While pregnant, some of you may experience pelvic pain, also called pelvic girdle pain or symphysis pubic dysfunction (SPD). It’s a very common problem, affecting 1 in 5 pregnant women.
Though it doesn’t harm your baby, it may have a profound effect on your quality of life and could make it hard for you to do daily chores.
However, early diagnosis and treatment can help relieve your pain.
What causes pelvic girdle pain?
Pelvic girdle or bony pelvis is a ring of bones at the base of the spine that connects your trunk and legs. Changes in the pelvic joints and muscles during pregnancy are the main cause of pelvic girdle pain.
Normally, the joints of the pelvis work together and move slightly. During pregnancy, however, the hormonal changes make your joints lax while the growing baby inside your womb and your weight gain put a strain on the pelvis. This results in uneven movement and a load on the pelvic joints, contributing to pelvic pain. In addition, your tummy, back, and pelvic muscles are also going through pregnancy changes, thus playing their part in pelvic girdle pain.
The exact reason why this pain affects some women is still unclear, but many associated risk factors have been identified.
The presence of these risk factors could make you more prone to developing SPD:
- History of trauma or injury to the pelvis (e.g., because of a fall or an accident)
- Existing backache or back problems
- History of pelvic girdle pain while pregnant
- Hypermobility syndrome (a condition where the joints stretch more than normal)
- A strenuous and physically demanding job
- A multiple pregnancy (twins, triplets, etc)
- Excess weight
When does pelvic girdle pain start?
The pain can start at any time during pregnancy or labor and even in the postpartum period. However, it mostly affects the 2nd half of the pregnancy.
Pelvic girdle pain symptoms
This pain can range from a mild ache to severe, debilitating pain. The following are the symptoms of pelvic girdle pain:
- You can have pain in the front of your pelvis, hips, perineal region (the area between the vagina and the anus), and lower back. This pain can also radiate through your thighs to your knees. Normally, this pain doesn’t affect your legs below the knees.
- You may experience clicking or grinding sounds and sensations in the pelvic area.
- The pain is usually triggered and aggravated by movements like:
- Walking long distances
- Prolonged sitting with a poor posture
- Walking on uneven surfaces
- Standing on one leg
- Going up and downstairs
- Getting dressed
- Turning and rolling over in bed
- Moving your legs apart as in getting in and out of the car
How to deal with pelvic girdle pain during pregnancy?
Some simple lifestyle changes and modifications can help you ease the pain. You should stay active but, at the same time, avoid activities that make your pain worse.
Here are some go-to tips for you:
- Avoid walking long distances. Keep your pace slow and give yourself some extra time. It’s advisable to take small and even steps.
- Avoid sitting for more than 30 minutes at a time. Change your position very often. Use a supportive chair with a footrest and avoid sitting with crossed legs.
- Refrain from lying on your back; always lie on the right or left side. Try sleeping on the less painful side. Use pillows under your tummy and bump and also between your legs. You can use 3 separate pillows or a single maternity pillow. Keep your knees together when rolling over in bed.
- Put equal weight on each leg while standing. Avoid standing on one leg. Wear comfortable flat shoes to help you maintain your balance.
- Try to get dressed while sitting so that you can avoid standing on one leg when putting on pants.
- While going up and down the stairs, take one step at a time. Lead with the less painful leg while going up and reverse this on your way down. Don’t go up and down too often.
- Try to keep your knees together while getting in and out of a car. In this way, you can avoid uneven strain on the pelvic girdle.
- Avoid carrying heavy weights, pushing heavy objects, and vacuuming. It’s better to use a small backpack instead of carrying shopping bags in one hand.
- Avoid twisting and stooping down or carrying your toddler on one hip. It’s better to put your kid in a stroller when going out.
- Request and arrange help for your daily household activities if you are finding it hard to get around. Feel free to talk with your partner, family, friends, and doctor about problems you’re facing because of pelvic girdle pain. Also, consider changing the nature of your job or working fewer hours if it’s making your pain worse. Listen to your body and take plenty of rest.
Treatment options for pelvic girdle pain
Talk to your doctor if you’re having some or any of the symptoms of pelvic pain. You will be offered an appointment with a physiotherapist, who will assess you to confirm the diagnosis of pelvic girdle pain. After a thorough evaluation and examination, your physiotherapist will suggest the right treatment for you.
This treatment may include:
1. Advice regarding lifestyle changes
You will be advised to avoid positions and postures that aggravate your pain. You’ll also be guided to adopt favorable positions to move, sit, and lie.
You will be encouraged to do exercises that strengthen your abdominal, back, and pelvic muscles and help relieve your pain. These exercises will improve your balance and make it easier for you to move around. Make sure that these exercise sessions are comfortable, safe, and pain-free.
3. Manual therapy
You may be offered manual therapy (also known as hands-on treatment) by a physiotherapist or an osteopath who specializes in pelvic girdle pain relief.
In manual therapy, they gently mobilize your joint with their hands and place it back in its position to relieve pain. After that, the joint starts moving normally again.
4. Aquatic therapy (hydrotherapy)
Hydrotherapy is a safe and gentle way to maintain fitness during pregnancy. It’s also a good option to treat pelvic girdle pain.
5. Warm baths and packs
A warm bath, a warm water bottle, or warm packs help in reducing joint and muscular pain. You can use them to alleviate pelvic girdle pain.
Gentle massage by a person who specializes in pelvic girdle pain relief could be beneficial.
You may be offered acupuncture—a system of complementary medicine in which fine needles are inserted at specific points in the skin to treat various physical and mental conditions. It has shown very good results in the management of pelvic girdle pain.
8. Pelvic support belts for SPD
Many pelvic support belts are available online and in stores, and they are very effective in relieving SPD.
After consulting your doctor, you can try the pregnancy support maternity belt, which provides support to your pelvic joints and lower back. It helps in reducing strain on your spine and maintaining balance by distributing your weight more evenly. The belt is very elastic and made up of comfortable breathable fabric.
9. Crutches or wheelchair
In cases of debilitating pelvic girdle pain, the temporary use of crutches or a wheelchair may become necessary to move around.
If your pain is still not easing, you may be advised to take some painkillers that are safe in pregnancy.
11. Hospital admission
If your pain is unbearable and you have very restricted mobility, then you may be offered admission to the antenatal ward for management. There, you will get regular physiotherapy and effective pain relief. You may have to be admitted from time to time during the course of your pregnancy.
Does pelvic girdle pain affect labor?
Do you know that most women suffering from pelvic girdle pain deliver vaginally? Yes, SPD isn’t normally considered an indication for elective C-section.
You can discuss your birth plan with your midwife before labor and get detailed information about the most comfortable and most suitable birth positions for you. You can consider the option of water birth because it allows you to move more easily.
Also, make sure that the team looking after you during labor is aware of your condition so that they can ensure your legs and pelvis are well supported and assist you to change position.
When does pelvic girdle pain go away?
In the majority of cases, pelvic girdle pain eases in the 1st month after delivery, but sometimes it may take longer. If you have ongoing pain after delivery, continue taking treatment and pain relief.
In case of persistent severe pelvic girdle pain, consider talking to your doctor. He may refer you to a specialist to exclude other causes of pelvic pain.
Will pelvic girdle pain recur in my next pregnancy?
You are more likely to have SPD in your next pregnancy if you had it in the previous one. Therefore, it’s better to optimize your health and fitness beforehand to decrease the chances of recurrence.
Try to be in the normal weight category and do regular exercise to strengthen your abdominal and pelvic muscles. If it still occurs again, start early treatment to get better.
Pelvic girdle pain is a common problem that many of you may have to face during pregnancy. It’s always best to seek treatment early—the sooner you start, the better the results.