Where is Pelvic Pain located?
Pelvic Girdle Pain (PGP) is defined by pain experienced between the posterior iliac crest and the gluteal fold, particularly close to the sacroiliac joints (Vleeming 2008). The pain may radiate into the back of thighs and can also occur in conjunction with/or separately in the pubis symphysis. PGP symptoms include pain while walking, bending, climbing stairs and turning over in bed which can have a major impact on your life. The pain can feel dull and achy, a sharp shooting pain or a deep muscle pain.
Why am I feeling pain in my pelvic area?
PGP is more common in pregnancy, following trauma or reactive arthritis. PGP is a common, usually a mechanical joint problem and in most cases is a treatable condition. Your pelvis consists of three joints (symphysis pubis and sacro iliac joints) which work together in a ring-type system. In PGP these joints are not working normally. Often, one joint becomes stiff and this causes irritation in the other joint/s as they have to work harder than they should.
What can pelvic pain be a sign of?
Other possible causes for PGP include ovarian cyst, pelvic inflammatory disease, appendicitis, peritonitis and urinary tract infection. Indeed constipation, irritable bowel syndrome, pelvic abscess and endometriosis are possibilities. Therefore it is very important to speak with your GP or manual therapist to describe your symptoms. To gain a specific diagnosis so your symptoms can be treated effectively.
Pain Relief during Pregnancy
GPs are advised to not prescribe any medications during pregnancy if possible to avoid interactions with your pregnancy (NICE 2020). They may prescribe paracetamol but if this proves ineffective then you would need to ask for a referral to your obstetrician for pain management during pregnancy. You could try pregnancy Pilates in London with our graded exercise programs.
Osteopathy provides a non surgical drug free alternative treatment. PGP can be safely treated at any stage (during or after pregnancy). Osteopaths have extensive training in joint problems however they are rarely available through the NHS. Osteopathy sessions will include hands on joint articulations, muscular stretching and joint manipulations. In addition rehab exercises (mixture of stretching and strengthening) for the pelvic girdle muscles and upper back hips to aid mobility. The focus of the treatment will be to reduce mechanical loading into the irritated joint, restore function and reduce pain. It may take a few sessions but your Osteopath will discuss with you how long it is likely to take to feel better. They will give you exercise and lifestyle advice to optimise your recovery. If you feel no benefit after a few sessions then discuss this with your Osteopath.
Physiotherapy is available on the National Health Service (NHS) through most maternity units or through your GP. Ideally seeing a physiotherapist who has undergone extra training in treating pelvic joint pain, women’s health or musculoskeletal and use hands on techniques. Also, if you are pregnant make sure whoever refers you is aware that you need to be seen quickly as this can reduce the deterioration of your condition. Alternatively, you can use a private physiotherapist but it might be worth trying the NHS first. If you feel you are not progressing and making a full recovery, as with any other medical condition, discuss this with your physiotherapist, or return to your GP and ask for a second opinion.
At Wellthy Clinic we are big fans of meaningful movement especially within pregnancy. The Pilates instructors (also Osteopaths) will give graded exercises depending on the severity of your symptoms. We will find the right balance and regular review your exercises to ensure progression. We believe light exercise should be encouraged as it helps to improve the condition of both abdominal and pelvic floor muscles. Which in turn stabilises the joints of the pelvis.
The pelvic floor consists of layers of muscles that go from the pubic bone (in front) to the end of the backbone (spine). Increasing your pelvic floor muscular tone is important to help both with the contraction and relaxation of muscles with childbirth, as they come under great strain. Also to reduce the likelihood of leaking urine when you cough or sneeze (stress incontinence). We run private and group mat and studio Pilates sessions. We can advise on what type of session would be the best for you. The studio sessions involve reformer, cadillac and chair equipment so you can add resistance to make exercises easier (great for PGP rehab). Interested? Book a Pilates session with our specialists now. We now offer Online pilates classes.
Nutritionist for Pelvic Pain
Pelvic pain can be difficult and can take a while to recover so combining approaches (Osteopathy, Pilates and Nutrition) will give your body the best chance of recovery. A Nutritionist would address your current diet and develop a bespoke plan for you to help you reduce your pain levels. Everybody is different and so are people’s nutritional needs (especially if you are pregnant) so having a tailored plan can make a big difference.
Sounds good? We offer FREE 15 minute consulations with our Nutritionist.
NHS Pelvic Pain (2020) available at https://www.nhs.uk/conditions/
Pelvic Partnership (2020) available at https://pelvicpartnership.org.uk/
Pelvic Obstetric and Gynaecological Physiotherapy Guidance for Health Professionals
Pregnancy related Pelvic Girdle Pain https://pogp.csp.org.uk/system/files/pogp-pgppros_1.pdf
Vleeming (2008) Guidelines for the diagnosis and treatment of pelvic girdle pain Eur Spine J. 2008 Jun; 17(6): pp. 794–819.