Pregnancy Related Pelvic Girdle Pain

This article is by Eglantine Hallo, the osteopath in Islington at the Angel Osteopathic Clinic. Eglantine has a keen intertest in seeing mothers and babies and mum's to be, and the feedback from the mums is that Eglantine really gets to grips with the problem and works tierlessly to find a solution.

What is Pregnancy Related Pelvic Girdle Pain (PGP)?

- Pregnancy-related pain, instability and dysfunction of the lumbo-sacral region, sacro-iliac joints (SIJs) and symphisis pubis joint (SPJ).
- It may have a mechanical origin and be related to a level of instability of the pelvic joints
It was previously described as symphisis pubis dysfunction SPD

Diagnosis

Pain distribution can present differently in each individual:

Lower back
Symphisis pubis joint
Sacroiliac joints
Groin
Anterior and posterior thigh
Hip region
Pelvic floor

Common Signs and Symptoms

- Difficulty walking (waddling gait) with a diminished endurance for standing, walking or sitting.
- Pain on weight bearing on one leg (climbing stairs, dressing)
- Pain and/or difficulty in straddle movements (getting in and out of bath and/or car, turning in bed)
- Clicking or grinding in pelvic area (may be audible or palpable)
- uncomfortable in lying positions
- Pain and difficulty during sexual intercourse

Epidemiology

- About 1 in 5 pregnant women have PGP
- 50% to 70% of women suffer from lumbar- pelvic pain during pregnancy
- True PGP occurs in 14-22% of all pregnant women and 5-8% of these have severe pain and disability
- PGP remains in 7% of women after birth

What Causes Pregnancy Related Pelvic Girldle Pain?

It can be due to various factors and often there is no obvious explanation.
Combination of factors:

- the pelvic girdle joints move asymmetrically
- dysfunction in the pelvic girdle biomechanics (from altered activity in the spinal, abdominal, pelvic girdle, hip and/or pelvic floor muscles)
- the hormone Relaxin tends to loosen the pelvic girdle creating instability
- Occasionally the position of the baby may produce symptoms allied to PGP.


Main Risk Factors:

- History of previous LB/pelvic girdle pain and/or previous trauma to the pelvis girdle
- Poor muscle function in the back and pelvis
- PGP in a previous pregnancy
- Multiparity
- Heavy workload and poor workplace ergonomics
- overweight pre and during pregnancy.
- General joint hypermobility


Advice

- Having some symptoms doesn’t mean it will automatically get worse
- Early diagnosis, advice and treatment can lead to full resolution or reduction of the symptoms (However, in a small % of women, PGP may persist after the birth, mainly if not managed appropriately)
- Osteopathy can help prevent and manage PGP with the use of soft tissue, gentle mobilization and balancing. We can follow your pregnancy make sure your body stays balanced and ready for birth.

Your osteopath will show you appropriate stretches and exercises to do such as:
Pelvic tilts
Circles
Abdominal strength and awareness.

If you are pregnant or have just had a baby and if you have any of these symptoms please call Eglantine at the osteopathic clinic in Islington to arrange an appointment on 020 7288 2999 or click the link below to make an appointment.



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