Clinical Education

Pregnancy Back and Pelvic Pain

  • It is estimated that pelvic girdle pain (PGP) affects up to one in five pregnant women to some degree.  Symptoms and severity vary between women and pregnancies
  • Many pelvic problems are dismissed as the “normal aches and pains” of pregnancy, but you can adopt lifestyle changes and carry out simple exercises to reduce pain and improve function
  • PGP is a specific form of Low Back Pain (LBP) which can occur separately or in conjunction with LBP
  • There is an overall agreement that PGP results in more affliction of pain and functional disturbances than LBP
  • As the pregnancy progresses, the pelvis tries to cope with the changes associated with the baby growing such as the altered shape and posture, the muscles stretching and the weight gain
  • With appropriate treatment the pressures on the pelvis are minimised so that the discomfort is manageable

Subjective Examination:

Pain in the front of the pelvis
Pain in the lower back and can radiate down the legs
Pain in the groin
Pain over the inner thighs
Pain between the legs
Clicking/grinding over the front of the pelvis if severe
Women often describe having difficulty doing the following activities:

Walking distances (often a “waddling” gait is common)
Climbing up and down the stairs
Getting in and out of the car
Climbing in and out of the bath
Turning over in bed
Standing for long periods

If you feel that your patient is suffering with pregnancy related back and pelvic pain advice can be given;

Reassure the patient that most Pelvic girdle symptoms settle as soon as their have given birth
Advice on simple lifestyle modifications such as;
Appropriate footwear that is cushioned and supportive
Sitting posture and trying supportive chair rather than sofa
Avoid standing for long periods
Cuddle children sitting on your lap rather than lifting them, if have to liftg young children sit down and then pick up child
Sit when getting dressed and putting on shoes
Rest frequently throughout the day. Take the weight off your pelvis – lie down
When sleeping/resting on your side, use a small pillow between your knees
Take smaller steps and avoid rushing
Accept help form your partner/family/friends particularly in stressful postures or strenuous shopping trips etc.
Avoid straddle movements or activities where you stretch your knees apart
Referral to physiotherapy if the patient is unable to manage their pain and we can work with the patient to get them to manage their condition by:

Exercises for posture and core stability
Education and advice on lifestyle modifications
Education on sleeping and sexual position
Advice on specialist equipment if required for example pelvic belts and crutches
Education on birthing positions and the postnatal period