Pelvic Girdle Pain: Pregnancy & Post Delivery Induced Back Pain !!

What is Pelvic Girdle Pain?

Pelvic girdle pain (PGP) is an umbrella term that describes pain, instability, limitation of movement and function of the pelvic joints (Sacroiliac joint and Symphysis Pubis joint).  PGP is a most commonly reported musculoskeletal disorder during pregnancy, post-partum and in young adults although the degree of affliction spans over a wide range.

What is the prevalence?

Recent research suggests that almost every second pregnant women are suffering from PGP, it is highly prevalent in late pregnancy and falls substantially during the first 3 months post-partum. PGP is also highly prevalent in sportsperson due to high physical demand and minor repetitive strains to the pelvic joints.

What causes Pelvic Girdle Pain?

PGP arises most likely because of a combination of several factors allowing abnormal stress on the pelvic joints such as:

1. The weakness of muscles around the pelvis and Hip.
2. Uneven movements in the joints.
3. Minor trauma.
4. Tightness in muscles.
5. Strenuous Physical work.
6. Faulty sitting and Standing posture.

How does PGP affect a person?

PGP characterizes itself as a Dull ache or a Sharp pain in the lower back, groin, inner thigh and sometimes at the back of the thigh.

The most common complaints of people with PGP are:

1. Difficulty in lifting leg straight up.
2. Difficulty to stand on one leg.
3. Pain while turning on the bed.
4. Pain while trying to stand up from sitting.
5. Difficulty to sit/stand/walk for a long duration.
6. There can also be an association with bladder dysfunction (Urinary Incontinence)

What is the difference between Low Back Pain and PGP?

Differentiating between Low Back pain and PGP will require exquisite professional assessment skills. In general, Low back pain generally characterizes itself as a dull aching pain in the low back and aggravates with bending forward movement with tenderness in the spinal muscles. Whereas, PGP is experienced in between the posterior iliac crest and gluteal fold (typically near the Sacroiliac joint).

What is the treatment for PGP?

According to current evidence, the first line of treatment for PGP is Physiotherapy. The most commonly used treatment approaches are Manual therapy (to develop the normal function of joints); tailored exercise programs (to allow normal muscle and joint function); pain reduction using electrotherapy.

A sacroiliac belt is advised for a severely malfunctioning pelvic joint for time being to prevent further stress on joints.

In rare cases where physiotherapy is not beneficial, the patient might require intra or extra-articular injections.

Regards: Dr Arun Kumar Rawal, PT

+91-9986855650