Aches and Pains in Pregnancy

I have a special interest in treating pregnancy related aches and pains, having suffered with acute pelvic pain when i carried my first child.  The good news is that you don’t have to suffer silently – most forms of manual therapy may be of benefit, even if you gave birth years ago.

I have undertaken specialist training courses with Pelvic Partnership, a charity who aims to provide women and healthcare professionals with information about best practice for the treatment and management of pregnancy-related pain, and to enable and empower women to access the right treatment.

You can access them in full here, or below I have summarised their information on the most common areas where women experience pain:

Pelvic pain in pregnancy affects up to one in five women. Pelvic pain is also known as Pelvic Girdle Pain (PGP). It is also is known as:

  • Symphysis Pubis Dysfunction (SPD)
  • pelvic joint pain
  • twisted hips
  • pelvic relaxation
  • pelvic arthropathy
  • osteitis pubis

All of these describe pain in the pelvic joints related to pregnancy.

Quick facts

  • Pelvic girdle pain during or after pregnancy is common but not normal so don’t put up with it.
  • Symptoms of pelvic girdle pain include pain at the front and/or back of the pelvis, pain when walking, climbing stairs, turning over in bed and standing on one leg (e.g. getting dressed).
  • Pelvic girdle pain is usually caused by an asymmetry or change of normal movement or alignment in your pelvic joints – a mechanical joint problem not a hormonal one.
  • Pelvic girdle pain (PGP) is very treatable both during pregnancy and afterwards – get treatment for your pelvic pain as soon you get symptoms.
  • Treatment for pelvic girdle pain involves assessing the joints and muscles in and around the pelvis and returning them to normal function, usually using manual therapy techniques.
  • Pelvic girdle pain can be treated by a Chartered Physiotherapist, Registered Osteopath or Chiropractor with experience in manually treating pelvic girdle pain.

Myths about pelvic girdle pain:

Women are often told that their pelvic pain is due to:

  • round ligament pain
  • hormones
  • sciatica
  • trapped nerve
  • normal aches and pains of pregnancy
  • low back pain
  • nerve irritation; and that it is not treatable and will get better on its own, or as soon as the baby is born.

Many women have discovered later that it was pelvic girdle pain and could have been treated as soon as symptoms occurred.

PGP is really treatable at any stage of pregnancy or postnatally as soon as you feel able to visit your therapist.  There used to be ideas that you had to wait a few weeks “for the hormones to settle” but now that we know it is not the hormones causing the problem, this is no longer the case.  As soon as you feel able to see your therapist postnatally, you are ready for treatment.

The aim of treatment is to assess the position and the symmetry of movement of your pelvic joints, especially the sacro-iliac joints at the back of the pelvis. Find out which one is causing the problem, and then treat it.  The treatment is not usually painful, so it is nothing to be worried about, and you should expect to feel an improvement or some relief of your symptoms after each treatment.  Keep going until you are completely pain-free after you have had your baby.  We get a lot of calls from women who just had a few niggles in their joints after one pregnancy but just put up with it because it was much better than it had been, then develop symptoms very early in their next pregnancy because the underlying problem has never been resolved.  This can be prevented or at least minimised by making sure that you are pain-free through getting treatment after your baby is born.

Treatment involves a combination of joint realignment or mobilisation and soft tissue or muscle treatment.  This is because the muscles often become tight or compensate when you have a lot of pain, and this tightness has to be released to allow the joint to move normally and prevent the problem from happening again as soon as you leave the therapist’s room.

Manual treatment involves the realignment of joints which are not working symmetrically. Gentle hands-on techniques are used. This can be done by a physiotherapist, chiropractor or osteopath with training and experience in treating PGP.

There are varying approaches to treating PGP, but the main things you should expect from your therapist are:

  • The therapist will ask you about your PGP and how it affects you.
  • They will ask you to undress down to your underwear.
  • They will look at and feel how the joints at the back and front of your pelvis move when you move (e.g. standing on one leg, bending forwards etc).
  • They will feel how symmetrically the joints move when you are lying down on your back and your front (or your side if you are very pregnant).
  • They will discuss their findings and agree a plan of treatment with you, explaining what they are going to do.
  • Treatment is likely to include realigning joints which have moved slightly, so that they move symmetrically again. This may need to be done at each visit, until your muscles become strong enough to keep them in place without treatment.
  • You may be given gentle exercises to help your pelvic stability.

As you recover, your exercise programme will be adapted to suit your individual needs until you get back to normal.