My Pregnancy

Symphysial pain or posterior pelvic girdle pain (PGP)

Symphysial pain or posterior pelvic girdle pain (PGP)

Pelvic girdle pain is common complaint during pregnancy. It can be in front that is symphyseal pain, or posteriorly that is posterior pelvic girdle pain. 

The pelvic girdle is basin-shaped complex of bones that located in the lower part of the trunk and connects the trunk and the legs. Pelvic girdle  is formed by four separate bones that fuse together in front at symphyseal joint and posteriorly sacrum joins on both sides to ilium and inferiority to the coccyx. 

Normally pelvic girdle joints are fixed and stable. In pregnancy due to hormone relaxin, these joint become hyper mobile, relaxed and stretchy so your baby can ease his way into the world. In some woman these changes bring pain in these joints. The pain may range from a mild ache to severe pain that limits your daily activities. This may start at any time during pregnancy. Good news is after delivery your joints revert back to fixed and stable state and pain goes away. 

Symphyseal pain

Symphyseal pain in focused in pubic area which is lowest part in front of your trunk. However it can radiate to upper thighs. In very rare cases, the joint may gape apart, a condition called diastasis symphysis pubis or symphyseal separation and require medical intervention. 

Posterior pelvic girdle pain

Some women experience pain more in their lower back, buttocks, and hips 

Activities causing PGP

– Walking, making it difficult and painful so women adopt waddling gait. 

– Putting weight on one leg while standing, during climbing stairs, getting dressed or getting in and out of car. 

– Pain and/or difficulty in straddle movements, such as getting in and out of the bath.

– Hip abduction (the movement of the leg away from the body) like turning over in bed or or getting in and out of car.

– Asymmetrical position of thighs like lying on sides without pillows to maintain angles. 

– Certain positions during sex. 

Avoid & modify following..

– Avoid activitit’sactivities that you know will make pain worse. 

– Avoid standing on one leg. 

– Try dressing sitting down in a way your knees don’t distant apart much. 

– Use pillows between your legs and under the leg while lying on your side to maintain the correct alignment of your thighs. Turn ‘under’ when turning in bed, or turn over with knees together and squeeze your bum.

 – While turning over bed avoid splaying your thighs try to keep your knees together.

– Avoid heavy lifting and pushing.

– Avoid sitting cross legged. 

– Avoid reaching, pushing or pulling to one side.

– Avoid bending or twisting to lift.

– Avoid carrying anything on one hip. 

– Avoid positions during sex which are painful, consider alternative positions for sex, such as lying on the side or kneeling on all fours. 

– Rest frequently. Put time limits for activities. 

– Opt to sit down than standing for activities like ironing or chopping vegetables. 

– While climbing stairs try one leg at a time with more pain free leg first.

Consider following… 

– Walk more slowly and with shorter strides. 

– Accept offers of help.

– If climbing stairs the plan ahead to decrease number of trips.

– Set up changes to make things more workable for you. 

– Apply heating pad or ice pack to pubic bone not more than 10 minutes.

– Wear a support belt.

– Apply topical pain medications.

– Consider physiotherapy.