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What is pelvic girdle pain (PGP)?

It is a general term for pregnancy-related muscle pain in the pelvic region (as shown in the picture). The HSE define the pain as ‘pain in the joints that make up your pelvic girdle’ (Management of pelvic girdle pain in pregnancy and post-partum, HSE clinical practice guideline 2012). Pain can also travel into the back of the thigh. PGP is common in pregnancy and is reported in an estimated 20-25% of women. This reduces to 5% post-natally. The onset of pain can be sudden or gradual.

Where may I experience the pain?

  • Lower back pain, usually to one or both sides i.e. around your sacro-iliac joints
  • Pain in the Pubic Symphysis joint (pubic bone) between your legs in front
  • Pain in your groin and inner leg
  • Buttock pain that radiates down your leg but usually no further than your knee

What can cause pelvic girdle pain?

  • Physical changes in the body
  • Reduced activity levels
  • Poor sleep
  • Hormonal influence can sensitise structures
  • Fear and anxiety increases fear and tension
  • Having an increased pariety (number of children) and or having two pregnancies within a close time frame (i.e. less than two years between pregnancies).

What are the signs and symptoms?

  • Difficulty walking
  • Difficulty climbing stairs
  • Pain moving from sitting to standing or lying to sitting, turning in bed, getting in/out car, driving, getting dressed/activities involving standing on one leg and pain with sexual intercourse.

What can physiotherapy do to help?

  • Look at movement strategies for getting in and out of bed and going from sitting to standing
  • Posture in sitting and standing
  • Advice on general exercise-strengthening and stretching
  • Education about labour
  • Post natal advice
  • Fit you with a belt accordingly for support
  • Manual therapy, if indicated

What to do if experiencing symptoms?

  • Speak to your midwife or medical team about being referred for physiotherapy.
  • Based on physiotherapy assessment your physiotherapist will help you decide the most appropriate course of treatment. She can offer you one to one physiotherapy or a class situation where you will be provided advice on exercise, movements, self management and prescribed with a belt for support.
  • Your physiotherapist can also educate you about your signs and symptoms and help you to reduce your fears and potential anxiety about physical changes in your body and you beliefs/thoughts about what is happening during pregnancy.
  • Your physiotherapist can assist you during your pregnancy and afterwards if you are still experiencing symptoms. Pain post-natally only occurs in a small percentage of women but physiotherapy will continue to be beneficial.

Management during labour and delivery

Most women with PGP have a normal vaginal delivery. Make sure that your consultant/midwife is aware of your symptoms. It is beneficial to adopt an upright position for as long as possible during labour. It is helpful to maintain a position (for your legs) that is within a pain-free range as much as possible during labour and delivery.