Finding the right treatment for me
Thanks to Jane for providing this uplifting account of her experience of PGP and for sharing the avenue she took to finding appropriate treatment which enabled her to successfully manage her symptoms.
I have had Pelvic Girdle Pain since I was six months pregnant with my second child who is now sixteen months old. Towards the end of my pregnancy, I ended up on crutches and was seeing my local NHS physiotherapist on a weekly basis. After the birth, my PGP got slightly better and I was determined to try and manage looking after my then eighteen-month-old daughter and my new baby. After a few months, my PGP got much worse again and by six months after the birth I couldn’t walk for more than five minutes and was in constant pain. Finally, I decided I needed a lot of help so I employed a full-time nanny (a huge and, for me, very upsetting step).
The NHS referred me to an orthopaedic surgeon and, after some MRI scans, he said surgery was a possibility but that he had previously only varied success with women presenting with my symptoms. I phoned the Pelvic Partnership who suggested travelling to see a physiotherapist who specialised in PGP (Claire Woodward). Claire was great and I decided to have a course of prolotherapy injections. I used a consultant in Cambridge and over the next three to four months, I had three lots of injections into my sacroiliac (SI) and symphysis pubis (SP) joints.
Initially, I made very good progress and was really able to increase the amount of exercise I was doing but I seemed to keep on overdoing it and would just go back to the start again. I think the problem was that I was not getting much physiotherapy treatment in between the injections to sort out the stiffness and problems in the muscles.
My second child turned one on the 23rd of April 2009. I had finished my course of prolotherapy injections and I was back where I started – well actually a lot worse. I was in pain in so many places. I couldn’t sleep at night and I spent about a week lying on my back crying. I phoned the Pelvic Partnership again and they suggested doing some intensive physiotherapy. I decided to see Maeve Whelan in Dublin. (Although Claire Woodward is also excellent I chose to see Maeve because she specialises in women’s health issues and the pelvic floor as well as PGP and this link was particularly relevant to my problems). At first I thought it was crazy to travel all the way to Dublin just to see a physiotherapist, but it was the best decision.
My husband came with me on my first trip and I used a wheelchair through the airports. I saw Maeve Whelan, who is a Specialist Chartered Physiotherapist, in her clinic at Milltown Physiotherapy Clinic in Dublin. I was with her for 1 hour 30 minutes and cried for most of the appointment. She did a full internal examination of my pelvic floor as well as looking at all the problems on the outside. She understood exactly what was wrong and did not seem fazed by how to get me back to full recovery. I decided to commit to regular intensive physiotherapy in Dublin. For the first five weeks I went to Dublin for three days every week and had a one-hour session on each day. After that, I went every two weeks, then every three weeks and now my next appointment is a month away and I’m going for just two days. During the first six weeks I wore a pedometer to measure how many steps I did each day. I very gradually increased my steps – starting at 2,000 steps, increasing to 10,000 over about six weeks.
In three months, I have made considerable progress; originally I was able to walk for only five minutes but now I can keep walking for 90 minutes. I am now doing so much with my children and I can lie comfortably on my side and sleep really well at night. My family can’t believe the improvements in me and my three-year-old daughter keeps saying “my mummy is getting better and better!”. I now know that I am going to get completely better.
My tips for getting better
Given my experience, I would really like to pass on some tips to help other women in my situation:
- Get help with your children as early as possible. Initially I went through a nanny agency and employed a fully-qualified nanny. This was very expensive and not really necessary. A cheaper way to do it is to just advertise for someone local to work as a mother’s help. I now have a local girl who has just left university and wants a job for six months to help pay for some travelling. I use PAYE for nannies to do all the tax bit (very easy). Another alternative would be to use an au pair.
- Find a physiotherapist who specialises in PGP and don’t be afraid to travel. Commit to intensive treatment if necessary.
- Once you are getting better, increase your activity levels gradually – a pedometer is a brilliant way to do this.
- Take painkillers – these can really help and especially to help you sleep at night. I started taking amitriptyline, which on a low dose is a muscle relaxant and helps with nerve pain. I just take one tablet before bed and it has made sleeping very easy – a good night’s sleep is so important.
The cost and practicalities of going to Dublin
(Please note that this article was first published in 2009 so costs have probably increased).
For the flight from Liverpool to Dublin return with Ryan Air, I have never paid more than £20 return including all taxes! I suggest that you book wheelchair assistance when you book your flight. I have done this trip a number of times by myself when I could hardly walk and it was fine (I now walk through the airports usually overtaking everyone else)! The taxi from Dublin airport to the clinic is 30 Euros each way or you can use the Luas tram system and airport bus.
For accommodation, I stay at the Ardagh house guesthouse http://www.bandbdublin.net/ ardagh-house.ie/. Rooms cost from 65 Euros per night and it is a very quiet friendly guest house with good beds and a shop directly across the road. It is a five minute taxi ride from the clinic or you can use the bus
Treatment – Maeve costs 120 Euros per hour www.milltownphysiotherapy.com. When I come I see Maeve for one hour (she treats the pelvic floor, re-aligns my pelvis and treats the muscle tightness using her hands), Hana for one hour (she treats muscles tightness/ trigger points using dry needling which I find very effective) and Mary (she realigns my pelvis, treats muscle tightness and does rehab work). Yes the total cost is huge but three prolotherapy injections can cost over £3,000. Personally I think your money is much better spent on a number of trips to Dublin.
Thank you, Jane, for this article which is both reassuring and a call for women with PGP to take action! Some women who contact us that are either not responding to treatment from an experienced manual therapist or respond well but symptoms flare quite quickly between treatments have gone on to find associated problems with their pelvic floor and often find that a combination of ‘trigger point’ release treatment of their pelvic floor and manual therapy of their pelvic joints has been the key to their recovery.
Maeve Whelan has another website which is very helpful and also includes a list of physiotherapists who are trained in manual treatment of the pelvic floor: www.pelvicphysiotherapy.com.