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Pelvic Girdle Pain
Pelvic Girdle Pain (PGP) is the name given to pain in one or more joints of the pelvis and mobility problems most commonly associated with pregnancy.
It was formerly known as Symphysis Pubis Dysfunction or "SPD" and these terms are still regularly used. Indeed there is much confusion regarding the correct name to use for this collection of symptoms and you may also see it referred to as "pelvic arthropathy" "pelvic girdle relaxation","pelvic girdle dysfunction" ,"pelvic ring syndrome", "posterior pelvic pain" and "sacro iliac joint dysfunction"
While all of the names given above describe the area of pain they are not in themselves a diagnosis, because people develop pelvic girdle pain for a variety of different and very individual reasons. Treatment should therefore be tailored to each individual person.
Pelvic Girdle Pain affects an estimated 1 in 5 women during pregnancy with around 1 in 20 having serious problems with pain and/or mobility. Symptoms vary widely from mild occassional discomfort to serious problems with pain and mobility such that crutches or a wheelchair are required.
Research has shown that untreated around 7% of women will still experience symptoms beyond three months post natally if the condition is untreated.
Diastasis Symphysis Pubis (DSP) is a separate but related condition when the symphysis pubis joint actually separates. To make a diagnosis of this condition, further investigations such as X rays or MRI are required.
A bit of anatomy
The pelvis is made up of 3 bones: the sacrum (a wedge shaped bone at the base of the spine ) and the 2 large hip bones or ilia. Each hip bone made up of three bones which are fused together, the ilium, ischium and pubis. These three bones join together at the acetabulum a cup shaped socket that forms the hip joint with the head of the femur (thighbone).
The hip bones are joined at the front by the pubic symphysis joint and at the back the hip bones attach to the sacrum at the sacro iliac joints, one on either side. As the pelvis is a closed ring of bone any change in movement at one joint will affect how all the other joints function.
One of the functions of the pelvic girdle is to transfer the weight of the upper body to the legs. The pelvic joints are supported by strong ligaments which, together with a complex arrangement of muscles attached directly to the pelvis and/or hip bones, assist in keeping the pelvis stable.
Who gets Pelvic Girdle Pain?
Pelvic Girdle Pain most commonly affects women during pregnancy. It can however occur in women who are not pregnant and men too, sometimes as a result of trauma or an injury related to sport.
What causes Pelvic Girdle Pain?
In some women pelvic girdle pain in relation to pregnancy develops without any clear identifiable risk factors. Others may have previously suffered low back or pelvic girdle pain or previous trauma to the pelvis. Increased mobility of other joints in the body (hypermobility) may also be a risk factor.
In pregnancy the hormone relaxin is released to help prepare the body for birth. This makes all the ligaments more stretchy and the joints become more flexible. This increase in the flexibility of the joints makes them more prone to injury as the pelvis and spine is not as well supported.
Changes in posture and the growing weight of the baby also play some part in the development of pelvic girdle pain.
In people with pelvic girdle pain there is often asymmetry in the way that the the pelvic joints move with one joint having become stiffer or more mobile than the others.
It can occur at any stage of pregnancy or in the some women only in the post natal period but is most common in the last few months of pregnancy.
Will it affect my baby?
No, it will not affect your baby.It is important, however that the midwives caring for you are ware that you have pelvic girdle pain. Have a look at the recent guidelines issued by the Association of Chartered physiotherapists in Women's health for for further information on antenatal care, birth planning and things to consider in the postnatal period.
Click here to have a look at our symptoms page
Hints and Tips, craniosacral therapy, post natal pelvic girdle pain, planning another pregnancy, what you might expect if you are referred to an orthopaedic surgeon, chiropractic management, and pelvic girdle pain unrelated to pregnancy.If you have any suggestions we would be delighted to hear from you. Further information on other sources of help can be found on our links page and we would recommend having a look at the ACPWH Guidelines on pregnancy related pelvic girdle pain.