Pregnancy-Related Pelvic Girdle Pain

Pregnancy-related pelvic girdle pain (PGP) affects a significant number of expectant mothers, leading to discomfort and challenges in daily activities. While hormonal changes and the growing baby contribute to this condition, effective management strategies are essential for maintaining quality of life during pregnancy. This article delves into the causes, symptoms, and non-invasive treatments for PGP, highlighting the role of pelvic support belts and targeted exercises in alleviating pain and enhancing mobility.

What is pelvic girdle pain?

More than half of all pregnant women develop pelvic girdle pain during or after pregnancy and the prevalence of pregnancy-related pelvic girdle pain (PGP) ranges from 23 to 65% [Albert, 2002; Robinson, 2010; Kovacs, 2012]. Pregnancy-related pelvic girdle pain is a condition that affects many pregnant women. It is characterized by pain and discomfort in the pelvic area, which is between the posterior iliac crest (inferior to L5) and the inferior gluteal folds, particularly near the sacroiliac joints, and pain may radiate in the posterior thigh and can occur in conjunction with or separate from pain in the symphysis [Vleeming, 2008]. Women with PGP often find it challenging to perform daily activities such as walking or climbing stairs, with 7 to 12.5% having to use crutches or a wheelchair [Ronchetti, 2008; Van, 2007; Robinson, 2006]. Pregnancy-related pelvic girdle pain is also a leading cause of sick leave during pregnancy [Malmqvist, 2015; Dorheim, 2013; Mogren, 2006]. The pain is often caused by changes in the body during pregnancy, including hormonal changes and the weight of the growing baby, which can cause the pelvic joints to become unstable.

Symptoms of PGP

The symptoms of pregnancy-related pelvic girdle pain (PGP) can include:

Pain in the pelvic region, which can range from a dull ache to a sharp pain
Difficulty walking or standing for long periods of time
Pain when turning over in bed or getting in and out of a car
Difficulty climbing stairs or standing on one leg

The symptoms of pregnancy-related pelvic girdle pain can vary from patient to patient and can change over the course of the patient's pregnancy.

Management of pregnancy-related pelvic girdle pain

The management of pregnancy-related pelvic girdle pain (PGP) can involve a combination of physical therapy, pain management techniques, and lifestyle changes. Some common approaches include:

Physical therapy: Physical therapists can help alleviate pain and improve stability through exercises designed specifically for PGP. These may include pelvic tilts, stretches, and strengthening exercises.
Pain management techniques: Pain relief can be achieved through a variety of methods, such as hot or cold therapy, over-the-counter pain medications, and transcutaneous electrical nerve stimulation (TENS) therapy.
Lifestyle changes: Making lifestyle changes such as avoiding standing for long periods of time, wearing supportive shoes, and using a pelvic support belt can help reduce stress on the pelvic region.

How pelvic belts can help reduce pregnancy pain

Pelvic support belts have been used by physiotherapists to treat pelvic girdle pain during pregnancy and the postpartum period [Depledge, 2005; Stuge, 2004]. The belts limit excessive motion by exerting an external force which compresses and stabilizes the joint(s), helping to generate a self-bracing effect and facilitate neuromuscular coordination of the pelvic region. Many studies have shown the benefits of using pelvic belts:

Reduce pain in the lumbopelvic region by 13% and pain during movements by 33% (Cogill, 1996)
Increase SI joint stability by 23-50% (Cha HG, 2016; Damen, 2002)
Increase muscle strength by 11% in patients with pelvic girdle pain (Mens, 2006)
Improve neuromotor control of the lumbopelvic and thigh muscles (Cha HG, 2016; Yoo WG, 2017)

Exercises for pelvic girdle pain during pregnancy

Several exercises can help with pregnancy-related pelvic girdle pain (PGP):

Pelvic tilting: This exercise involves tilting your pelvis forward and backward while lying on your back. It helps to stretch the lower back and strengthen the abdominal and gluteal muscles.
Hip rotation: This exercise involves rotating your hips in a circular motion. It helps to loosen up the hips and improve mobility in the pelvic region.
Pelvic rocking: This exercise involves rocking your pelvis back and forth. It helps to stretch the lower back and hips and improve stability in the pelvic region.
Kegel exercises: These exercises involve contracting and relaxing the muscles of the pelvic floor. They help to improve strength and control in the pelvic region.

It's important to note that not all exercises may be appropriate for every woman with PGP. It's important to consult with a physical therapist or healthcare provider to determine which exercises are right for you.

References

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