Pelvic girdle pain is a condition that affects up to 20 per cent of pregnant women, writes Sylvia Thompson
ODRAN RODGERS (33) was about three-and-a-half months into her first pregnancy when a severe shooting pain in her hip bone and down the side of her leg started to give her sleepless nights.
"I'd wake up and grab hold of the edge of the bed in pain. I'd turn onto the other side and then 20 minutes later I'd have to change sides again. This would go on all night," she explains.
When Rodgers made an appointment at her ante-natal clinic, she was told she was suffering from pelvic girdle pain, a pain condition that affects up to 20 per cent of pregnant women.
Clare Farrell, physiotherapist at Mount Carmel Hospital, Dublin, says that the symptoms of pelvic pain vary from person to person.
"It can start as an ache and develop into a pain and can occur at any time of the pregnancy. It can be difficult to distinguish between normal pregnancy aches and pains and pelvic girdle pain, so it's very important to seek medical diagnosis," she says.
Some women experience pelvic girdle pain as pain in the groin or pubic bones while others experience it as pain in their hips, abdomen, inner thigh, buttocks and legs.
Many have difficulty sitting or standing for long periods, walking up the stairs (the advice is often to bring both feet to each step rather than taking one step after another) or when driving.
Rodgers was referred to a physiotherapist who used hands-on techniques to relieve the muscle spasm that was causing her pain. She was also given advice on posture and movement which would alleviate the pain and a belt to wear to support her pelvic girdle as her pregnancy developed.
"The belt relieved the pressure and the manual therapy relieved the shooting pains but I was still waking up at night and I couldn't do simple things like empty the dishwasher. I had to learn to keep my knees together as much as possible to avoid extending the pelvic girdle too much," she explains.
"I was still working intensely in a full-time job, thinking that I should just keep going and not become a hypochondriac," she says.
However, the pain got so bad that her obstetrician advised her to stop work when she was six months pregnant. "She told me that my body just couldn't keep going at this pace. I was driving to and from work every day and not sleeping at night.
"I was at the point of exhaustion so had to stop work to get some sleep. It was a shock to be signed off and have to clear my desk in two to three days," she explains.
Rodgers, who works as a marketing manager, was given sick pay for the rest of her pregnancy. "This meant that I could now rest during the day but even with that, I found that my mobility got worse and worse. From the seventh month of my pregnancy onwards, I had to use crutches to move around."
Luckily for Rodgers, her baby girl, Grace Lauren arrived one month early in perfect health. "I had a normal delivery and although it's not great for a baby to arrive early, it was better for me. It took me about four weeks before I could walk normal distances again," she explains.
Physiotherapist, Clare Farrell who treated Rodgers says that the static nature of many jobs nowadays is a risk factor for pelvic girdle pain.
"Anyone who has a history of low back pain or who had an injury or fall as a child or adult is at greater risk of suffering from this," explains Farrell. Long working days coupled with long journeys to and from work can lead to pelvic girdle pain in some pregnant women.
"The important thing is that women seek medical diagnosis earlier rather than later. Otherwise, the pain can get in on them and everything else will get on top of them which puts them at risk of ante-natal and post-natal depression," explains Farrell.
Farrell says that the treatment varies according to the extent and site of the pain. Physiotherapists take a three-pronged approach.
"We help reduce the pain by massaging the muscles. We give advice on good posture and offer lifestyle management strategies."
Most women don't take pain-relieving medication for the condition for fear of affecting their baby. "Some women find that aqua movement classes help. Yoga usually isn't good because the stretches extend too far. We are hoping to develop specific pilates exercises to help pregnant women cope better with the pain," says Farrell.
Looking back on the experience now, Rodgers says, "If I'd realised how immobile I would become, I would have cut out a lot more at an earlier stage and would have asked for help sooner. I would have considered working partly from home or passing on work to someone else but I wanted to perform and do my best at my job even though I was pregnant.
"What I realise now is that there is very little awareness of pelvic girdle pain in the workplace."
• Pelvic Girdle Pain - a dynamic approachis the theme of a multidisciplinary conference on the management and treatment of acute and long-term pelvic girdle pain (also known as symphysis pubis dysfunction) in the Tara Towers Hotel, Dublin on Saturday (October 11th) from 9.15am-5pm. Obstetrician, Dr Valerie Donnelly will chair the conference.
A workshop for physiotherapists on the management and treatment of pelvic girdle pain will be held in Mount Carmel Hospital, Dublin on Thursday and Friday. Further details on both events from physiotherapist, Clare Farrell on tel: 01-406 3464. See also www.pelvicpartnership.org.uk
