Pregnancy and labour are miraculous events in a woman’s life.  For some women, these wonderful experiences are clouded by the presence of low back and pelvic joint pain, 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).

Pelvic Girdle

In pregnancy, the hormones relaxin and progesterone help the body 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 advancing pregnancy, increased demand is put on the body’s muscles, ligaments and joints.  This is part of the natural changes in pregnancy and your body is strong and built to adapt to the changes.

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 in the groin which lasts beyond the short-term and are associated with simple, daily activities such as turning in bed, getting up from a chair, standing on one leg to put on trousers, walking and climbing stairs. It is now understood that there is increased sensitivity of the nerves and soft tissues of the pelvis joints in PGP, often driven by complex factors including: changes to how a woman moves as a result of fear and anticipation of pain, negative expectations placed on pregnancy, labour and delivery as a result of the pain, and increased systemic inflammation [1,2].

If you are experiencing persistent sharp pains in your pregnancy or in your post-partum recovery, you should consult a physiotherapist for an assessment.  The therapist will help you to learn more about the causes of the PGP, use movement exercises to decrease sensitivity in your pelvic joints, teach you ways to improve your energy and improve your confidence to be able to move again.

References:

  1. 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.
  2. 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.
Pelvic Joint Pain (Pelvic Girdle Pain) in Pregnancy