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Pelvic girdle pain PGP & SPD

Some women develop a condition known as pelvic girdle pain (PGP) during pregnancy, but there are other factors that can be responsible for causing pain in the pelvic girdle.

What is pelvic girdle pain?

There are several bones and joints that make up your pelvic girdle - the bony arched structure in your hip area that supports your legs - including the symphysis pubis joint, hip joint, coccyx, sacrum and sacroiliac joint. Pain can occur when there is a mechanical problem within these joints - often one joint becomes stiff, causing irritation in the other joints. Discomfort in the pelvic girdle usually occurs in the front or back of the pelvis. This is known as pelvic girdle pain or PGP. It was formerly referred to as symphysis pubis dysfunction or SPD. Because PGP often occurs during pregnancy, it is also referred to as pregnancy-related pelvic girdle pain or PPGP.

What causes PGP?

There is usually a combination of factors responsible for the instability in joints that causes PGP. The pelvic girdle joints might move unevenly, or changes in the muscles during pregnancy, such as those in the stomach, pelvic girdle, hip and pelvic floor, make the joints less stable, resulting in pain. The hormone relaxin, along with other hormones, affects the ligaments in the pelvic girdle, allowing for an increased range of motion in the pelvic joints. The position of the baby can be a factor.

Non-pregnancy-related causes include a previous injury to the pelvis or a sports injury. Arthritis or osteoarthritis can also lead to PGP. However, sometimes there's no obvious cause.

What are the symptoms of PGP?

The severity of the discomfort varies from one person to another. It can be a mild or moderate discomfort or it cause severe pain that makes it difficult to move about. The symptoms can occur any time during pregnancy, either suddenly or gradually, or during a difficult birth. In some cases, it can occur weeks or months after a birth.

Most often, the discomfort occurs over the pubic bone in the front, below your stomach, or across one or both sides of your lower back. There can also be pain in the perineum, the area between your vagina and anus. Some women experience pain in their thighs. Sometimes a pregnant woman can feel or hear clicking or grinding in the pelvic area. In pregnancy, the symptoms can be aggravated by the baby's increasing weight, but it may get no worse.

Being in an unbalanced position can make the pain more noticeable such as when:

  • Standing on one leg (such as when getting dressed)
  • Walking
  • Going upstairs
  • Turning over in bed
  • Moving your legs apart such as when getting out of a car.

Who is at risk of developing PGP?

The majority of people with PGP are women, and up to one of every five women, will experience some form of discomfort in the pelvic girdle during pregnancy. If you have had PGP during a previous pregnancy or a history of lower back pain, you are more likely to experience PGP. Other risk factors include:

  • A hard physical job
  • Poor posture at a work station or awkward or inappropriate working conditions
  • Increased body mass index (BMI) and body weight before or during pregnancy

Even if you don't have one of these risk factors, you can still experience PGP.

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