Pregnancy and labour are miraculous events in your life. For some women, these wonderful experiences are clouded by the presence of low back and pelvic joint pain. This type of pain is also known as pregnancy-related pelvic girdle pain (PGP).
The pelvis is made up of three bones which join together and form a ring. Three joints are part of this pelvic ring: the symphysis pubis joint at the front (marked green in the diagram below) and two sacroiliac joints at the back (the areas marked red in the diagram below).
In pregnancy, the hormones relaxin and progesterone help you to prepare for birth by causing ligaments to soften and relax. Joints become more flexible, including the joints of the pelvis. As the baby grows with each trimester, increased demand is put on your muscles, ligaments and joints. This is part of the natural changes in pregnancy. Your body is strong and built to adapt to these changes.
When You Have Pain That Lasts Longer than Expected
PGP is a pain experience that is more intense than the aches and pains felt in pregnancy which resolve on its own within a few days. Women with PGP may have sharp pain in the low back or groin which lasts beyond the short-term. You may have pain with simple activities such as turning in bed, getting up from a chair, standing on one leg to put on pants, walking and climbing stairs. It is now understood that there is increased sensitivity of nerves and soft tissues of the pelvis in PGP. Often, pain is driven by complex factors including: changes to how you move as a result of fear and anticipation of pain, negative expectations placed on pregnancy, labour and delivery, and increased systemic inflammation [1,2].
If you have persistent pain in your pregnancy or postpartum recovery, consult a physiotherapist for an assessment. The therapist will help you understand the causes of your PGP, and teach you movement exercises to decrease sensitivity in your pelvic joints. Ultimately, the goal is to improve your confidence to be able to move again!
References:
- O’Sullivan PB, Beales DJ (2007) Diagnosis and classification of pelvic girdle pain disorders – Part 1: A mechanism based approach within a biopsychosocial framework. Man Ther 12(2):86-97.
- Vandyken C, Hilton S (2012) The puzzle of pelvic pain: a rehabilitation framework for balancing tissue dysfunction and central sensitization – a review of treatment considerations. J Wom Health Phys Ther 36(1):44-54.