance in the pelvis will make the pain worse.

That means activities like turning over in bed, getting out of bed, or climbing stairs – things that are difficult for most heavily pregnant women – become extremely problematic for sufferers of pregnancy girdle pain.

Treatment for pelvic girdle pain in pregnancy

If you think you might be suffering from PGP, see your doctor or midwife as soon as you can. An early diagnosis of PGP means you will have the correct information to understand PGP and how to manage the pain.

The first thing to do is to see an expert who specializes in PGP. This is usually a physiotherapist who specializes in women’s health and pregnancy.

These specialists can create a treatment plan for you to help manage pain and to prevent it from becoming worse or causing long term problems.

The therapist who treats you will be able to assess your pain levels, offer advice and give you any further assistance necessary.

For some women, simply learning how to sit with a straight back, instead of slumped, can make all the difference. Some women find they need crutches to get about comfortably.

How do you relieve pelvic girdle pain?

The following tips might help you manage your PGP:

• For low back pain, ensure your back is well supported when sitting or standing. Use a pillow to support your buttocks when sitting
• Wear a support belt. These belts help provide pelvic support. The use of a pelvic support belt will help support the hip joints
• Try to ensure even weight distribution when walking. This means you should not carry shoulder bags or lift your toddler up onto your hip while you are walking
• Avoid activities that cause strain on the pelvic joint ligaments
• Get help getting dressed
• Talk to health professionals about relaxation techniques to relieve the symptoms of PGP.

Is walking good for pelvic girdle pain?

When you have pelvic girdle pain you might find difficulty with any kind of movement.

Your physiotherapy plan may include manual therapy, relaxation techniques, and protection of the pelvic joints as appropriate activities.

The physiotherapist might also recommend activities, such as walking and other exercises, once your baby is born. In fact, walking can help regain muscle function as it strengthens the pelvic floor muscles.

Pelvic girdle pain pregnancy belt

Many women who experience pelvic pain swear by using a pregnancy belt.

These belly belts are designed to support your lower back and abdomen. The belt supports the area that is putting pressure on the front of your pelvis, where the pelvic joint is slightly separated at the pubic bone.

Belly belts also take some of the extra weight and pressure off your ligaments, by distributing the weight more evenly across your pelvis. They can also help you to correct your posture.

Always make sure you are using a belt correctly, and only for short periods, to avoid difficulty caused by blood flow restriction or weakening muscles. Speak to your care provider or physiotherapist for guidance about using a belt when pregnant.

Pelvic girdle pain in pregnancy – sleeping

If you are having difficulty getting in and out of bed, try crossing your ankles, keeping your knees and feet together, and moving slowly to protect your lower back.

Turning over in bed can aggravate pelvic pain.

Try bending first one leg, then the other leg, and rolling over inch by inch, while keeping your knees and hips aligned. The key is to avoid twisting.

Physiotherapists recommend that women experiencing PGP sleep with a pillow between their legs. The pillow helps to keep stability in the hips and pelvis and reduces your waking from joint pain.

Pelvic and low back pain in pregnancy treatment

There are several modes of therapy that help with pelvic pain.

They might involve one or several of these treatments:

• Therapy to help the joints of your pelvis, hips and spine to move as they should
• Exercise to strengthen the muscles of your pelvic floor, core, hip muscles and back
• Aqua therapy, exercise in water
• Pain relief, including TENS machine
• Advice about positions to adopt, or avoid, during sex or labor
• Support equipment, such as pelvic support belts or crutches.

Will pelvic girdle pain affect my birth plan?

Most sufferers of pelvic girdle pain are able to have a normal birth. Women with PGP can give birth as they want to, although they might need support in preparing for labor and planning for recovery.

Discuss your birth plan with your doctor or midwife so they know you have PGP and can best support you during labor.

Make sure your birth partner is aware of how to support your movement, especially when you’re going to your birth setting. For women with PGP, getting in and out of a car during labor can be especially difficult.

It’s a good idea to think about the positions that are most comfortable and those you can use during birth. Try to find the range of movement that you can comfortably manage and is pain free. This will help you during labor, especially if you have an epidural for pain relief, when you won’t be able to feel any pain related to PGP and might extend your legs too far apart.

Water births or water immersion during labor are great options because the water supports you and takes the pressure off your hips, pelvis and lower back during labor. Consider whether water birth is the right choice for you and whether a birth pool is available at your birthplace.

During the second, or pushing, stage, you might decide to lie on your side as the pain might be reduced. This prevents your legs from being too far apart and creating more problems. You can ask for support to hold your upper leg.

When someone experiences so much pain and discomfort, it’s completely understandable to wish for pregnancy to be over with. It’s also important, though, to make an informed decision about whether or not to have an induction or c-section.

A c-section is a major surgery that comes with its own set of risks for mothers. In addition, you’ll have a 6 week recovery from surgery to deal with.

What about the induction of labor?

For women with PGP, induction of labor isn’t a medical necessity. It’s something you should make an informed decision about, weighing up the amount of pain and your quality of life against the risks of inducing labor.

Induced labor contractions tend to be longer, stronger and closer together. Coupled with pelvic girdle pain, they tend to be more difficult to cope with. You are more likely to choose pain relief options that could affect your ability to move.

There are a lot of differences between natural and induced labor.

For more information read Natural Labour vs Induced Labour – 6 Main Differences.

Does pelvic pressure mean the baby is head down?

Generally, if you can feel some pressure in your pelvis and you’re around the full term, then it’s likely your baby is head down and dropping into the pelvis.

Your bump might also look lower. You could feel as though you need to waddle when you walk. Try to take it easy and slowly and rest frequently.

If you’re experiencing pressure and you’re not yet 37 weeks, have a chat with your midwife or GP. They can quickly assess you and make sure all is well.

When should I be concerned about pelvic pain during pregnancy?

Pain caused by pregnancy-related pelvic dysfunction is usually quite distinctive and feels like joint pain. For most women, by the time they’ve reached the later stages of pregnancy, pelvic pain is a regular feature of their life.

The baby’s head is putting pressure on their pelvic joints, their muscles and ligaments are stretched to capacity, and there’s a lot of weight to be moved around. Even the simple act of standing up from a sitting position can cause pain.

Remember, any vaginal or pelvic pain with the following symptoms needs attention:

• Vaginal bleeding
• Fever or chills
• Cramping that comes and goes
• Severe pain.

Contact your doctor or midwife immediately. It doesn’t matter how pregnant you are, there are some serious reasons for pelvic pain that include ectopic pregnancy, preterm labor, and miscarriage.

Will pelvic pain go away?

The good news is, for most pelvic girdle pain sufferers, giving birth to your baby will make your PGP symptoms disappear.

Bear in mind, you have relaxin in your body for around 4-5 months, so it can take this long for your pelvic girdle pain symptoms to fully resolve.

Unfortunately, around 20% of women will still have pain for up to 2 years after the birth of their baby.

Postpartum therapy with a physiotherapist might seem like a luxury, but it can make all the difference in your recovery after pregnancy and birth. It might also prevent long term conditions, such as incontinence and back or core problems.

If you experience pain after your baby is born, make sure you visit your doctor, midwife or physiotherapist for a long-term treatment plan.