Pelvic girdle pain is common during pregnancy and often confused with pregnancy lower back pain. It is also known by other terms such as pubic symphysitis, or symphysis pubis dysfunction.
While it is commonly accepted that aches and pains are a general part of pregnancy, it is important to know that there is a difference between lower back pain and pelvic girdle pain during pregnancy, and that they can both be treated and managed with physiotherapy.
But first of all, what is the pelvic girdle?
The pelvis is the amazing space that houses and protects the pelvic organs, which include the bladder (for storing urine), the uterus (for bub), and the rectum (for faeces or stools). The pelvic girdle are the three bones that make up the bony pelvis. These consist of the two bones which wrap from the sides to the front (the ilium bones), and the sacrum (the tailbone) at the back.
Between these three main bones are three main bony joints. At the front of the pelvis is the pubic symphysis (aka the pubic bone) and the two joints at the back (near those little dimples) which are the sacroiliac joints. It is any of these three joints that can become irritated and cause discomfort during pregnancy causing the symptoms of pelvic girdle pain.
What are the main symptoms of pelvic girdle pain?
During pregnancy, pelvic girdle pain is often felt at one or multiple of these areas:
- Pain on the pubic bone which can refer into the inner thighs, clitoris and pelvic floor
- Pain or discomfort at the back of the pelvis (in one or both of the sacroiliac joints) that can refer into the buttocks, tailbone, or down the thighs
It is commonly felt:
- When turning in bed
- After prolonged walking, sitting or standing
- When putting on shoes and socks
- When going up and down stairs, or after some forms of exercise
What causes pelvic girdle pain?
During pregnancy, the body’s joints become more lax. This includes the pelvic girdle, to prepare it to widen for baby to come through during a vaginal birth. It is this laxity that causes changes in joint dynamics in the pelvic girdle, which can irritate the pelvic girdle joints, causing pain and discomfort. However, it is important to understand that this laxity and discomfort does not mean that the pelvis or joints are unstable.
This change in joint dynamics means that asymmetrical movements (for example standing on one leg when putting on shoes and socks), and even some exercises that favour one side of the pelvis instead of both may continue to irritate the pelvic joints if they are not modified. Recovery rates can to vary depending on how many joints are involved, and this is something your physio can help you predict and manage.
What is the best treatment?
It is important to see a physio who specialises in management of pelvic girdle pain and who can make a correct diagnosis (as it can be confused with lower back pain during pregnancy). Treatment can consist of exercises, changes to how you are performing your daily activities, modifications as needed to any exercise you may be doing, massage and manual therapy, and often fitting for a pregnancy pelvic girdle pain specific belt can help.
As the pelvic girdle is also the home to the pelvic floor, pelvic girdle pain can often have an impact on the pelvic floor and vice versa if you are having any pelvic floor issues. Our physios have specialised knowledge in pelvic floor conditions and understand the influence and interplay between the two. If you have pelvic girdle pain, this may change which pelvic floor exercises are suitable during pregnancy (sometimes squeezing and strengthening is not always appropriate despite what we commonly think or are told!).
Our physios also love exercise and will advise on the exercise modifications during pregnancy. We want all our mums to stay fit and healthy but with consideration to suitable exercises to avoid irritating the pelvic joints.
At Sunrise Pelvic Physiotherapy, we specialise in pelvic girdle pain management and all pregnancy related aches and pains please contact our clinic for more information if you think you may have pelvic girdle pain that we can help with.
Written by Tusanee Jierasak
