Pregnancy Related Pelvic Girdle Pain – PGP 
Pelvic Girdle Pain is very common – affecting 1 in 5 Pregnant females.
PGP is characterised as pain anywhere across the pelvic region – although most commonly found at the back. PGP is persistent pain that can occur during the gestational period, labour or during birth.
10% of pregnant mums can experience their first episode of PGP after giving birth.
Although it PGP occurs during pregnancy then it is more likely to subside after giving birth.
PGP will usually resolve few weeks to months after birthing. However 1 in 13 can experience is for longer. Where they may need a professional consultation.
Risk Factors for having PGP includes:
- Past pelvic trauma
- history of lower back pain
- previous PGP in other pregnancies
PGP is multi-factorial. Meaning there is or can be more than one issue. This is stress, stress is anything that evokes a stimuli of sorts from sitting physical stress, to psychological stress and even your alarm that wakes you in the morning is a form of sensory stress.
Multiple factors contributing to PGP:
- Hormone Changes
- Biomechanical postures
- Metabolic change
- Genetics
the pain can radiate to the thighs at the front or back as well. It is usually worse on standing and sufferers tend to waddle when they walk. Sometimes they even here their joints clicking a lot.
If your in a lot of pain go and seek help from a Professional – PGP specialist, Chiropractor trained in the Pregnant Pelvis, Physiotherapist or massage therapist.
They will perform the appropriate orthopaedic and neurological examination, rule out any sinister problems that could be the cause of your PAIN – this is the most important thing – when in doubt go and get checked out.
There is some evidence to state the following treatments can be very beneficial to some individuals suffering form PGP:
- Acupunture
- Cranio-Sacral therapy
- Manipulation of joints
- exercises specific to the individual and the cause of their problem. – NB. Each PGP persons may have different original causes for developing PGP.
- Royal College of Obstetricians and Gynaecologists have recommended patients seek Chiropractic Care within the colleges Guidelines for management – found here
- Hydrotherapy – light gentle floating, swimming -initially supervised by professional
- Hot and Cold pack therapy 🥵 + 🥶
- TENS machine
- Stabilisation exercises
- Support Belt and Crutches
When seeking Chiropractic Care – your Chiropractor may seek to utilise Hands on Mobilisation with Manipulation as well as using Block wedges to support posture, activator methods and others muscular release techniques.
There are very good outcomes for those with PGP whom go and seek professional help.
93% of patients report no symptoms within 3 months after birth. Early DIAGNOSES and TREATMENT can help reduce down symptoms.
Most Patients with PGP will have a natural vaginal delivery.
REFERENCES
1.Kanakaris, N.K., Roberts, C.S. and Giannoudis, P.V., 2011. Pregnancy-related pelvic girdle pain: an update. BMC medicine, 9(1), p.15. 2. Royal College of Obstetricians & Gyaecologists (2015). Pelvic girdle pain and pregnancy. [online] Available at: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-pelvic-girdle-pain-and-pregnancy.pdf [Accessed 10 Jan. 2019]. 3. Australian Journal of General Practice (2019). Pelvic girdle pain in pregnancy. [online] Available at: https://www1.racgp.org.au/ajgp/2018/july/pelvic-girdle-pain-in-pregnancy [Accessed 8 Jan. 2019]. 4.Berg, G., Hammar, M., Möller-Nielsen, J.E.S.P.E.R., Lindén, U.L.F. and Thorblad, J., 1988. Low back pain during pregnancy. Obstetrics and gynecology, 71(1), pp.71-75. 5.Östgaard, H.C., Roos-Hansson, E. and Zetherström, G., 1996. Regression of back and posterior pelvic pain after pregnancy. Spine, 21(23), pp.2777-2780. 6.Albert, H.B., Godskesen, M., Korsholm, L. and Westergaard, J.G., 2006. Risk factors in developing pregnancy-related pelvic girdle pain. Acta obstetricia et gynecologica Scandinavica, 85(5), pp.539-544. 7.Vermani, E., Mittal, R. and Weeks, A., 2010. Pelvic girdle pain and low back pain in pregnancy: a review. Pain Practice, 10(1), pp.60-71. 8.Verstraete, E.H., Vanderstraeten, G. and Parewijck, W., 2013. Pelvic Girdle Pain during or after Pregnancy: a review of recent evidence and a clinical care path proposal. Facts, views & vision in ObGyn, 5(1), p.33. 9.Albert, H.B., Godskesen, M., Korsholm, L. and Westergaard, J.G., 2006. Risk factors in developing pregnancy-related pelvic girdle pain. Acta obstetricia et gynecologica Scandinavica, 85(5), pp.539-544. 10. Aldabe, D., Ribeiro, D.C., Milosavljevic, S. and Bussey, M.D., 2012. Pregnancy-related pelvic girdle pain and its relationship with relaxin levels during pregnancy: a systematic review. European Spine Journal, 21(9), pp.1769-1776. 11. Pelvic Obstetric and Gynaecological Physiotherapy (2015). Pregnancy-related Pelvic Girdle Pain. [online] Available at: https://pogp.csp.org.uk/system/files/pogp-pgppros_1.pdf [Accessed 17 Jan. 2019].12.O’Sullivan, P.B. and Beales, D.J., 2007. Diagnosis and classification of pelvic girdle pain disorders—Part 1: A mechanism based approach within a biopsychosocial framework. Manual therapy, 12(2), pp.86-97. 13.Albert, H., Godskesen, M. and Westergaard, J., 2000. Evaluation of clinical tests used in classification procedures in pregnancy-related pelvic joint pain. European Spine Journal, 9(2), pp.161-166. 14.Vleeming, A., Albert, H.B., Östgaard, H.C., Sturesson, B. and Stuge, B., 2008. European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal, 17(6), pp.794-819. 15. Cochrane (2015) 16. Albert, H., Godskesen, M. and Westergaard, J., 2001. Prognosis in four syndromes of pregnancy‐related pelvic pain. Acta obstetricia et gynecologica Scandinavica, 80(6), pp.505-510. 17. Browning, M.C., 2010. Low back and pelvic girdle pain of pregnancy: recommendations for diagnosis and clinical management. J Clin Chiropr Pediatr, 11(2), pp.775-79. 18. Davidson, E. (2018) Chiropractic Care of the Pregnant Pelvis CPD (Lecture 1: Chiropractic Management of Pelvic Girdle Pain in Pregnancy) University of South Wales. 29 September.
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