Everything you need to know about pelvic pain during pregnancy

Many women experience pelvic pain in pregnancy, and while it is relatively common, it is extremely uncomfortable.

  Why do my hips and groin hurt now that I'm pregnant? The two halves of your pelvis are connected in the front through a rigid joint called the pubic symphysis. This joint is reinforced by a dense network of ligaments, which means that, under normal conditions, very few movements occur. Of course, pregnancy messes with 'normal conditions' quite a bit. In order to help your baby to pass through the pelvis more easily, your body produces a hormone called relaxin, which softens the ligaments of the pelvis. As a result, these joints move more during and immediately after pregnancy - hello pelvic pain! What are the symptoms? The most common symptoms are pain in your pelvis and groin area. You may also experience back pain, posterior (rear) pelvic pain, or hip pain. It is also common to feel a 'squeal' or a 'click' coming from that region, and the pain can travel down the inside of the thighs or between the legs. The pain usually worsens when you separate your legs, walk (especially up or down the stairs), or turn over in bed. Pelvic pain can build up during the night, meaning you don't get much sleep. Even getting up to go to the loo in the middle of the night can be very painful. What can I do about it? Doctors and physios classify any type of pelvic pain during pregnancy as pelvic girdle pain (PGP). Although many mums-to-be generically use the term 'SPD', symphysis pubis dysfunction is just one type of pelvic pain. Diastasis symphysis pubis (DSP) is another type of pelvic pain and happens when the gap in the symphysis pubis joint widens too far. However, DSP is rarer, and can only be diagnosed by an X-ray, ultrasound, or MRI scan. The use of a support belt or a pelvic girdle (attractive eh?) can provide some major relief. You may need to see a physiotherapist for mobilisation (a delicate form of manipulation) of your hip, back, or pelvis to correct any underlying movement dysfunction. Exercises during pregnancy - especially for the muscles of the abdomen and the pelvic floor - are an important part of treatment and can help to improve the stability of your pelvis and back. Hydrotherapy can be helpful sometimes. You can also ask your doctor, midwife, or physio for advice on making normal everyday activities less painful. If you are experiencing pelvic pain, you should avoid movements that exacerbate pain and exercising on your own is not generally advisable. As part of treatment, your physiotherapist is likely to give you an exercise routine to follow that will strengthen the muscles of your abdominal wall and pelvic floor. Water-based exercises have the advantage that they take a significant weight load off the pelvis and legs. As a general rule, exercise during pregnancy should comply with some basic principles: it must be aerobic, should not cause fatigue or pain, and not be high-impact. Can I take anything for it? The pain reliever of choice during pregnancy is paracetamol. Anti-inflammatories are generally contraindicated. Muscle relaxants can also be used to relieve the muscle contractions that sometimes occur, but ONLY under medical advice and supervision. Will it go away after birth? Several studies indicate that about 60 percent of women with PGP or SPD continue to experience symptoms even after their baby arrives. For most women the symptoms improve after they give birth, although a small percentage still experience pelvic pain one year after childbirth. If possible, you should continue physiotherapy after birth and get help caring for your baby during the first few weeks. Some women who have experienced pelvic pain during pregnancy find that they re-experience pain every month just before their period, which is caused by hormones that have a similar effect to relaxin. Don't you just love being a woman?