Pelvic girdle pain

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Pelvic girdle pain
Synonyms	PGP
Pronounce	N/A
Specialty	Orthopedics, Rheumatology, Obstetrics
Symptoms	Pain in the pelvic region, lower back pain, hip pain
Complications	N/A
Onset	Pregnancy, postpartum period, trauma
Duration	Varies, can be chronic
Types	N/A
Causes	Pregnancy, pelvic joint dysfunction, trauma
Risks	Pregnancy, previous pelvic injury, obesity
Diagnosis	Clinical assessment, imaging studies
Differential diagnosis	Sciatica, hip osteoarthritis, sacroiliitis
Prevention	N/A
Treatment	Physical therapy, pain management, exercise
Medication	Analgesics, NSAIDs
Prognosis	Generally good with treatment, but can be chronic
Frequency	Common in pregnancy
Deaths	N/A

Pelvic Girdle Pain (PGP), formerly known as Symphysis Pubis Dysfunction (SPD), is a condition associated with discomfort and pain in the pelvic region. It is particularly prevalent among pregnant women, although it can affect individuals of any gender and at any stage of life. The pain primarily arises from the instability or stiffness of the pelvic joints at either the back or front of the pelvis.

Causes and Risk Factors

PGP is caused by a combination of factors that may include hormonal changes, particularly during pregnancy, which lead to the relaxation of ligaments and joints in the pelvic area. Additional risk factors include a history of lower back or pelvic pain, trauma to the pelvis, and activities that place uneven pressure on the pelvis, such as carrying a child on one hip or engaging in asymmetrical sports activities.

Symptoms

The symptoms of PGP can vary but often include:

• Pain in the front and/or back of the pelvis
• Pain radiating to the lower back, thighs, or perineum
• Difficulty with activities that involve lifting one leg, such as climbing stairs, walking, or getting in and out of a car
• Clicking or grinding in the pelvic area
• Pain during sexual activity

Diagnosis

Diagnosis of PGP involves a thorough medical history and physical examination by a healthcare provider. Imaging tests are not typically used to diagnose PGP but may be employed to rule out other conditions.

Treatment

Treatment for PGP aims to alleviate pain and improve the individual's functional ability. Approaches may include:

• Physical therapy focusing on strengthening the pelvic floor, abdominal, back, and hip muscles
• Use of pelvic support belts
• Pain relief methods such as acupuncture, hydrotherapy, and the use of analgesics
• Modifications to daily activities to avoid movements that exacerbate the pain

Prevention

Preventative measures for PGP include maintaining a healthy weight, engaging in regular, balanced exercise, and avoiding activities that strain the pelvis asymmetrically.

Prognosis

The prognosis for individuals with PGP varies. Many women experience significant improvement postpartum, although some may continue to have persistent pain. Early intervention and treatment can improve the outcome.

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