Pelvic pain in pregnancy is a fairly common problem. In most cases, the symptoms go back after giving birth, but some have pain even after pregnancy.
What is joint release?
The pelvis consists of several legs. Normally, the three major joints – the symphysis and the two sacroiliac joints – in the pelvis are tightly connected with ligaments that prevent movement. In pregnancy, the joints in the pelvis become more mobile. This occurs as a natural process for the pelvis to stretch and give in during childbirth. For some pregnant women, the movement between the different pelvic bones can trigger pain that is particularly prominent during stress.
Pelvic pain in pregnancy (joint discharge, symphysisolysis) is relatively common. About 15% report pelvic pain during the latter part of pregnancy. Pelvic pain is the most common cause of sick leave during pregnancy.
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Typical complaints are pain in the area around the pelvis during stress. The pain can sit on the front or back of the pelvis and radiate to the groin and down the legs. The pain typically comes when walking or standing. Movements that are particularly difficult are, for example, getting up or walking down stairs. Feeling that the pelvis is unstable is common.
The pain often increases during the day and gets worse when changing positions. It is also common for the symptoms to start earlier and earlier for each pregnancy. Occasionally, pelvic pain already occurs during the first three months of pregnancy.
For women suffering from joint discharge, it is about much more than the pain itself. It can affect the woman’s everyday life. Some can only work short workouts, or can only walk short distances, and some get poor night’s sleep.
Hormonal changes during pregnancy probably play an important role. It is also believed that asymmetric movement patterns in the sacroiliac joints at the back of the pelvis and limp ligaments may be important.
Risk factors for pelvic pain in pregnancy are previous back pain, high BMI, symptoms of depression, low age, low education and heavy work.
The diagnosis is based on the description of the pain – where they sit, how strong they are and how they vary – as well as on body examination.
X-rays or other imaging diagnostics are usually not needed.
In pelvic pain during pregnancy, adapting to everyday life is the most important strategy.
It is individually how much and what kind of activity causes pain. For many, the pain comes with a time delay after loading. For some, it works well to be quieter than usual.
Good resting positions combined with adapted activity are recommended. If the pain comes to a stand, try to sit more. For example, you can sit on a high stool while cooking, sit on a chair when emptying the dishwasher, take a break when you are out or go shopping. To vary between sitting and standing can be good for many.
If the tasks trigger the pain, you may need to get customized tasks. If this does not help, sick leave may be necessary in some cases.
Even load on both legs is important. This is achieved by standing with the weight evenly distributed on both legs and walking with short steps. When turning to bed, it is good to pinch the pelvic floor and then move around with your legs together. Sitting with crossed legs is not good if you have joint joint.
When carrying things, weight should be evenly distributed over the arms, you should carry things close to the body. The use of a backpack can be recommended.
Physiotherapy and exercise
Some may be assisted by the advice of a physical therapist. You can get an individualized exercise program that does not cause pain. This does not always reduce the pain, but can be good for strengthening the muscles so that you get better sooner after delivery.
Some may be helped by a belt or corset that compresses the hips. Some need to use crutches, but the use of crutches for a longer period of time should be avoided as it can weaken the muscles of the back and pelvis, which can later increase and prolong the pain.
Acupuncture can also have an effect on pelvic pain during pregnancy.
Some manage to perform some physical exercise even with pelvic pain during pregnancy. Some have pain when walking, but not when cycling. Swimming can also be a good exercise option. Water gymnastics has shown good results in some studies.
Pelvic pain during pregnancy almost always disappears after childbirth. In a large Swedish study, almost all were good at post-control after twelve weeks. Those who have had very severe pelvic pain during pregnancy are most at risk for long-term problems, especially if they also have anxiety and depression.