The diagnosis of PGP can be made based on the symptoms alone: if you have pelvic joint pain and it is related to a pregnancy, it is likely to be PGP and likely to respond to being actively treated. However, you need to be assessed by a manual therapist who will exclude any other possible diagnoses. If you have had a fall or another trauma to your pelvis (including a difficult birth) and if the symptoms do not get better with treatment, it can be helpful to have further investigations to exclude Diastasis Symphysis Pubis (DSP).
These are pelvic X-rays where you stand on one leg and have an X-ray taken and then stand on the other leg and have another X-ray taken. This shows how much the pelvis moves on each side when you are taking weight (so it shows whether it will be moving while you walk, for example). A normal pelvic X-ray does not usually show any movement, and therefore this is often not very helpful.
The normal range of movement (vertical shift or horizontal gap) is 0-3 mm, and moderately abnormal is 3-10 mm. Women can still function very well with this amount of movement, but it may need to be taken more into account when looking at types of exercises in the rehabilitation phase of treatment. If the shift is over 10 mm this can be more difficult to manage (see DSP above), but if you have not yet had any manual treatment you should discuss the options with a therapist before deciding on further treatment, and it is usually worth trying this before resorting to more invasive treatment such as steroid injections or surgery.
These show any inflammation in the joints more clearly, which can also confirm why you have pain, as inflammation is usually painful. Some inflammation can sometimes be seen on X-rays, but it is usually clearer on an MRI scan. They will also show any bony changes more clearly, and may show any severe muscle or ligament damage. Even if bony changes are shown on the scan, manual treatment may improve your symptoms as it helps the joints to work properly together, which reduces the irritation and inflammation over time.
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