Pelvic girdle pain (PGP) and lower back pain during pregnancy

Pelvic girdle pain and lumbar pain is common during pregnancy. It is estimated that up to 61 per cent of women experience discomfort in the low back (lumbar) region, between the ribs and the top of the pelvis. Around 20 per cent of women experience pain in the front or back of the pelvis between the top of the pelvis bone to the upper thigh regions (pelvic girdle pain). Approximately three per cent of all women experience pain in the front of the pelvis (symphysis pubis dysfunction).

The pelvic girdle includes the sacroiliac joints at the back (joint between the sacrum at the base of the spine and ilium of the pelvis) and the pubic symphysis joint at the front (joint between the two pubis bones of the pelvis).The lumbar spine includes joints and discs between each of the five lumbar vertebrae, and the lowest vertebrae with the sacrum.

What activities are difficult or painful with pelvic girdle pain and low back pain?

Walking
Standing on one leg, for example climbing stairs
Rolling in bed
Pain moving from sitting to standing
Opening your legs apart, for example, getting out of a car
Heavy housework or lifting

What causes pelvic girdle pain and lumbar pain?

During pregnancy the joints in your lower back and pelvis are under greater strain. The ligaments become more flexible due to increased levels of a hormone in your body called Relaxin. This is to accommodate the growing baby and assist labour. As the baby grows, your weight increases, your abdominal and pelvic floor muscles stretch, and your centre of gravity moves forward, changing your posture. These changes can create new problems or aggravate any pre-existing back or pelvic problems you have noticed before. If your pelvic girdle joints move unevenly, you will be more likely to experience pelvic girdle pain.

Exercise

Maintain your fitness with an exercise bike, swimming (but no frogkick as with breaststroke), walking in pool walking lanes, aqua aerobics or low-impact or seated aerobics
Improve your core muscle support and posture by trying pregnancy Pilates or Yoga
Sit on an exercise ball for 20 minutes or more every day
Complete deep abdominal (transversus abdominus) muscle and pelvic floor muscle training every day.

Supports

Pelvic support belts may reduce pelvic girdle pain while standing and walking. Pelvic belts can be bought from the pharmacy at The Whittington Hospital or online. Measure the widest part of your hips to get the correct size.
Our physiotherapists can provide you with abdominal support. This is stronger than a bump band and can be worn all day.
If you are having severe difficulty walking, our physiotherapists can provide you with crutches for a short time.

Pain relief

Either use heat from wheat bags (bags filled with grains which are heated in a microwave) and hot water bottles, or use ice packs or a bag of frozen peas. Wrap them in a towel or cover and use for 20 minutes maximum. Remove for at least 20 minutes or until the skin returns to normal temperature before reapplying. Ice has an anti-inflammatory effect and so may be more useful after activity. Heat is more comfortable and relaxes the muscles.
Try deep tissue massage