pregnancy related pelvic pain
ETIOLOGY
The pain can be caused from:
The pain can be caused from:
- Hormonally mediated joint relaxation
- Strain from gestational changes
- Loss of pelvic bone integrity
5 categories of pelvic pain
- Pelvic girdle syndrome: daily pain in the pubic symphisis and both sacroiliac joints)
- Symphysiolysis: pain in the pubic symphysis only
- One-sided sacroiliac syndrome
- Double-sided sacroiliac syndrome
- Multiple joint pain involvement
Risk factors
RISK FACTORS FOR DEVELOPING PELVIC PAIN DURING PREGNANCY
The folllowing are NON RISK FACTORS:
- History of previous low back pain
- Previous trauma to the pelvis
The folllowing are NON RISK FACTORS:
- Contraceptive pills
- Time interval since last pregnancy
- Height
- Weight
- Smoking
- Age
diagnosis
Even though there is NO GOLD STANDARD TEST, the following tests are recommended for use during the clinical examination:
- Active straight leg raise test
- Gaelen's test
- Pain provocation for the long dorsal sacroiliac (LDL)
- Pain provocation of the symphysis by Modified Trendelenburg test
- Faber's test
- Posterior pelvic pain provocation test
- Symphysis pain palapation test
Treatment
- Stabilizing exercises for control and stability of the pelvis
- Acupuncture (may reduce pain during pregnancy)
references
- Frank et al. Musculoskeletal Causes of Chronic Pelvic Pain: A systematic Review of Diagnosis: Part I. Obstetrical an Gynecological Survey (2005) 80(6).
- Thomas H. Obstetric Lecture: ATSU; 2012
- Vleeming A. et al. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J (2008) 17:794-819