Pelvic pain in pregnancy

By Megan Storey | January 30, 2019

pregnant woman holding hipsYou’re growing a human – a tiny person that will change your life and body forever. Of course, we expect changes and some discomfort as our body adapts to our growing belly, but seriously – this pelvic pain is another level! But what is it?

Pelvic pain during pregnancy can be from a range of things, but Symphysis Pubic Dysfunction (called SPD) is a pretty common cause. It can also be called Pelvic Girdle Pain (PGP). SPD & PGP can be explained as a bunch of signs or symptoms relating to pain in the pelvic area and lower back. It also includes musculoskeletal pain radiating to the upper thighs and crotch area.

So why does this happen? At certain stages throughout pregnancy, your body produces the Relaxin hormone, which relaxes the ligaments, producing more movement in the pelvic region to allow for expansion, not just for the baby to grow, but ultimately for the delivery of bub. This relaxation of the pelvic ligaments leads to increased joint mobility.  Where the ligaments usually provide support to the joints, the muscles now have to step in and help stabilise them – they get overworked and that’s when the pain starts. Symptoms of SPD can vary widely – from mild discomfort to severe pain that can see women bed-ridden or needing walking aids.

It’s hard to say how many women actually experience SPD in pregnancy. Research suggests it’s somewhere between 4 – 84%! The variation is because of the wide range of definitions and diagnosis of SPD, as well as differing research cohort selections.  However research also suggests that the incidence rate increases during the later stages of pregnancy. So what influences its onset, and how do you treat it?

Influences of SPD

While there is no way of accurately predicting which women will experience SPD, common factors that might influence the onset include women:

  • who have a history of low back pain or trauma of the back or pelvis
  • with an increased number of previous pregnancies
  • who partake in physically demanding work
  • with a high Body Mass Index (BMI)
  • experiencing emotional distress
  • who smoke
Treatment

There isn’t one particular treatment, but common treatments include:

  • Physiotherapy: Research suggests that women receiving physio treatment reported less pain in the mornings and evenings than those women who didn’t have treatment.
  • Acupuncture: As with physio, acupuncture helped with pain, and functional movement.
  • Pelvic support garments: Research suggests that these improved women’s ability to do things like walk and perform basic movements.
  • Exercise: This can also help improve functional movement and help decrease pain, but ensure you visit your physio first, to understand what exercise is right for you, your condition and your pregnancy.
  • Rest: It’s not always possible to rest completely but try to limit doing the activity that causes the most pain, avoid standing on one leg, limit weight-bearing exercises like climbing stairs or standing for long periods of time.

Pelvic pain in pregnancy is common. If you are experiencing pelvic pain, your first step is to see your physio to understand what it is and how to treat it.

In the meantime, try changing your routine by sitting down to get dressed and rotate those stilettos for low heels or flat shoes. One of the best things to try is pretend you’re always ‘walking around in a pencil skirt’ – take small steps, and when getting out of the car, slide your bottom 90 degrees and get out with your legs together. Heat might also provide some temporary relief.

To help you see an end point of your pain, know that SPD usually sporadically fixes itself after birth. And of course, holding that tiny human in your arms makes up for the grief (and you can remind them about the pain they put you through for years to come).