The good news is that because PGP is a mechanical joint problem not a hormonal problem, it can usually be treated effectively by 'hands-on' manual therapy from a physiotherapist, osteopath or chiropractor experienced in treating PGP. PGP is treatable at any stage of pregnancy or postnatally as soon as you feel able to visit a manual therapist.
There are various routes to find this type of treatment:
- You can ask your GP or midwife to be referred to an experienced physiotherapist who has undertaken extra training to learn to treat PGP. This may be an outpatient or musculoskeletal physiotherapist, or a women’s health physiotherapist at your local hospital or health centre. It is important to find a physiotherapist with experience in treating PGP with manual or ‘hands-on’ techniques. It is also important not to give up if the first physiotherapist you see does not help you. It can often take persistence to find someone who knows how to treat PGP effectively. To assist you with this, you could refer your GP, midwife and physiotherapist to the Pelvic Partnership ‘Stickmum’ leaflet and the national guidelines for PGP is also useful to provide a summary of information about the best practice for treatment of PGP.
- You may find a private manual therapist in your area listed on our 'Recommended practitioners' list. Practitioners on this list have been recommended by at least two separate women with PGP who have been successfully treated.
- You can try your local sports injury clinic where you can ask to speak to a sports physiotherapist, who ideally specialises in pelvic joint problems, to discuss whether they have relevant experience. They do not have to have specific experience of treating pregnant women. It is most important that they are confident at manually treating the pelvic joints and getting their patients back to playing sport and doing all the normal activities of daily life, rather than just coping with pain and avoiding normal activities. To find a manual or sports physiotherapist in your area visit the Physio First website.
- You can contact your local osteopath or chiropractor – again, check that they have experience in treating pelvic joint problems. You may find these websites helpful: General Osteopathic Council, British Chiropractic Association and McTimoney Chiropractic Association.
Unfortunately, many NHS and private manual therapists do not know how to effectively treat PGP using manual therapy techniques. If your PGP does not improve after each treatment, then it is important to try another therapist, as you may not be receiving the best manual therapy available.
Exercises, crutches, support belts and painkillers, can help relieve some of the symptoms you are experiencing but do not address the underlying cause of your pain. Often pain from the underlying joint problem prevents the muscles from working, so it doesn’t matter how much exercise you do to try and get stronger because when there is pain, the muscles can’t function properly. However, once the joints and surrounding muscles are treated with manual therapy, restoring free movement in the pelvic joints, and your pain has reduced, exercise can be very helpful to strengthen the muscles supporting your pelvis. Please see our Exercise and PGP page for more information.
For more information about why you may not be improving following manual therapy treatment please visit our 'What to do if treatment is not helping' web page.
It is rarely too late!
If you are told that it is too early or too late in your pregnancy to do anything, or that treatment is not effective during pregnancy and you have to wait until you have had the baby, or that you are too acute to treat, or that your symptoms are too mild to worry about, it is worth getting another opinion. Ask to be referred on to someone who has experience of treating PGP in pregnancy, or look for private treatment if this is an option for you.
Traditionally, it was thought that nothing could be done in pregnancy, but it is now known that for most women PGP is a treatable condition, and the women who contact us confirm this regularly.
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