Pregnancy-related pelvic girdle pain (PGP) can continue after pregnancy. While some women find that symptoms disappear quickly, unfortunately many find that they do not. If you find yourself experiencing PGP postnatally, remember PGP can be safely and effectively treated with hands-on treatment, including manual therapy.
It is never too late to see a physiotherapist, osteopath or chiropractor for a hands-on assessment and treatment tailored to you, including manual therapy.
You can seek treatment from your manual therapist as soon as you feel comfortable to do so, even within a few days after birth. Treatment is the same for PGP during and after pregnancy.
You can talk to your GP or midwife about a referral for NHS physiotherapy, or if you are in a position to pay for private treatment, please check our list of recommended practitioners.
We know that it may not always be easy to discuss your PGP with your GP, midwife or health visitor.
Download our free toolkit “Talking about your pelvic girdle pain” to help you explain how PGP affects you physically and emotionally, from our resources page.
You can also download our free ebook “PGP is treatable!” for tips and strategies to help you manage your PGP, alongside individualised treatment from a manual therapist.
Please note, pelvic pain can be caused by other conditions. If your pain changes, gets worse or is not improving it is important to seek medical advice to rule out other possible causes.
When their periods restart, some women find that their PGP pain comes back. This may be because you are more sensitive to pain during your periods or due to hormone changes with underlying joint problems. Most women find that if they take this as a signal that they still have a bit of an alignment/joint asymmetry problem, manual therapy will sort it out.
If you had PGP during one pregnancy, you may have it again in your next pregnancies. The PGP may start earlier and be more painful if you did not have treatment last time. However, you can use a range of tools alongside manual therapy to manage your PGP symptoms during and after pregnancy.
Try and see a manual therapist as soon as the symptoms start. This can make a big difference to your pain levels during pregnancy and your recovery after your baby is born.
If you had severe problems last time and think this may happen again, you can proactively plan what help you may need and arrange it in advance. Think about:
There are no hard and fast rules on the time you should leave between pregnancies, but it is helpful to recover as much as possible from one pregnancy before starting another. For example, being pain-free, back to previous fitness and mobility levels can help you manage your PGP well in your next pregnancy.
It is worth seeking treatment as soon as you become pregnant again or even while you are planning your pregnancy. We suggest keeping your PGP under control as much as possible rather than waiting to see if it starts again. This can also help you to feel in control of your PGP rather than the other way around.
If you have had PGP it can seem that everyone has an opinion on whether or not you should have another baby. Whilst this concern is often well-meaning, it is not for other people to comment.
Remember, the decision whether or not to have another baby is yours and your partner’s only – nobody else counts. Having a baby is not only about pregnancy, birth and the early months. Babies grow into children and adults, and are part of your whole family unit.
You may find it helpful to talk over your decision with somebody neutral, such as the Pelvic Partnership helpline. Call and leave a message for one of our volunteers on 01235 820921.
From time to time you may find that you have a setback in your progress to recovery, a sudden return of pain or immobility.
Usually it is because you have simply pushed yourself a little too hard, undertaken a particularly strenuous activity or simply contorted your body into an awkward position (playing on the climbing frame in the park seems to be a common culprit!). Sometimes there is no reason for the setback – it just happens.
There is no need to panic – it does not mean that you have permanently damaged your pelvis or that you are back to square one on the road to recovery. Try to see a physiotherapist, osteopath or chiropractor and expect to return to your previous level of activity.
If you have had PGP you may need to take extra care when undergoing gynaecological treatments or interventions, including:
You will know your own body and its limitations or when you feel particular pain or a flare-up in symptoms. It is important to explain this to healthcare professionals so they can take extra care.
Here are some points to bear in mind:
If you continue to experience severe pain around your periods despite manual therapy, it is worth exploring further. Please talk to your GP about a referral to a gynaecologist or the pain clinic to explore this further.
It is also important to remember that PGP is not the only cause of chronic pain.
There are many women with PGP who respond well to treatment initially, but struggle to get that last 10% of ‘normal’ back.
There are a few common reasons why progress slows, including:
You may need to ask for a second opinion from another experienced manual therapist to help you to progress further.
It is important to remember that we are all different, what works for one woman may not work for another.
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