With pregnancy can come all manner of aches and pains – it's hard work carrying a baby around in your belly, especially as you approach full term. But pelvic girdle pain (PGP), sometimes known as symphysis pubis dysfunction (SPD), has very specific causes, and they can be treated to make your life more comfortable.
What is it?
Pelvic pain occurs during pregnancy because your hormones have made your pelvis less steady than normal. Usually, it stays locked in position when you are walking around and standing, but at this time your pelvis becomes flexible – and this can lead to inflammation, misalignment and stiffness. It's thought about one in five pregnant women experience it to some degree. Many women start experiencing pain around half way through their pregnancy, and it can continue until after you have given birth. The pain can be felt at the front, around the pubic bone and/or in the perineum (between the vagina and anus), or it can be felt in the lower back (on one or both sides) and in the hips. For some women, the pain even radiates down their legs.
Quite often, the pain feels worse when you part your legs, for example, when you get in and out of bed. It can be difficult to stand on one leg (not that you would want to do this much when heavily pregnant but, for example, when putting trousers on!) and walking and climbing stairs can become very uncomfortable. Some women report a grinding noise in their pelvis, or feeling like they need to 'pop' their hips into place when they stand.
Known risk factors for pelvic pain during pregnancy include having a history of pelvic or lower back pain; a previous injury to the pelvis; and having suffered from pelvic pain in a previous pregnancy.
What can I do?
Pelvic pain can be a real problem during pregnancy and can make it very difficult to get around. If you're in a second or later pregnancy, and you have suffered with pelvic pain previously when pregnant, do speak to your midwife straight away, because the symptoms might come on quicker and be worse this time round.
When you tell your midwife about your symptoms, she might refer you to a physiotherapist, who will gently manually manipulate your pelvis to help it back into the correct position, easing your symptoms. Pelvic pain can also be treated by an osteopath, or chirpractor. Always make sure the therapist is registered.
If you are suffering from pelvic pain, it's unlikely to completely go away until after your baby has been delivered, and so it's worth getting treatment sooner rather than later, and keeping up with it on a regular basis.
The therapist will give you exercises to do at home, which are designed to strengthen your pelvic floor muscles, as well as the muscles in your back, hips and tummy. Gaining strength in all these areas will help by giving added support to your joints which are under pressure.
If you have been referred for physio, your therapist might provide you with equipment to ease your symptoms and make your life easier – for example, crutches or a pelvic support belt. They might also help you discover your 'pain free range of movement' – basically how far apart you can open your legs without experiencing pain. Although many women with PGP can manage a normal vaginal delivery, knowing this range can be important when considering labour positions, and particularly if you have an epidural.
Just like with regular back pain in pregnancy, there are various things you can consider and factor into every day life in order to minimise the pain your experience from PGP. For example, rest whenever you can, but do stay active within your pain limits, because those exercises really are helping.
Wear flat and supportive shoes, and work on your posture – don't cross your legs, and don't sit or stand in one position for long periods of time. Avoid heavy lifting, and avoid carrying a baby or child on one hip (or keeping a heavy handbag on one shoulder, get yourself a rucksack instead). You may find it difficult to push a hoover round, let alone a loaded shopping trolley, so get help with these sorts of things (yes, that's like to be doctor's orders!).
You might need to find new ways of doing normal things. If you are finding it hard to sleep, try popping a pillow between your legs and if stairs are an issue, you might try going up backwards on your bum (that'll be a talking point at the office if you don't have a lift).
There are many things you can do to ease your discomfort, so speak to your midwife or GP about any specific concerns. Soon after your baby is born, things should return to normal.
The Association of Chartered Physiotherapists in Women's Health (ACPWH) has a free downloadable booklet with more information and advice.
The General Osteopathic Council website allows you to search for a registered osteopath.
Go to the General Chiropractic Council to search for a registered chiropractor.
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