Sep 03 2010
Pelvic Girdle Pain
Your pelvic girdle or pelvis is made up of two ‘hip’ bones
(called ilia) joined to a bone called the sacrum at the back.
The two ‘hip’ bones are connected at the front by a joint
called the symphysis pubis. The joints between the sacrum
and the ‘hip’ bones at the back are called sacro-illiac joints.
All of these joints are strengthened by ligaments and
normally are very stiff.
P e l v i c G i r d l e P a i n
In order to help your baby move through your pelvis when it
is born, your body softens the ligaments in your pelvis.
This causes the joints around your pelvis to move more
during and just after pregnancy.
What happens to these joints during
pregnancy?
What causes pelvic girdle pain?
We are still learning about the exact causes of pelvic pain
but it is thought that this softening, along with your
posture, weak muscles and differences in the way the right
and left pelvic joints move, can cause too much stress on
the joints, ligaments and muscles of the pelvis.
Pelvic girdle pain can sometimes be mistaken for sciatica
but studies show that only around 1% of women suffer
from sciatica during pregnancy.
What are the symptoms of pelvic girdle pain?
The pain is often on one side and may be strongest
around one of your buttocks. It may appear to jump from
side to side or be accompanied by a general back pain or
pain at the front of your pelvis, near your bladder. It can
send shooting pains into your buttock or down the back of
your legs. You may also have pain in your hips. One or
both of your legs may feel very weak and you may not be
able to lift your legs, especially when lying down.
What makes the pain worse?
The pain is usually made worse by lying on your back,
turning over in bed or walking and standing from a sitting
position. It is often worse at night and the amount of night
pain will probably be related to how active you are during
the day. Separating your legs, especially when sitting in a
slumped position or lying down can be painful
At what stage in pregnancy does it occur?
Pelvic girdle pain can begin as early as 2-3 months or as
late as the last few days before delivery. If the pain comes
on at the very end of pregnancy, it may be due to the
baby’s head ‘engaging’ or moving down into the pelvis. If
this is the case, it is not usual to have pain after delivery.
If you experience pelvic girdle pain in one pregnancy it is
more likely to happen earlier in your next pregnancy, and
without professional advice or treatment, may be more
severe.
How is it diagnosed?
A maternity physiotherapist will assess how stable your
pelvic joints are, examine your back to make sure the
symptoms are not coming from there, and take a detailed
look at how the muscles of your tummy, back, pelvis and hip
are working.
How will it be treated?
If your pelvic joints are found to be moving more than is
normal, you will initially be given a pelvic support belt. In
around 80% of women, these give instant relief and can be
worn safely for as long as you need them. You may need
mobilisation (a gentler form of manipulation) of your hip,
back or pelvis. Exercises – especially for the tummy and
pelvic floor muscles – form a large part of the treatment and
are aimed at making your back and pelvis more stable.
You will also be given advice on how to make normal daily
activities less painful and on how to make the delivery
easier.
Will it affect my labour?
With the correct advice, it is rare for pelvic girdle pain to
cause any problems in labour. If possible, it is advisable to
avoid lying on your back to deliver your baby – upright or
kneeling positions protect the pelvic joints and are generally
more comfortable. If you have to sit on the bed during
labour, sitting as upright as possible makes separating your
legs easier.
