Treatment for Posterior Pelvic Pain in Pregnancy

 

In the previous article [Posterior Pelvic Pain in Pregnancy? Never heard of it] on Posterior Pelvic Pain, we explained what posterior pelvic pain is, why it occurs and how to recognise the symptoms. In this article, we will talk about the necessity to seek treatment for posterior pelvic pain and the treatment methods available.

Do I need to seek treatment for posterior pelvic pain?

It is advisable to seek medical advice with regards to posterior pelvic pain in order to determine the severity of your condition. In any case, if your pain has affected your mobility and ability to function normally – it is best to consult with a medical professional.

Why seek treatment for posterior pelvic pain?

Chronic or persistent pain is pain that lasts for more than 3 months and this type of pain tends to have a debilitating effect on individuals who suffer from it. Persistent pain is a widespread issue that is plaguing Singaporeans – from those who lead sedentary lives to those who are active. 92% of Singaporeans agree that pain interferes with certain aspects of their lives and that pain can negatively affect quality of life. 

Very often, the physical impact of pain affects one’s ability to perform simple day to day tasks such as walking or climbing the stairs. This can make it difficult for you to go out and get things done and eventually cause you to be bedridden and homebound. This would also take a toll on your social life as you may be forced to keep social gatherings to a minimum due to the discomfort. The sudden impact on one’s mobility and the inability to perform such simple tasks would negatively affect your state of mind and mood. 

Pain is also one of the most common causes of insomnia – for people with persistent pain, sleep issues are extremely common. Insomnia is present in two thirds of people who suffer from persistent pain conditions such as posterior pelvic pain. The vicious cycle of pain is that it negatively affects your quality of sleep and at the same time, the lack of sleep aggravates the pain as when one is not well rested, it makes the body more sensitive to pain. 

Living in constant pain and having your mobility hindered can be a huge setback. All these factors brewing together could eventually lead to depression and make your pregnancy experience a miserable one. 

Types of treatment for posterior pelvic pain

The good news is that many of these pregnancy related aches and pains are treatable and there is no need for you to put up with the pain. These treatment options listed below are safe during pregnancy – but do consult with your gynaecologist before embarking on the treatment option to ensure that the treatment is suitable for your pregnancy as each pregnancy is different.

Bed Rest

For Posterior Pelvic Pain, the pain is usually aggravated with increased movements such as walking or climbing the stairs. In order to reduce the pain, bed rest is recommended for a period of 1 to 2 days. 

Heat Therapy

A quick and convenient pain relief fix would be heat therapy – you can apply a heat pack or a hot water bottle at the painful area. The heat will loosen muscle tension and tightness which will help with pain relief temporarily. If you do not have a heat pack or a hot water bottle, you can also take a hot shower or bath as well. 

Pain Medication

Over the counter painkillers and non-steroidal anti inflammatory medications (NSAIDs) can be taken to reduce pain and inflammation in the sacroiliac joints. Do consult with your gynaecologist on what types of painkillers are safe for consumption during your pregnancy before taking any medication. Some expecting mothers may also prefer not to take medication unnecessarily for the safety of their foetus. 

Physiotherapy

Physiotherapy can counter the two main causes of sacroiliac joint dysfunction – hyper mobility and hypomobility. Hypermobility issues are usually the main causes of sacroiliac joint dysfunction and is caused by instability and weakness in the sacroiliac joints. Hypomobility is less common but it causes pain due to stiffness in the sacroiliac joints. 

Your physiotherapist will assess your condition to determine if the posterior pelvic pain is caused by hyper mobility (instability and weakness) or hypo mobility (stiffness in the joint) and prescribe a suitable treatment plan. Hypermobility issues can be resolved through pelvic strengthening exercises that are suitable during pregnancy. Strengthening exercises are essential in order to strengthen the surrounding muscles to increase overall structural stability. 

Manual manipulation could also be a suitable treatment method if the pain is caused by hypomobility. Pain can be a result of stiffness and a restricted range of movement. Manual therapy can reduce muscular tension and tightness that is causing the pain and increase your range of motion in the pelvis. It is important to consult with a physiotherapist who is experienced in dealing with pregnancy related musculoskeletal problems to ensure that the prescribed exercises and treatment methods are suitable during pregnancy.

Bracing

If the pain is caused by hypermobility, a pelvic brace can be used to stabilise the pelvis and provides comfort. When there is inflammation and pain, the pelvic brace can also provide pain relief and make it easier to perform day to day tasks. A pelvic brace looks like a thick belt and is wrapped tightly around the pelvis to create stability. This however is just a temporary solution and does not resolve the root cause of the pain. 

Pilates

Pilates exercises can help with pelvis stabilisation, mobilisation and stretching of stiffer areas such as the lower back. Similarly, it is important to find a instructor who is familiar with teaching clients who are pregnant and trained to handle clients with pain and injuries. In order to combat posterior pelvic pain, the programme should aim to stretch the lower back muscles and strengthen the muscles that support the pelvic floor. 

In the next article [Physiotherapy Treatment for Posterior Pelvic Pain], we dive deeper into physiotherapy as a treatment option for posterior pelvic pain and how exactly physiotherapy can help to permanently resolve sacroiliac joint dysfunction and help you to have a smoother and pain free pregnancy journey.