Understanding Pregnancy – Low Back & Pelvic Girdle Pain

A Physiotherapy Guide to Pregnancy-Related Low Back and Pelvic Girdle Pain

What is Pelvic Girdle Pain (PGP)?

Pregnancy-related Pelvic Girdle Pain (PGP), can affect  50%-70% of all pregnant women. Pelvic girdle pain describes pain experienced at the front and/or back of your pelvis, the pubic bone, groin, lower back, hips or buttocks.

You may have difficulty:

  • Walking
  • Taking weight on one leg at a time e.g. climbing stairs, dressing
  • Parting your legs e.g. in/out of car/bath
  • Turning over in bed
  • Lying on your side
  • Rising from sitting to standing

What causes PGP?

Hormonal changes: Your pelvic ligaments become softer & looser, leading to small but uneven movements within the pelvis. It is important to note that the pelvis is still very stable despite this. Hormonal changes can also increase your sensitivity to pain.

Postural & Muscular changes: As your baby grows your posture changes. This leads to a change in the activity of the muscles of your tummy, pelvic girdle, hips and pelvic floor. This can increase the strain on your lower back and pelvis. Some muscles become a source of pain and discomfort.

Increased load on pelvis: This is due to the weight of your growing baby, but may also include carrying a toddler and heavier items on a daily basis. Holding your breath in reaction to/on expectation of pain also increases the load on your pelvis.

History of pain/trauma to the back/pelvis.

What can I do to help?

  • Be as active as possible within your pain limits. Listen to your body!
  • Ask for and accept help with household chores.
  • Rest when you can.
  • Sit down to get dressed and undressed
  • Minimise prolonged postures i.e. sitting/standing
  • Avoid unnecessary heavy lifting.

Sleeping:

Try lying on your side with a pillow between your knees. An additional small pillow to support your bump may also help. A spare duvet over the mattress can provide cushioning for sore hips.                                              

Turning in bed:

Bend your knees up. Turn your head in the direction you want to go. Bring your arm across your body to the side you are turning. Take a deep breath in and on the breath out roll onto your side. Wearing satin/silk pyjamas can also ease the movement.                                                                                      

Getting in & out of bed:

Roll onto your side and use your elbow and hands to push your body into a sitting position. To get into bed reverse this procedure. Remember to breathe out on the effort.

Sit to Stand:

Sit at the edge of the seat, feet hip distance apart. Lean forwards- ‘nose over toes’, push up through the heels to stand.

Gym Ball Exercises

Sitting on an exercise ball reduces the load on the pelvis and naturally engages the core muscles. Alternating between the ball and a chair can be more comfortable for sitting, both at home and at work.

Pelvic Tilting

  • Roll the ball back with your bottom (anterior tilt)
  • Then roll the ball forwards as you drop the pelvis back into a ‘slump’ (posterior tilt)

Circling

  • ‘Circle’ pelvis in each direction, starting with small circles, then making them bigger.

What else can be done?

  • It is important to note that the overall goal with pelvic girdle pain is learning how to self-manage, as it is a pregnancy related condition.
  • However, if you are struggling to perform your normal daily activities despite the advice on this leaflet, you may need referral to Physiotherapy. Ask your GP, midwife or hospital team to refer you.
  • Once referred to Physiotherapy, you will be offered a place in our pelvic girdle and low back care workshop. This has both education and exercise components and provides the opportunity to be fitted with a support belt.
  • Those who have attended the workshop and are struggling to walk may require one-to-one review for further management.

How will having pelvic girdle pain affect my delivery?

Pelvic girdle pain does not affect your chances of having a vaginal delivery. Certain positions may be more comfortable such as side lying or high kneeling. These will be discussed further in the workshop. 

Will this pain go away?

Pelvic girdle pain resolves on delivery of your baby in the majority of cases. For those whose symptoms persist postnatally, ongoing physiotherapy will help.

Additional helpful resources:

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