Pelvic Pain During Pregnancy: PGP And SPD And What to Do About It
What Is Pelvic Girdle Pain?
Pelvic girdle pain (PGP) is a common pelvic pain condition in pregnancy, affecting 1 in 5 pregnant women. While pelvic pain is very common in pregnancy, it does not have to be accepted as normal or as par for the course. Relief from pelvic pain in pregnancy is possible with adequate diagnosis and treatment with a skilled pelvic floor therapist.
Some experts consider PGP an umbrella term for pain specific to the bony structures and joints of the pelvis, which covers other more specific diagnoses, such as symphysis pubis dysfunction (SPD). Some sources explain PGP to previously have been called SPD, which more specifically describes pain stemming from dysfunction at the joint at the front and center of the pelvis – the pubic symphysis joint.
For this blog, we will be using the term PGP while recognizing that some may refer to their concern as SPD or have more trouble with their sacroiliac (SI) joint. However you would like to refer to your pain, being specific about describing your pain sensation, location, and any aggravating or relieving factors can be helpful for appropriate diagnostics and treatment by a pelvic floor therapist.
What Does Pelvic Girdle Pain Feel Like?
Pregnant people may experience pelvic girdle pain, PGD differently and may describe their pain as shooting, aching, throbbing, or burning. Others may find it feels more like a grinding or popping feeling upon movement. They may find that certain movements exacerbate the pain, such as climbing stairs, shifting onto one leg to thread on underwear or leggings, walking, or otherwise weight shifting.
Pain location may include one or a number of the following:
Front of the pelvis
Low back
Sacroiliac (SI) joint(s)
Inner thighs or adductors
Perineum – the area between the vagina and anus
Severity of symptoms as well as their impact on quality of life can range significantly among those dealing with PGP. While some women may have occasional irritation with mild symptoms, others may be so severe that they have trouble walking or leaving the house due to pelvic pain. Furthermore, this type of pain may be constant, intermittent, or come in waves. There may or may not be clear movements or activities that exacerbate the pain and the pain may radiate to other locations. Some experts note that if there has been a history of PGP (pelvic girdle pain) before pregnancy or during prior pregnancies, it may be more likely for some of this to recur during the next pregnancy, although there is no guarantee.
Why Do I Have PGP?
There are huge hormonal changes during pregnancy that may contribute to increased laxity in areas such as the pubic symphysis as well as the sacroiliac joint (SI joint). Especially when there are muscular imbalances at play and shifts in one’s center of gravity as the body changes during pregnancy, the increased ligament laxity and joint movement can cause pain in these areas. The upside is that these changes are helpful for promoting physiological processes that permit an optimal environment for the baby and are conducive to vaginal childbirth.
How to Fix PGP?
To start reducing discomfort from PGP, you may want to try limiting or avoiding any of the following first for a period of time:
Unnecessary single leg stance – sit down to thread leggings or underwear on
Carrying little one on your hip, especially for prolonged periods
Heavy chores like vacuuming and steam mopping (yes, even when nesting)
Large shearing motions of your legs when getting into or out of a car, couch, or bed
Prolonged sitting
Crossing legs
On the flip side, there are some things you can start doing to see if you can get your pelvic pain down to a whisper as we recognize avoiding movement is not a long-term solution. Appropriately engaging your core and partaking in appropriate body mechanics during daily activities can make the world of a difference when it comes to PGP - Pelvic Girdle Pain. Try out keeping your legs close to one another as you are transitioning into your car or going to rest in bed or on the couch. Check out if there are any other parts of your day where you tend to partake in any movements where your legs are widely separated from one another – can you reduce the space and add some control here to get your daily pain to settle down?
Sleep position and moving in bed can also be a problem area for folks with PGP. Adjusting your body positioning when in bed is sometimes easier said than done when you are the one dealing with the pain on those sleepless nights. Ideally, your hips should be aligned with a pillow between the knees when on your side. This will be helpful to use for support if you do need or want to transition to your other side during the night.
How Does Pelvic Floor Therapy Help With PGP and SPD?
When working with a pelvic floor therapist, they will explore your specific movement patterns and any muscular balance or stability issues that may be contributing from your hamstrings, adductors, glutes, abdominals, pelvic floor, and other areas. Your pelvic floor therapist will work with you to improve your core and pelvic floor’s strength and coordination if these are contributory factors to your pain. All of these areas connect to the pelvis and play a significant role in PGP (pelvic girdle pain) and SPD (symphysis pubis dysfunction) . Postural considerations while sitting, standing, and moving are other key players that will be involved in treatment while taking into account your specific lifestyle, problem areas, and activities you would like to get back to. Manual therapies may be indicated to support myofascial restriction and decrease pain within and surrounding these areas.
Can you have PGP postpartum?
Yes! There are still major bodily changes happening throughout the postpartum period, which lasts far beyond 4-6 weeks. Once you have a child, you are forever postpartum. The good news is that there are strategies you can work on with your pelvic floor therapist for PGP whether you are pregnant, postpartum, or if you have never birthed a child but are otherwise experiencing this type of pelvic pain.
No matter which stage you are in, there is relief from pelvic pain. We are here to meet you where you are and help you feel your best during all of life’s phases.
At Bloom Pelvic Therapy, we work with clients experiencing PGP, SPD, and SI joint pain daily and are experts in decreasing pelvic pain and improving quality of life.
Connect with a team member at 813-515-9008 to discuss if we would be a good fit for you!
Reference:
Brockwell, E. (2021). Why Did No One Tell Me? Random House.