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Causes, Symptoms & Treatment for Pelvic Girdle Pain (PGP)

Pelvic girdle pain is a condition that arises from problems within the pelvis. Both women and men can suffer with PGP, although it's likely to have different causes. What's more, because it's frequently associated with pregnancy, women are more likely to be affected by it than men.

It's common for pelvic girdle pain to be mistaken for lower back pain. But if it's diagnosed early, then treatment can be very effective in relieving the symptoms. So, how do you know if it's lower back or pelvic pain that you're feeling?

In this article we describe the causes and symptoms of pelvic girdle pain and discuss ways to treat it to find relief.

What is Pelvic Girdle Pain?

You might also see PGP referred to as symphysis pubis dysfunction (SPD). However, this term is less common now because this type of pain is not confined to the pubis but can be felt in many different areas.

The symptoms of pelvic girdle pain may range from mild and manageable to so severe that it seriously affects your ability to walk, get out of bed or perform other everyday movements. Each woman is different, and so the experience of this problem will also be unique. But most people have symptoms in the mild-to-moderate range.

Although it might feel similar to lower back pain, PGP is caused by problems specifically located in the pelvic girdle when the joints become stiff or inflamed or if each side moves unevenly.

The Pelvic Girdle

The pelvic cavity is surrounded by a ring of bones made up of the top and bottom of the hip bones, the sacrum and the coccyx. This structure of bones is called the pelvic girdle. It's the structure of bones that connects the spine to the legs.

Symptoms of Pelvic Girdle Pain

The discomfort caused by PGP can be felt at the front or back of the pelvic area or even extend to other areas.

You might feel pain in your back at the sacroiliac joints where the sacrum connects to the hip bones or in the front at the symphysis pubis joint that connects your pubic bones. You will feel this across your lower back or at the pubic bone in the front.

But the discomfort can also extend to your groin, perineum, hips and thighs—or even your knees.

Sometimes pelvic girdle pain can be felt in more than one area or all of them at once. So, it's easy to see how the pain can be intense.

For some women, PGP causes a clicking sound or grinding sensation in the pelvic area.

What does pelvic girdle pain feel like?

If you suffer from PGP, normal day-to-day movements can trigger problems or make existing pelvic girdle pain worse:

Walking. This condition can cause you to walk with a waddling gait.
Lying on your back. Your joints can settle in a less stable position.
Rising to stand up or climbing stairs. The movement of the hip joint when you stand or during the action of lifting your leg to walk up stairs can cause instability that irritates the joints.
Standing on one leg. Similar to going up stairs, standing on one leg (such as when getting dressed, for instance) might worsen your symptoms.
Opening your legs. The movement you make to get out of a car or out of bed can be painful.
Turning over. Pelvic pain can be provoked by changing position in bed.

It's not unusual for the discomfort to be more intense at night. That's because the muscles in that area—particularly those of the bottom—are relaxed, affecting the stability of the joints.

PGP in Pregnancy

Pelvic girdle pain is widely associated with being pregnant. In fact, up to 65% of women experience serious pain during pregnancy, and for about 7% of them, the pain will continue after they have given birth.

Even more remarkable, up to 12% of women who suffer from pregnancy-related pelvic pain have seriously impaired mobility that means they need to use crutches or even a wheelchair.

For pregnant women, PGP can have a significant effect on their day-to-day life and, as a result, on their mental health. It can even impact their careers, with most pregnant women who have PGP needing to take sick leave.

What Causes Pain in the Pelvis During Pregnancy?

1. Hormones

When you're pregnant, you have increased levels of relaxin, progesterone and estrogen. One of the reasons for this is to make the ligaments of the pelvis softer and more elastic to enable your baby to move through your pelvis more easily at birth. These physical changes create more movement through the joints and muscles of the pelvis.

2. Posture

The weight of your developing fetus changes your centre of gravity towards the front as your belly grows. In addition to this, the relaxing of ligaments means that the abdominal muscles expand to accommodate the baby.

3. Uneven movement

The adjustments to your body that affect your posture also have an impact on the way that you stand as well as on your balance and the way that you walk. Differences in levels of stiffness and mobility on the two sides of your body can create uneven force through the joints.

4. Hypersensitivity

In a study of 61 women, it was discovered that pregnant women have a significantly lower pain threshold than those who were not pregnant. The researchers suggested that the reasons were related not only to the physical changes experienced by the pregnant women but also to their feelings and more volatile emotional health.

Risk Factors for PGP when Pregnant

Some women are more likely than others to develop pelvic girdle pain during their pregnancy. The factors that increase the risk of developing this condition include:

PGP during a previous pregnancy
Strenuous physical activity
History of lower back pain
History of injury or trauma such as a car accident, serious fall or sports injury
Being overweight or obese
Smoking
Mental health problems, including anxiety and depression
Poor job satisfaction

How to Treat Pelvic Girdle Pain

Although pain during pregnancy is common, it's not considered normal, so pregnant women should not just suffer in silence. Getting good advice and practical tips for dealing with PGP can really help you manage it. So, it's important to speak up and ask for help.

Women's physio. A professional women's health physiotherapist who is experienced in dealing with dysfunction of the pelvis will be able to identify what's causing your pelvic pain and give you fast, effective treatment. They will assess your pelvic floor and abdominal muscles, symmetry and movement and decide on a comprehensive treatment plan. It might include manual manipulation, exercises, stretches.

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Medication. There are some medical pain relief options that are safe for you and your baby, so ask your physiotherapist, GP or midwife for advice if you feel that could be an option for you.

Alternative therapies. Many treatments that are considered 'alternative' can be beneficial in managing pain, such as acupuncture or hypnosis. Complementary activities can also help. You can try exercise (like gentle yoga), meditation or massage. A TENS machine can also help manage pain. Whenever you do choose alternative therapies, be sure to tell your practitioner that you're pregnant.

For more information about how to treat pelvic girdle pain or other women's health problems, call Magdalena on 07877 017 936 or drop PelviCare an email. Alternatively, you can book an appointment online .

PelviCare Women's Health Physiotherapy is located in Greenwich, London, serving women across South London, East London, Essex, Kent and beyond.