Pelvic Pain in Pregnancy
What is pelvic pain in pregnancy called?
Pelvic pain in pregnancy is called Symphysis Pubic Dysfunction (SPD) or Pelvic Girdle Pain (PGP). It is where a pregnant woman experiences pain in her pelvic region.
What are the symptoms of SPD?
The pain from SPD is commonly felt right in the centre of your pubic bone, but it can include any pain in the front, back or side of your pelvis and can even radiate to your thighs. It can be a dull ache to shooting pains and can vary on a spectrum to mild aches to extremely debilitating. The pain is there on movement such as walking, bending, standing on one leg such as when walking the stairs or even rolling over in bed.
What are the causes of pelvic pain in pregnancy?
The pelvis in pregnancy can become more unstable where your centre of gravity changes. Your bump pulls you forward and often women arch their lower back putting putting extra strain on your pelvis. The core muscles and pelvic floor muscles also loosen in pregnancy this can cause the pelvis to be less stable as to what it was pre pregnancy. This instability can cause uneven movement in the pelvis causing pain.
When we get closer to our due date, our relaxin hormone increases which softens the ligaments in the joints of our pelvis. This is great for birth as it means that our pelvis can move and widen to accommodate baby travelling through. But, in pregnancy this softening of the ligaments can cause our pelvis to shift unevenly, and not be as well supported, causing the pain.
When should I seek help? The sooner the better. If you feel like the pain is effecting your day to day living then self refer to a physio for some help. The quicker it’s picked up the better it can be managed. PGP doesn’t always get worse in pregnancy but it doesn’t get better and is unlikely to go away until after baby is born so get help from a physio. As well as seeing a physio, seeing your GP is also a good idea if you need some medication for the pain. Remember ibuprofen isn’t recommended in pregnancy.
What treatment is there for pelvic pain in pregnancy?
Whilst you wait to see a physio there are some things that you can do at home to help. The main thing is to keep your legs close together when you do day to day activities. For example, when you climb the stairs, take one step then meet your feet together before taking the next step, when you get out the car turn your legs out of the car together before you stand (sitting on a plastic bag can help with this) and when you get dressed avoid standing on one leg to put trousers on and sit down instead.
Your physio will most likely give you some exercises to do at home, some manual therapy checking that your spine, pelvis and hips are moving normally. They may also recommend waking aids such as crutches or a TENS machine to manage the pain.
You could also see another professional that specialises in the treatment of PGP such as a chiropractor or osteopath.
Will SPD effect my labour?
The majority of women who have SPD are able to labour without their SPD causing too much bother. For those who have SPD severe, you may find that there are certain positions that won’t be comfortable for you such as squatting or on a birth stool. It may be that you want to avoid certain positions or have an active labour because standing and walking are too painful for you. Make a note on your birth preferences as to what positions you find most comfortable, you can try some out at home in pregnancy to see what works for you. Most women who have SPD are worried about labour contractions intensifying their SPD but often women find that their SPD isn’t any worse in labour. Women with SPD may find water helpful as it can help with change of positions and the warmth can be soothing.
How long does it take for SPD to go away after birth?
For the majority of women SPD goes away pretty much straight away after birth. For some women it can take a little longer than this. If you’re still experiencing discomfort a few weeks after baby then refer to your GP and/or physiotherapist.
