The specialist women’s health physiotherapy team can treat antenatal and post natal back pain, pelvic pain, hand numbness/pins and needles, postnatal separation of the tummy muscles and pelvic floor problems. They can provide specific advice to pregnant women with pre-existing back pain. They also run regular ‘back care in pregnancy’ advice groups.
Around 1 in 5 women suffer from pain in their pelvic bones or joints during pregnancy. It is often called pregnancy-related pelvic girdle pain (PGP) or symphysis pubic dysfunction (SPD), and is caused by instability in the pelvic joints during pregnancy.
Although PGP is painful, it is not dangerous for your baby and most women who suffer from it can have a vaginal birth.
It’s hard to predict who will suffer from PGP but you are more likely to get it if:
- You’ve had it before in a previous pregnancy
- You have a physically demanding job
- You are having twins or more
- You have a history of back or pelvic pain
- You’ve had a previous injury to the pelvis
- You have a high body mass index (BMI)
- You have hypermobility
The causes are unclear, but in some cases it’s caused by relaxin, a hormone that makes your ligaments softer and more supple so that your baby can pass through the pelvis. In some women this can cause instability in the pelvis which leads to pain.
- Pain in the lower back
- Pain in the middle of your pelvis at the front
- The feeling that your pelvic bones are pulling apart
- Clicking or grinding in the pelvis
- Pain in the inner thighs / between your legs
- Pain that’s worse when your legs are moved apart, or by standing on one leg
- Pain that’s worse in the night and when standing after sitting or lying for a long time
If you are struggling with pain in your pelvis, speak to your midwife or GP – they can refer you to a physiotherapist who can give you some exercises to help, and help you to find less painful ways of sitting, lying, standing and walking. They may give you a pelvic support belt, or crutches if you are really struggling to walk.
You can reduce the amount of pain by modifying the way you move and your activities:
- Exercise gently, but avoid activities that make the pain worse
- Practice the pelvic floor and tummy exercises advised by the physiotherapist
- Wear flat shoes that offer lots of support
- Rest as much as possible
- Squeeze your knees together when trying to roll over in bed, stand up or lie down
- Swivel to get out of the car, rather than standing on one leg
- Get dressed sitting down
- Place a pillow between your legs when sleeping
- When using stairs, go up backwards on your bum, or take one step at a time
- Ask for help with chores, particularly vaccuuming or emptying the washing machine
- Sit down for chores like ironing and cooking where possible
- Wear high heels
- Stand on one leg, or put all your weight on one leg (e.g. when getting dressed, climbing stairs)
- Don’t push things with your feet (e.g. doors, boxes etc.)
- Lift anything too heavy
- Push anything too heavy, like a full shopping trolley
- Carry anything heavy in one hand / on one shoulder – a backpack will help spread the load
- Sit on the floor
- Cross your legs when sitting
- Sit in one position for too long
PGP should improve after birth, although you may find you still have twinges around the time your period is due – this is because of similar hormones being released. If the pain continues, it’s a good idea to go back to the physiotherapist – you may be able to arrange an appointment directly if your referral has been left open, or you may need a new referral.
Find out more about PGP/SPD from Pelvic Partnership
You could try these exercises to manage pelvic girdle pain: