Pelvic Pain During Pregnancy: Causes and Treatment

Pregnancy is a journey with lots of joy and anticipation. Along the journey the expecting mother experiences many discomforts of which most common being pelvic pain. It’s important to understand that the pain may stem from multiple factors and of these pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD) are two possible reasons causing Pelvic pain during pregnancy. Understanding the underlying causes and the possible treatment options can not only ensure pain free pregnancy and eliminate discomfort but also significantly improve the health and well being of both mother and fetus.

Symphysis pubis dysfunction (SPD):

• The pelvic bone or hip bone are two equal halves that are usually stabilized by the surrounding ligaments. 
• These ligaments are sensitive to certain hormones that make them loose there rigidity.
• During pregnancy, from as early as ten weeks, Symphysis pubis dysfunction may begin due to a hormone that is released called relaxin.
• This hormones makes the pelvic bones destabilized as they move around while climbing, walking or changing positions during sleep. 

Pelvic girdle pain (PGP):

• Pelvis can be described as the area that is located between the thighs and abdomen. The pelvic bone surrounds or houses the reproductive organs like uterus and ovaries and the urinary system including the urinary bladder and ureters.
• This pelvic bone can radiate pain usually in the later months of pregnancy due to undue pressure of the growing fetus.
• The pain is reportedly felt in the center of the lower back which spreads or radiates downwards.
• The back of the thighs become sore leading to difficulty in carrying out regular activities

Uterine ligament pain:

• The uterus or womb houses the growing fetus.
• As the size of fetus increases, the round ligaments of the uterus stretch and strain.
• This change in the anatomy of uterus sometimes causes sharp, stabbing pain  during pregnancy.

Increased pressure:

• As the weight of the baby increases there are several changes that happen in the pelvic as well as the abdominal area.
• The increased pressure due to the weight of the fetus, on certain organs can lead to dull aching pain in pregnancy.

Urinary Tract Infection:

• Pelvic pain can also arise from frequent Urinary Tract Infections that are common in pregnancy.

Treatment and Management of Pelvic Pain in Pregnancy:

There are certain lifestyle modifications that can be done to decrease pain and discomfort during pregnancy.

• Regular pregnancy safe exercises: Pelvic muscles can be strengthened with gentle exercises that include walking, jogging, yoga, strength training and swimming.
• Pelvic belts: Certain wide strapped belts wrapped around the pelvic region have shown to offer stabilizing effects on the pelvic bone easing the discomfort.
• Rest: Ample rest is advised in high risk pregnancies and in cases where pelvic pain is unbearable.
• Physical therapy: Certain physical therapy exercises as guided by a certified physical therapist can offer a lot of benefit to not only ease Pelvic pain in pregnancy but also facilitate recovery post partum.

When should you seek help for Pelvic pain in pregnancy:

• Intense unbearable pain: Pain that causes hindrance in regular activities and becomes unbearable should always be evaluated by an OB-GYN or Obstetrician - gynaecologist. This ensures optimal health of both mother and baby. 
• Other symptoms: Having high fevers, chills or even upset stomach with diarrhea and vomiting can indicate some infection which might be the reason for Pelvic pain. Prescription that is pregnancy safe is given based on the associated symptoms.
• Incessant pain: Pelvic girdle pain, Symphysis pubis dysfunction, or Uterine ligament pain are generally non continuous. This essentially means that the pain that arises last only for a short period of time. It is hence essential that any sort of pain that is continuous and relieved for a long period especially in the pelvic region is examined by the physician.
• Impaired mobility: Although some activities that include bending and walking become difficult in the final weeks of pregnancy, severe mobility issues can indicate underlying problems like arthritis of the pelvic bone. 
• Pharmacological intervention: For pelvic pain, NSAIDs or nonsteroidal anti-inflammatory drugs can reduce pain and inflammation instantly. These are considered safe in most cases but are best to use when prescribed by an OB-GYN.
• Topical creams: There are certain topicals that are available which can be applied for pain relief. These provide targeted relief to certain muscles around the pelvic region and are directed by a physician based on the area of pelvic pain.

Regular Check ups:

Dealing with pelvic pain during pregnancy can be difficult without the supervision of an experienced OB-GYN. Getting accurate diagnosis and knowing the underlying cause for pelvic pain may direct the treatment plan. It is hence essential to keep up with the regular check ups and get complete assessment of mother and fetal health. 

Conclusion:

There is no particular method to completely prevent pelvic pain and changes in the pelvic joint during pregnancy. It is important to protect and prevent injury to this area as the loss of muscle tonicity can increase chances of injury. Effective management of pelvic pain in pregnancy is guided by an Obstetrician - gynaecologist that includes home remedies, prescribing medications and physiotherapy.