Pregnancy Related Pelvic Girdle Pain

by Elle Russell, MSOT, OTR/L, CYT, PCES
Pelvic Floor
Occupational Therapist

In general, pregnancy related pelvic girdle pain (PPGP) is described as a CONSISTENT pain geographically experienced anywhere around the pelvic structure that occurs in the context of pregnancy and/or up to one year of the postpartum period.

It is a condition affecting 1 in 5 pregnant and birthing women with many reporting pain when walking, climbing stairs, getting out of a car, and/or turning over in bed. Pain may be localized to the hips, the front of the pubic bone, and/or radiating down the thigh.

The diagnosis of PPGP is made through self-reporting of pain history as well as in conjunction with the administration of specific pain provocation clinical tests.

While it was previously believed that the hormone relaxin (a hormone that is believed to contribute to joint laxity during the pregnancy) was the primary cause of PPGP, current research is now indicating conflicting evidence for and against this held belief.

Although the causation is not well understood, the underlying risk factors of PPGP have been well studied and include the following: previous pregnancy, trauma, stress, lack of rest/sleep, previous low back pain, and increased body mass index (BMI).

Although acute pain or discomfort is common during pregnancy and postpartum, this pain and discomfort should resolve with low risk pain management interventions such as rest, over the counter pain medications (consult with your doctor first), or change in position.

One of the recommended positions I encourage mothers to try is lying on their back (semi-recline) on a yoga mat with legs up against the wall, incorporating slow 4-count diaphragmatic breathing.

If the pain or discomfort does not resolve with these low risk pain management strategies, it is highly recommended that you follow up with your primary care provider and request a referral to Pelvic Floor Therapy.

Pelvic floor therapy is an evidenced-based, conservative, non-invasive, holistic, first-line treatment for PPGP. This is an outpatient service that can be provided one to two times per week by an Occupational Therapist or Physical Therapist with specialized training in pelvic floor therapy.

Treatment approaches may include activity modification, support belts, manual therapy, and therapeutic exercise. Without this level of skilled intervention services, PPGP can result in decreased participation in preferred activities, care for the baby, quality of life, and maternal mental health and wellbeing.

Pelvic Floor Therapy Services are currently available at Rehabilitation Services of Stafford, located on the first floor of the Stafford Medical Pavilion.