Pelvic girdle pain: The Stickmum project 3 years forward
Pelvic girdle pain related to pregnancy (PGP) is increasingly well recognised by midwives and women. There is a growing awareness that PGP results from a mechanical dysfunction of the pelvic joints, causing pain and disability, and that it is treatable. Recent literature has examined the prevalence and duration of PGP; the use of caesarean section, treatment with manual therapy and exercise during and after pregnancy (now gaining more and more acceptance as the most effective way to manage and resolve PGP); and evidence to support continued breastfeeding. There are new studies about the long-term prevalence and consequences of lack of treatment, both physical and psychological, and the financial impact on society. By treating PGP with manual therapy during pregnancy, as symptoms arise, the associated morbidity can be avoided or minimised. This article reviews the recent literature on PGP and reflects on the response to the Pelvic Partnership's 2015 ‘Stickmum’ campaign.
Pelvic girdle pain (PGP), previously known as Symphysis Pubis Dysfunction (SPD), is becoming better recognised by midwives, GPs and women. PGP is a result of an asymmetry of movement of the joints around the pelvis and lower back that results in pain and difficulty moving. It can occur at any stage during or after pregnancy and birth. It can be treated effectively with manual therapy, which involves a full assessment of the function of joints and muscles around the pelvis, and treatments including joint mobilisation, muscle energy techniques and trigger point treatment to restore normal joint function of joints and muscles. More work is still required to treat women promptly in pregnancy and reduce short- and long-term morbidity, including both physical and psychological aspects. If untreated, studies have shown that 10-19% of those with PGP in pregnancy still have significant symptoms 11 and 12 years later (Elden et al, 2016; Bergström et al, 2017), producing pain, dysfunction, inability to work, and the need for disability pensions. Studies showing the outcomes of manual therapy treatment suggest that much of this is avoidable, and that both the availability and the effectiveness of the treatment offered to women with PGP need to be improved.
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