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Topic of the Month - August 2009

Pelvic Girdle Pain in Pregnancy
[Also known as Symphysis Pubis Dysfunction and Pelvic Dysfunction]

Pelvic Girdle Pain is one of the side effects of pregnancy that you tend not to hear about until it affects you. The pain, which usually begins about 14-15 weeks into pregnancy makes it hard to walk, climb stairs, turn over in bed, drive and even get in and out of a car. The pain distribution is saddle-shaped: inner thighs, pubic area, groin, seat and hips. Sometimes there is a clicking or graunching feeling on movement. It might feel like your pelvis is falling apart.

What is happening

Joints are moving out of their normal position due to the effects of a pregnancy hormone called relaxin. Normally the joints are kept in a stable supported position by ligaments and fibrous connective tissues. Relaxin softens the ligaments: nature's way of accommodating the growing foetus and eventually the birth. However if these ligaments loosen too much and/or too soon, your normally stable pelvis can distort due to a combination of the weight of your growing baby and the everyday twisting movements from ironing, hoovering, climbing stairs, driving etc.

Looking at the pelvis there are several places that often give you pain during pregnancy notably the symphysis pubis and the sacroiliac joints.

Female Pelvis available to purchase from Amazon

Your pelvis is shaped like a bony basin. At the back the sacrum wedges in between the two pelvic bones and has two joints called the sacroiliac joints. If you look at your back in a mirror you can see two dimples about 3 inches out from the midline at the base of your spine, the dimples are over your sacroiliac joints. At the front the two pelvic bones meet in the midline at the pubic symphysis. You can feel the symphysis quite easily as a slight groove at the top of your pubis, it is often tender when you press on it but when it is misaligned or separated it will be very tender. The sacroiliac joints and the pubic symphysis are the areas that most often cause pain during and after pregnancy.

Pelvic Girdle Pain is such a common problem that it has its own acronym, PGP. The other abbreviation you may come across is SPD (Symphysis Pubis Dysfunction) which is a more specific diagnosis.

If the pain has just begun try tying a sarong tightly around your pelvis, keep it low so as not to press on your tummy, until you can get something more supportive.

Support the pelvis by wearing a pregnancy support belt such as the Procare (Donjoy) Maternity Belt.

Procare (Donjoy) Maternity Belt for lumbar and pelvic pain in pregnancy

Be careful how you move. One of my physio friends gives the following advice "behave as if you are in public, wearing a short skirt and no knickers" Whenever you move keep your knees together and your movements small and careful, especially when getting in and out of chairs, cars and going up stairs.

Avoid activities that aggravate your symptoms, usually twisting activities like hoovering and ironing.

Call your osteopath. The good news is that because everything is so mobile it is easy for your osteopath to realign your pelvis at intervals during the pregnancy and after the birth (ideally within two weeks while the relaxin levels are still raised). The bad news is that you can easily twist your pelvis out of alignment if you are not careful.

I find gentle cranial osteopathic techniques work well. I like to use an air mattress on the treatment couch so that I can ease the pelvis slowly and gradually into a more balanced position while you lie on your back, or in the later stages of pregnancy, on your comfortable side.

If your pain is focused in your low back or hip I sometimes suggest acupuncture, especially in the late stages of pregnancy when your muscles are working overtime just to move you around.

View all lower back supports here

Bill Ferguson
Tenterden Osteopathic Clinic
2 St Benets Court
Tenterden, Kent
Tel: 01580 762754

Email: mail@billferguson.co.uk

© Created by Sue Ferguson
Enquiries to : mail@sueferguson.co.uk
Last Updated: 7 February, 2010