Pregnancy-related low back pain is an unfortunately common occurrence, affecting many women. More than 2/3 of pregnant women experience low-back pain (LBP) and almost 1/5 experience pelvic pain. Symptoms usually start around the 18th week of pregnancy, but can also begin in the first trimester or as late as three weeks after delivery.
2. The most frequent pain location and the most severe pain are related to the pelvic girdle.
Posterior pelvic girdle pain (PGP) has been defined as pain localized between the iliac crests and the gluteal folds with or without radiation down the leg. Anterior PGP is experienced in the symphysis and can occur in addition to posterior PGP or as a separate syndrome, previously referred to as SPD or symphysis pubis dysfunction.
B) Diagnosing pelvic girdle pain:
The diagnosis of pelvic girdle pain has been a contentious issue, with both poor inter- and intra-rater reliability demonstrated in using bony landmarks, asymmetry and misalignment theories. But as skilled therapists know, accurate diagnosis is the key to successful treatment outcomes.
This indicates that decreased joint stability may be compensated for by changed muscle function, postural patterns and ergonomic modifications.
- A pain drawing with well-defined markings of pain over the gluteal area or the symphyseal joint
- A history of weight-bearing related pain in the pelvic girdle
- Positive self-administered tests, which reproduced pain in the pelvic girdle
- No nerve root syndrome judged by a negative self-administered modified straight leg raise
It's both important and possible to identify women at risk for persistent PGP in the postpartum as early as possible. In addition, they can be used in perinatal care units as a ground for timely referral to specialist physical therapy for treatment.