Pelvic girdle pain (PGP) is the general term for all pelvic pain. It includes pubic symphysis pain – previously called symphysis pubis dysfunction (SPD) and Sacro-illiac joint pain (SIJ pain).
WHO: Most commonly in women who are pregnant BUT Pubic symphysis and Sacro-lilliac joint problems can occur in anyone.
CAUSE: If your PGP is related to pregnancy then the main factors seem to be a history of previous lower back, pelvic girdle or joint pain, hypermobility syndrome and/or previous trauma to the pelvis. Poor muscle function in the back and pelvis at the beginning of pregnancy is also a factor.
If Pregnancy is not a factor then the cause can be a little more vague – similar to mechanical low back pain. Usually through trauma or mechanical stress – activity related, often seen with poor movement patterns and muscle imbalances/weakness.
SYMPTOMS:
- pain over the pubic bone at the front in the centre, roughly level with your hips
- pain across 1 or both sides of your lower back
- pain spreading to your thighs
- Some people may feel or hear a clicking or grinding in the pelvic area.
The pain can be worse when you’re:
- walking
- going up or down stairs
- standing on 1 leg (for example, when you’re getting dressed)
- turning over in bed
- moving your legs apart (for example, when you get out of a car)
DIAGNOSIS: Initially a thorough assessment by a Physiotherapist will establish a diagnosis and treatment plan. If symptoms do not respond or if the Physiotherapist is concerned then a referral for further investigations, blood tests and scans may be required.
TREATMENT:
Physiotherapy aims to relieve or ease pain, improve muscle function.
This may include:
- manual therapy to make sure the joints of your pelvis, hip and spine move normally
- exercises to strengthen your pelvic floor, stomach, back and hip muscles
- pain relief, such as acupuncture or TENS
- equipment, if necessary, such as crutches or pelvic support belts
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