Pelvic Girdle Pain and SPD in Pregnancy
The information below is drawn from research-based evidence reviewed in 2014 when I wrote a paper on the Care and Management of Pelvic Girdle Pain within the NHS through Complimentary Therapies. I am an experienced massage therapist, with a background in midwifery and a special interest in pelvic girdle pain, and have treated many pregnant women with Pelvic Girdle Pain.
Pelvic girdle pain (PGP), which includes symphysis pubis dysfunction (SPD) effects 20 –25% of pregnant women severely enough to need treatment. The condition is poorly understood by health care professionals and descriptions vary, but generally it is pain in the joints of the front or back of the pelvis, lower back (lumbar region) and is often mistaken for sciatica. Pelvic Girdle pain effects women physically, emotionally, socially and financially, impacting on their quality of life, ability to work and care for their families.
The condition generally presents from 13 weeks onwards and worsens as the pregnancy progresses. It is important to get the correct treatment as soon as possible, and to make your midwife aware if you have pelvic or back pain. In the first instance, ask for an NHS Physiotherapy referral for proper diagnosis and treatment. However, many women find the NHS under-resourced and lack confidence in the NHS to give them the help and support they potentially need.
Pelvic Girdle Pain is not normal and can be treated in pregnancy and postnatally by physiotherapy and complimentary therapies such as massage, chiropractic, osteopathy and acupuncture. Research suggests that exercise and treatments, such as osteopathy or chiropractic that realign the pelvis, combined with massage and acupuncture which reduce pain, anxiety and aid sleep, may be the most effective way to manage PGP.
Pelvic Girdle Pain in pregnancy is probably caused by hormonal and biomechanical factors, trauma from past injuries/accidents and hyper-mobility of joints. This leads to the bones of the pelvis becoming misaligned and causes pain in the groin, coccyx, front or back of pelvis and/or lower back.
PGP often resolves spontaneously after the birth but a small percentage of women (7%) do experience on-going problems.
- All exercise must be taught and supervised by a properly qualified person, insured to teach pregnant women and who is knowledgeable about PGP.
- Pilates, yoga and exercises can strengthen the core muscles to help support the back and pelvis.
- Aquanatal exercise classes can reduce the intensity of PGP.
- Support belts may improve stability of the pelvis but there is a lack of research to suggest they provide complete pain relief. All women should have a proper pelvic assessment and if necessary realignment before buying and using a belt, or this may increase symptoms.
- Please also see the booklet Pregnancy related pelvic girdle pain produced by the ACPWH.
Please also see the links to therapists of whom I have personal experience and recommend to my pregnant mums. Although there is little research-based evidence about the use of complimentary therapies in pregnancy, research suggests that such therapies are safe and effective during pregnancy. Many of the pregnant women I see find massage and additional treatments such as osteopathy will relieve pain and discomfort.