Pelvic Girdle Pain

By Physiotherapist Demi Abbott.

What is Pelvic Girdle Pain?

Pelvic Girdle Pain is a collection of uncomfortable symptoms felt in the pelvis or lower back (lumbopelvic area) that come about due to increased pelvic joint mobility and relaxation of ligaments around your pelvic area.

Symptoms vary from person to person and can range from mild discomfort to severe, debilitating pain. These symptoms may include:

• Pain over the pubic bone at the front
• Pain across one or both sides of your lower back
• Pain in the area between your vagina and anus
• Pain that radiates to low back, belly, groin, hips, thighs, knees and legs

Pelvic girdle pain commonly presents between weeks 13 and 40 of pregnancy and limits functional everyday activities such as standing, walking, sitting, stairs and rolling over in bed.

It is estimated up to 70% of pregnant women will experience some degree of pelvic girdle pain by late pregnancy and 20% of pregnant women will experience severe PGP. In up to 25% of women, pain can persist into the post-partum period for up to two years post-partum.

Treatment

As Pelvic Girdle Pain can have several different causes, it’s important you see a physiotherapist for assessment to ensure best treatment. Your treatment may include:

• Soft tissue release including massage or dry needling
• Joint mobilization techniques
• Stretches and range of motion exercises
• Taping
• Equipment and support garments as required
• Patient specific exercises

Studies have found that women receiving physiotherapy reported less intense pain in the morning and evening than women that aren’t receiving physiotherapy care. It has also been found that women prescribed with appropriate support garments have improved functional outcomes compared with those without supports.

Management

What can you do to manage your pain at home?

• Wear low heeled shoes
• Limit non-essential weight bearing activities
• Reduce activities that involve standing on one leg (sit down to get dresses, elevator instead of stairs)
• If you need to take the stairs – use a step-to gait (one leg up, then other leg onto the same step)
• Avoid activities that involve taking one leg out to side (modify technique for getting in/out of car and bed)
• Apply heat to painful areas
• Wear a maternity support garment

Important points to note if you are suffering with Pelvic Girdle Pain

1. This pain is likely to resolve once your baby is born!
2. Your pain and the management of your pain will not impact your baby
3. Your pelvic is not unstable! Your pelvis is one of the strongest structures in your body. It is extremely stable and can safely transfer load.

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Reference List

Richards E, Van Kessel G, Virgara R et al (2012) Does antenatal physical therapy for pregnant women with low back pain or pelvic pain improve functional outcomes? A systematic review. Acta Obstet Gynecol Scand 91(9): 1038–45.

Pennick V & Young G (2007) Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Sys Rev 2007 Issue 2. Art. No.: CD001139. DOI: 10.1002/14651858.CD001139.pub2.

European Guidelines for the Diagnosis and Treatment of Pelvic Girdle Pain European Spine Journal. 2008; vol 17(6):794-819

Department of Health. Clinical Practice Guidelines: Pregnancy Care. 2019 Edition. Canberra: Australian Government Department of Health. https://www.health.gov.au/resources/pregnancy-care-