Saturday 10 December 2016

Pelvic girdle pain

Another issue pregnant women may suffer from, often in silence, is pelvic girdle pain. Physiotherapist Jenny Branigan explains about the condition

Published 08/10/2011 | 13:52

PELVIC girdle pain (PGP), formerly known as symphysis pubis dysfunction, is a significant problem for up to 20pc of pregnant women.

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Many suffer in silence, convinced it is part of being pregnant.

Ignoring the symptoms of PGP can lead to considerable aggravation of the condition, especially during the third trimester of pregnancy.

PGP is defined as pregnancy associated pain, instability and dysfunction of the symphysis pubis joint (at the front of the pelvis) and sacroiliac joints (at the back of the pelvis).

The symptoms can vary from mild discomfort to severe pain with disability and it can affect mums-to-be during pregnancy and new mums during the postnatal period.

In up to 10pc of women, PGP can begin in the first 12 weeks of pregnancy, well before any of the outward signs of being pregnant are present.

Many women who suffer from PGP initially neglect to mention their symptoms during routine antenatal visits.

The symptoms of PGP are frequently dismissed as normal pains to be endured during pregnancy and, in fact, PGP is frequently mismanaged as a low back pain problem.

PGP is a significant, common, and most importantly, treatable obstetric problem.

It can be safely treated during pregnancy and in the postnatal period.

For optimum results, women with symptoms of the condition should be promptly assessed and treated by a chartered physiotherapist used to dealing with pregnant and postnatal women.

According to European guidelines, the main risk factor for developing PGP is a previous history of low back pain or pelvic pain.

The static nature of many jobs with long commuting times and long hours are also significant considerations.

Recurrence rates of PGP are high. If you suffered with PGP in the past and are now pregnant, visit your local chartered physiotherapist for a full assessment of your lower back and pelvis.

This will allow identification of the reasons why you have developed PGP and a specific plan can be put in place to treat the condition early. PGP can occur at any stage of your pregnancy.

It may come on suddenly, or start gradually. The symptoms of PGP can vary greatly from person to person and can include pubic joint pain and tenderness to touch, pain or stiffness in the mid or lower back, catching or sharp groin pain, and pain or pulling sensation in the lower abdominal muscles, in the inner thigh or the front of the thigh.

These symptoms manifest in daily life as difficulty turning in bed, moving from sitting to standing or using the stairs.

Walking problems are more common later in the pregnancy and can range from feeling discomfort when walking, to developing a waddling gait pattern to needing crutches for support.

Difficulty walking after a period of sitting or resting is a common complaint as well as pain on any activity that involves lifting one leg at a time or parting the legs, such as getting into your car or bed.

Some relief can be achieved by using pillows between your legs when sleeping and one under your bump to support it; avoiding standing on one leg; standing with your weight evenly distributed through both legs; sitting down to put on underwear and trousers; swinging the legs together as a unit when getting out of the car; remaining active within pain limits but resting when necessary.

A visit to your chartered physiotherapist is needed to assess the position and the symmetry of movement of your pelvic joints, especially the sacro-iliac joints.

Treatment will involve manual correction of the dysfunction.

Soft tissue work and trigger point release is often necessary to reduce pain in the tightened muscles around the pelvis, lower back and hips.

Advice on suitable pelvic support will be given depending on your symptoms.

We can show you how to improve your posture with exercises and advise on how to manage the condition in the context of your lifestyle taking into consideration your work, commuting and your other children.

It is important that treatment continues until you are completely pain-free, to minimise the risk of a recurrence of PGP.

PGP is a significant, common, and treatable obstetric problem.

The earlier your symptoms are identified and diagnosed as PGP, the better the prognosis for your recovery will be.

PGP can begin in the first trimester of pregnancy, so contact your chartered physiotherapist if you have any of the symptoms mentioned above.

IMPORTANT:

This information is not a substitute for a proper assessment with your chartered physiotherapist. If you are suffering with any pain or injury, contact your local chartered physiotherapist. It is vital to deal promptly with these aches and pains as they will only get worse as your baby gets bigger and heavier.

Mother & Babies

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