- What is pelvic girdle pain?
- When does PGP develop in pregnancy?
- What causes pelvic girdle pain?
- What are the symptoms of pelvic girdle pain?
- How is pelvic girdle pain diagnosed?
- Treatment for pelvic girdle pain during pregnancy
- Exercises that help relieve pelvic girdle pain
- How to cope with pelvic girdle pain during pregnancy?
- Does pelvic girdle pain affect your labor?
- How soon will pelvic girdle pain disappear?
- Does PGP recur in your next pregnancy?
- Frequently asked questions
During pregnancy, your body is likely to undergo many changes. While some can make you happy, others can cause pain and discomfort.
One such unavoidable pain is pelvic girdle pain that affects about 80% of pregnant women. The pain can have a significant impact on your daily activities, which can also lead to a chronic disabling condition later in life (1).
What Is Pelvic Girdle Pain?
The pelvis, which is the largest bone of the skeleton, is where the hip bones are situated. The pubic symphysis joins them at the front, and two sacroiliac joints link it at the back. A strong network of ligaments surrounds these joints, keeping the bones intact.
Pelvic girdle pain (PGP) refers to the pain anywhere from the front of the pelvis to the back, buttocks or down the leg, groin, lower abdominal, inner thigh, and vaginal area. The pain can be mild to severe and can limit your mobility and quality of everyday life.
It may begin anytime during pregnancy or when you are nearing labor. It can develop after delivery as well (2).
When Does PGP Develop In Pregnancy?
- You will feel the pain during early pregnancy (or first trimester) or a few days before labor.
- The pain and discomfort you experience in the later stages of pregnancy (or third trimester) are due to the baby heading down into the pelvic region.
- You will also feel the pain during the postpartum period (3).
- If you have already experienced the pain during one pregnancy, you are likely to have it again in the subsequent pregnancies. However, the pain will be bearable if you have managed it well in the first pregnancy.
Keep reading to know why you experience this pain during pregnancy.
What Causes Pelvic Girdle Pain?
The primary cause of pelvic girdle pain is the low positioning of the fetus in the pelvic region. The increasing size of the fetus puts pressure on the pelvic bones, joints, and ligaments, leading to discomfort. However, there is also a combination of other factors responsible for increasing the risk of PGP (4) (5).
- Uneven movements of the pelvic joints
- Changes in the way the pelvic muscles work to support the girdle
- Abnormal functioning of one pelvic joint, which stresses the other joints
- Increasing maternal weight
- Change in the center of gravity as the fetus grows
- Pregnancy hormones affecting the connective tissues in the pelvic region
- Prior injury or trauma to the pelvic region, from an accident or a fall
- Repetitive or strenuous physical activities
- Exercise routines that strain the pelvic movements
- The position of the fetus putting pressure on the pelvic area
- History of the lower back or pelvic pain
- Physically demanding work routine
So, how do you know if it is PGP and not something else? Keep reading to know.
What Are The Symptoms Of Pelvic Girdle Pain?
The location and severity of pain vary from woman to woman. The pain can only be on one side, move from one side to another, or it can be a general ache or shoot up suddenly and disappear.
The common signs and symptoms of PGP include:
- Pain in the lower back, hips, knees, groin, pubic region and thighs
- Grinding or clicking in the pelvic region
- Pain is noticeable during movements such as – Walking on rough surfaces or for long distances, Climbing stairs, Sitting or standing for a long time, Moving your knees while getting in and out of the car or a bathtub, Lying on the bed in some positions and Sexual intercourse
Pain is often worse at night, especially if you are active throughout the day. Symptoms aggravate with the increasing weight of the baby and changes in the center of gravity. It occurs due to the relaxin hormone which usually softens the ligaments, allowing the pelvis to widen and make room for the baby (6).
How Is Pelvic Girdle Pain Diagnosed?
If you happen to feel any discomfort in the pelvic region, go to the doctor. The doctor will examine you thoroughly, and ask you about the origin of the pain and its severity. Provide all the relevant information about your activities or movements that may be causing the pain, so that the doctor can make the right diagnosis.
Pelvic girdle pain is usually diagnosed as sciatica by most doctors. However, a physiotherapist can make an accurate diagnosis as they take a detailed look at the pelvic muscles and joints.
Treatment For Pelvic Girdle Pain During Pregnancy
PGP is treatable, and you can manage the pain with a few home care tips. Specific exercises and lifestyle changes can help in easing the pain and making the pregnancy better (7).
A physiotherapist usually treats pelvic girdle pain. Treatment includes:
- Advise on avoiding movements that aggravate the pain, best positions for resting and movement, and pacing your activities to reduce your pain.
- Exercises that can relieve your pain, and help you move comfortably. They help strengthen your pelvic floor muscles to improve your balance and make the spine stable.
- Manual therapy that includes manual realignment of joints is done in multiple visits until the muscles become stronger enough to hold the joints.
- Pain relief methods such as TENS (transcutaneous electrical nerve stimulation)
- Hydrotherapy, which involves exercising in water, can provide relief to a certain extent.
- Acupuncture from an experienced acupuncturist
- A warm bath, heat and cold packs
- Pelvic support belts or crutches
If you have severe pain that is limiting your mobility, your doctor will prescribe pain relief medication such as paracetamol.
Exercises That Help Relieve Pelvic Girdle Pain
Some exercises will help relieve the pain but check with your doctor before trying them. Stretching and strengthening the muscles of your lower back, hips, and quads will greatly help (8).
- Bridge exercise: Lift your hips up by squeezing the pelvic floor and breathe out. Remain in this pose for two to three seconds, and lower the hips. Repeat.
- Hip lifts: Kneel on all the fours, lift one foot upwards and back down. Repeat.
- Leg press: Lie on a side and lift the hip towards the chest. Next, push out by squeezing the pelvic floor muscles and buttocks.
- Leg lifts: Lie on one side and lift your leg, but not too high. Bring it down slowly and involve in only small movements.
You can also do pelvic floor exercises such as pelvic tilts, kegels, cat stretch and hip bridge. Stability ball exercises will also help.
How To Cope With Pelvic Girdle Pain During Pregnancy?
You can manage the pain before and after treatment, with the below measures (9):
- Stay active as much as the pain allows you to, and rest whenever possible.
- Try alternating the positions from sitting to standing during an activity.
- Sleep on a side, with the pillow to support your belly and upper leg.
- Explore different ways of climbing stairs. While using the staircase, use the pain-free leg first and then the other leg.
- Avoid activities such as bending to lift something or carrying anything, as they put stress on the pelvis.
- Indulge in safe sex positions such as kneeling on all the fours, or lying on one side.
- While walking, take shorter steps rather than longer strides.
- Avoid sitting down in a cross-legged position
- Be alert while involving pelvic floor muscles before laughing, coughing or sneezing.
- Use chairs that have a backrest, or use a cushion for supporting your lower back.
- Keep your knees together while getting out of the bed.
- Use footwear with low heels and that have arch support.
- Get a prenatal massage from a specialized therapist.
Following these tips can help keep the pain away during pregnancy. That brings us to the next question.
Does Pelvic Girdle Pain Affect Your Labor?
PGP will not affect your labor in any way. But if you are still apprehensive, talk to your doctor about the birth options. The doctor will ask you to try a few positions for vaginal delivery. They include:
- Sitting upright or in a kneeling position
- Side-lying with knees or pillows against the chest
- Avoid lying down with your back
Take your doctor’s help to understand the right position for birth. In some cases, PGP can make it difficult to open your legs up during delivery. In the case of severe pain, you may have to go for an assisted birth.
If natural birthing is ruled out due to pain, your doctor will recommend a cesarean section. This is generally the last option as a cesarean can slow down your recovery from pelvic pain.
How Soon Will Pelvic Girdle Pain Disappear?
PGP will go away within a few weeks or months after birth. The chances of postpartum pelvic girdle pain usually exist if the condition was severe during pregnancy (10).
Mild pain might recur before periods, as the hormones (estrogen and progesterone) that act upon the menstrual cycle might affect as the pregnancy hormones do.
Does PGP Recur In Your Next Pregnancy?
Yes, PGP can recur in the subsequent pregnancy, but it can be managed effectively if you remain fit and healthy. Consider having a gap between pregnancies, and try to stay fit and lose weight to lessen the pelvic girdle pain.
Strengthening the abdominal and pelvic floor muscles will lessen the chances of PGP in the following pregnancy.
Next, we answer some frequent queries about PGP.
Frequently Asked Questions
1. Can I get pelvic girdle pain when you are not pregnant?
Yes, you may develop PGP from any injury or arthritis. However, pregnant women are more prone to this condition than those who are not pregnant.
2. Are pelvic girdle pain and sciatica similar?
Pelvic girdle pain is often misdiagnosed or confused with sciatica because both are known to cause pain in the lower back or buttock region. Sciatica is a pain that radiates from the lower back, towards the buttocks and into one or both the feet, whereas PGP refers to pain in any part of the pelvic region to the vaginal area.
3. Can PGP cause early labor?
PGP is unlikely to cause early labor. Exercises, support belts, and some lifestyle changes will help you reach full term.
If you experience any pain in the pelvic region, severe or mild, more often during your pregnancy, consult your doctor. The doctor will suggest you some exercises that will keep you going until your delivery.
Did you have to deal with pelvic girdle pain during pregnancy? Tell us you coped with it, in the comments section.