Pregnancy pelvic girdle pain (PGP) is a common condition experienced by pregnant women, characterized by discomfort and pain in the pelvic region. It results from the physiological and biomechanical changes that occur during pregnancy, affecting the joints, ligaments, and muscles in the pelvic area.

Causes:

1. Hormonal Changes:

   • Relaxin: This hormone increases during pregnancy, causing the ligaments in the pelvis to become more flexible in preparation for childbirth. This increased flexibility can lead to instability and pain.

2. Biomechanical Changes:

   • Weight Gain: The additional weight of pregnancy places extra stress on the pelvic joints.

   • Postural Changes: The growing uterus shifts the center of gravity, leading to changes in posture and gait that can strain the pelvis.

3. Joint Misalignment:

   • The sacroiliac joints and the pubic symphysis may become misaligned or move unevenly, contributing to pain.

4. Previous Pelvic Injury: Women with a history of pelvic injury or trauma may be more prone to PGP during pregnancy.

Symptoms:

• Pain Location:

  • Often felt over the pubic bone at the front, below the belly.

  • Can extend across one or both sides of the lower back, to the hips, and even down the thighs.

• Pain Characteristics:

  • Described as sharp, stabbing, dull, or aching.

  • May be aggravated by certain movements, such as walking, climbing stairs, turning in bed, or standing on one leg.

• Associated Symptoms:

  • Clicking or grinding sensation in the pelvic area.

  • Difficulty with mobility and performing daily activities.

Diagnosis:

• Clinical Examination:

  • A healthcare provider will assess the symptoms, perform a physical examination, and review the patient’s medical history.

  • Specific tests, such as the pelvic girdle pain provocation tests, can help diagnose PGP.

Treatment:

1. Physical Therapy:

   • Exercises to strengthen the pelvic floor, abdominal, back, and hip muscles.

   • Techniques to improve posture and pelvic alignment.

2. Pain Management:

   • Over-the-counter pain relievers like acetaminophen (under medical guidance).

   • Application of heat or cold packs to alleviate pain.

3. Supportive Devices:

   • Maternity support belts or pelvic girdle belts to stabilize the pelvis.

4. Activity Modifications:

   • Avoiding movements that exacerbate pain.

   • Practicing good posture and body mechanics.

   • Taking regular breaks to rest.

5. Manual Therapy:

   • Performed by a trained physiotherapist or chiropractor to realign and mobilize the pelvic joints.

6. Education:

   • Learning self-management techniques and exercises.

   • Understanding the condition and ways to minimize discomfort.

Prevention:

• Prenatal Exercise:

  • Regular, gentle exercise such as swimming or prenatal yoga to maintain strength and flexibility.

  • Pelvic floor exercises to support the pelvic region.

• Proper Body Mechanics:

  • Learning and practicing correct lifting techniques.

  • Avoiding heavy lifting and excessive physical strain.

• Healthy Weight Maintenance:

  • Ensuring gradual and healthy weight gain during pregnancy to minimize excess stress on the pelvis.

Prognosis:

• Short-term: PGP can significantly impact daily activities and quality of life during pregnancy, but with appropriate management, most women find relief.

• Long-term: Symptoms usually resolve after childbirth, though some women may experience lingering discomfort. Postnatal exercises and therapy can aid in recovery.

Pregnancy pelvic girdle pain is a manageable condition with the right approach and support. Pregnant women experiencing significant discomfort should seek advice from their healthcare provider to develop a tailored treatment plan.