The pelvis is made up of a number of bones forming two joints posteriorly, the sacroiliac (SI) joints, and the pubic symphysis anteriorly. The joints of the pelvis are held together by thick ligaments and ordinarily allow little motion. 1 in 5 women experience some degree of pelvic girdle pain in pregnancy, with either discomfort at the front or back of the pelvis. Common areas of pain are outlined below in red.
A number of changes during pregnancy may cause pain in the pelvic girdle, including hormones, altered posture, the growing foetus or trauma. Hormonal changes during pregnancy cause laxity in the pelvis, with increased mobility of the joints. Muscles of the pelvis and lower back attempt to compensate for this increased mobility and often develop tightness and pain. Some muscles may also be inhibited and thus cause altered function.
Diagnosis of pelvic girdle pain is based on signs and symptoms experienced in pregnancy. The most common of which include;
- Pain during single leg stance (e.g. Dressing, climbing stairs, walking/jogging etc)
- Pain when legs are moved apart (e.g. Getting in and out of the car)
- Pain on turning in bed
- Pain with twisting movements (e.g pushing a trolley, pram, or hoovering)
- Pain or difficulty with sexual intercourse
Physiotherapy for pelvic pain involves a full assessment of the pelvic girdle, hips and spine. Treatment often includes manual therapy, dry needling, lifestyle and postural advice, discussion regarding maternity belts, specific pelvic stability exercises and gentle stretches.