Pelvic Girdle Pain (PGP)
Pelvic girdle pain (PGP) is pain in the region of the pelvis and is a very common condition associated with pregnancy - up to 84% of pregnant women experience some degree of PGP or low back pain during pregnancy! (Homer & Oates, 2018)
The pelvis is a ring of three bones rigidly held together by bony congruity, ligaments and muscles, and sits at the bottom of your spine. It acts as an anchoring site for many stabilising structures, such as your abdominals, gluteal group and pelvic floor muscles. It also links the lower limbs to the spine via the hip joints. There are three pelvic joints: the pubic symphysis located at the front and centre of your pelvis, and two sacroiliac joints (SIJs) at the back of the pelvis, one located on either side of the base of the spine (sacrum).
PGP is defined as pain between the posterior iliac crest and gluteal fold, particularly in the region of the SIJs that may or may not be associated with pubic symphysis pain. The pain may be local or diffuse, and refer elsewhere such as into the gluteals and thighs. Common symptoms of pelvic girdle pain can include:
Pain at the front and/or back of pelvis, and pain at the gluteal or thigh region
Reduced endurance capacity for standing, walking & sitting
Pronounced difficulty during asymmetrical movements, such as turning over in bed, walking up the stairs, walking, prolonged sitting/standing
‘Catching’ of the leg whilst walking
Common areas where Pelvic Girdle Pain is felt
PGP is commonly experienced during pregnancy. As hormonal changes occur, the pelvic ligaments increase in laxity to prepare the body for birth. This means that there is increased movement between the joint surfaces of the pelvis as it becomes ‘looser’, resulting in instability, irritation and inflammation of the joints. Muscle spasm may also occur as there is now an increased demand on active stabilisers to maintain a stable pelvis. There may also be a movement of one component of the pelvis into a rotation, slip or torsion which can lead to compression of the joint.
PGP is different from pain that originates from the lumbar spine, and tends to gradually increase in intensity as pregnancy progresses. Common risk factors for PGP include
Previous pelvic or low back pain
Previous trauma to the area
Increased body mass index (BMI)
Multiparity
Emotional distress
Smoking
Early diagnosis and treatment is key to relieving pain, stopping symptoms from progressing, and to allow you to continue your normal everyday activities. A detailed history and physical examination is key in accurate and timely diagnosis, and to exclude other significant pathologies and obstetric complications.
Management aims to optimise the mechanics of the pelvis during this stage through manual therapy, specific exercise and activity modifications. Pelvic belts or taping to increase stability of the pelvis may also be beneficial.
Do you think you might be suffering from PGP? Give us a call and have a chat about how we might be able to help you.