Pelvic girdle pain

You are st5 registrar covering Antenatal clinic ,this case involves Mrs Jody Olsen aged
32 years with BMI 23 in her first pregnancy of 28 weeks duration confirmed by scan with
c/ o pelvic pain and difficulty in turning over bed and walking and her friend as told that
she as pelvic girdle pain

What is PGP

Pelvic girdle is a ring of bones around your body at the base of your spine
It commonly affects 1 in 5 pregnant women and can affect your mobility and quality of life

The three joints in the pelvis work together and normally move slightly ,in PGP joints move
unevenly which can lead to pelvic girdle becoming less stable and therefore painful

As your baby grows in womb the extra weight and the change in the way you sit or stand will put
more strain on your pelvis

It's more common if you have injured your pelvis in the past or have hyper mobility syndrome ,a
condition in which your joints stretch more than normal
PGP doesn't cause harm to your baby

PGP can be treated at any stage in pregnancy and if treated sooner you feel better .it is more
common in later pregnancy

PGP usually causes pain in pubic region,lower back,hips,groin,thigh or knees/ clicking or

grinding in pelvic area

I will offer appointment with physiotherapist who will make an assessment to diagnose PGP this
will involve looking at your posture,your back and hip movements and ruling out other causes of
pelvic pain

following simple measures may help to relieve your symptoms

● Keeping active but also getting plenty of rest

● Standing with your bumb and bottom tucked in a little
● Changing your position frequently..try not to sit more than 30 min at a time
● Sitting to get dressed and undressed
● Lying on less painful side while sleeping, keeping your knees together while turning in
bed and using extra pillow under your BP and between your legs for extra support in bed
Avoid anything that makes your symptoms worse like lifting heavy wieghts , going up and down
the stairs too often, sitting on floor or standing for long periods on one leg or crossing your legs
 Your physiotherapist will suggest right treatment for you like
● Advice on avoiding movements that may aggravate the pain and you will be given advice
on best position s for movement and rest and how to Pace your activies to lessen your
pain
● Excercise that should help relieve your pain and strengthe your abdominal and pelvic
floor muscles to improve your balance and posture and make your spine more stable
● Manual therapy ( hands on therapy) to the muscles and joints by
physiotherapist ,osteopath or chiropractor who specializes in PGP in pregnancy
● Warm baths,ice or heat packs
● Hydrotherapy
● Acupuncture
● A support belt or crutches
For many women early diagnosis and treatment should stop symptoms from getting
worse.
PGP is not something you just have ‘to put up with’ until your baby is born

If these measures fail you can seek help

● You will b offered regular pain killer like paracetamol
● Aids such as crutches or wheelchair for short term basis your physiotherapist may help
you with this
● Equipment s such as bath boards,shower chairs,bed levers and raised toilet seats may
be available
● Getting help with your regular household jobs
● If you work talk with your employer about ways to help manage your pain,you can
consider shortening your hours or stopping work earlier than you had planned
If your in extreme pain or have limited mobility we may offer admission in antenatal ward
and where you will receive regular physiotherapy and pain relief
You can aim normal vaginal birth,our team will ensure your legs are well supported ,help
you to change position and move around
Birthing pool may be more helpful as it takes weight off your joints and allow easy
movements

All types of pain relief are possible,including an epidural

Caesarean section is not needed for PGP and there is no evidence that it helps women
with PGP and it may actually slow down your recovery

Going for labour naturally is safe to you and your baby and strating off labor might carry
risk to you and your baby especially if it's before your due date

After birth usually PGP improve s only one in ten women will have ongoing pain, if this is
the case it is important you continue to receive treatment and take regular pain relief and
use aids if given until pain reduces
Severe PGP you will be offered room with tollet facilities nearer or en suite room if
available

If pain persists you may be referred (your gp may refer )to specialist to exclude other
causes such as hip problems or hyper mobility syndrome

Your more likely to have PGP in future pregnancy ,make sure your as fit and healthy as
possible , strengthening your abdominal and pelvic floor muscles before you get
pregnant again might help and reduce chances of getting pgp again

***Pregnant women are more likely to develop blood clots in veins of their legs, so if you
have less mobility the chance s of getting clot s is higher .so you will be advised to wear
special stocking s and may need blood thinning injections to reduce risk of blood clots .

Anjali