Many expectant mothers will develop back and/or pelvic pain during pregnancy. Pain during pregnancy can start from as early as the first trimester and during this time hormonal changes start to have an effect. The release of the hormone relaxin causes ligaments in the pelvic region to become more lax in preparation for the birth, thus placing an increased stress on the joints.
During pregnancy, postural changes also occur. Your centre of gravity almost immediately begins to shift forward to the front of the pelvis and the displaced weight increases the stress on the joints of the lower back and pelvis. As the baby grows larger, the extra weight is projected even farther forward, to compensate the curvature of your lower back is increased, placing extra stress on the lower back and pelvis. A previously underlying problem you may have had especially with your lower back or pelvis can be exacerbated during this time.
A common problem experienced by expectant mothers is pregnancy related pelvic girdle pain (PPGP), also known as Symphysis Pubis Dysfunction (SPD).
SPD is a collection of uncomfortable symptoms caused by a misalignment or stiffness of your pelvic joints at either the back or front of your pelvis. SPD is not harmful to your baby, but it can cause severe pain around your pelvic area and make it difficult for you to get around. Different women have different symptoms, and in some women SPD is worse than in others. Symptoms can include:
• pain over the pubic bone at the front in the centre
• pain across one or both sides of your lower back
Pain can also radiate to your thighs, and some women feel or hear a clicking or grinding in the pelvic area. The pain can be most noticeable when you are:
• going upstairs
• standing on one leg (for example when you’re getting dressed or going upstairs)
• turning over in bed
It can also be difficult to move your legs apart, for example when you get out of a car.
Who is affected by SPD?
It’s estimated that SPD affects up to one in five pregnant women to some degree. It’s not known exactly why pelvic pain affects some women, but it’s thought to be linked to a number of issues, including previous damage to the pelvis, pelvic joints moving unevenly, and the weight or position of the baby.
Factors that may make a woman more likely to develop SPD include:
• a history of lower back or pelvic girdle pain
• previous injury to the pelvis, for example from a fall or accident
• having SPD in a previous pregnancy
• a hard physical job
Tips to manage day to day activities
• Be as active as possible within your pain limits, and avoid activities that make the pain worse.
• Rest when you can.
• Get help with household chores from your partner, family and friends.
• Wear flat, supportive shoes.
• Sit down to get dressed – for example don’t stand on one leg when putting on jeans.
• Keep your knees together when getting in and out of the car – a plastic bag on the seat can help you swivel.
• Sleep in a comfortable position, for example on your side with a pillow between your legs. Click here for further information on sleep posture.
• Try different ways of turning over in bed, for example turning over with your knees together and squeezing your buttocks.
• Take the stairs one at a time, or go upstairs backwards or on your bottom.
• Talk to your midwife about a pregnancy support belt.
Avoid where possible
• standing on one leg
• bending and twisting to lift, or carrying a baby on one hip
• crossing your legs
• sitting on the floor, or sitting twisted
• sitting or standing for long periods
• lifting heavy weights such as shopping bags
• pushing heavy objects, such as a supermarket trolley
• carrying anything in only one hand (try using a small backpack)
Chiropractic aims to relieve or ease pain, improve muscle function and improve your pelvic joint position and stability. This may include manual therapy to make sure the joints of your pelvis, hip and spine move normally and exercises to strengthen your pelvic floor, stomach, back and hip muscles. Chiropractic is a safe and effective method of treatment that can help you gain comfort and control during your pregnancy and help to make it an enjoyable and as pain free a process as possible. If you are experiencing any of the problems outlined above, or like any further information, please do not hesitate to contact us at Harding Chiropractic Clinic.