Q&A: pelvic pain in pregnancy

Megan writes:

"I'm almost 6 months pregnant and about a month ago I've noticed a lot of pain around my lower back/sacrum.  After some research I found that I'm experiencing "posterior pelvic pain", mostly due to the loosening of tendons (thanks to relaxin, a pregnancy hormone) and the extra pressure of the baby's weight in the pelvic cavity.  I know that this is a common pregnancy ailment but I haven't been able to find much useful information on how to alleviate my discomfort.  Some resources recommended a pelvic belt.  Do those work?  The pain is so bad that I often have a hard time standing or walking, especially after sitting or lying down for long periods of time.

Do you (or your readers) have any advice?"

I've never used a belly belt, but friends have reported that they helped relieve some pressure and pain. I think your most direct route to relief, however is going to be the combination of chiropractic care and Pilates or yoga.

You should find a chiropractor who specializes in pregnant women and is trained to do the Webster Technique (the adjustment that helps relieve hip pain and turn a breech baby head-down). I'd ask your midwife or OB for recommendations. If they don't know of anyone, look up a chiropractor who specializes in children, because there's usually a lot of overlap between chiropractors who specialize in pregnancy and who specialize in children. You'll probably have to go for 2-3 treatments before you feel significant relief, but after that you should be able to maintain with visits every week or so. Chiropractic in pregnancy is very gentle, and the chiropractor won't do any x-rays to assess you.

Taking a prenatal Pilates or yoga class should also help keep your back pain-free. If you can't find a prenatal Pilates class in your area, there are several DVDs you could get. If you're not usually an exerciser and want something to help you stretch but not to tax you too much, get Pilates in Pregnancy. It moves reeaaallllyyy slowly, but if you can stay awake you'll get a nice stretch. If you're already used to Pilates and want more of a workout, try Pilates During Pregnancy with Niece Pecenka. Pregnancy yoga is all about breathing and stretching, and you may find it easier to get into some of the tougher poses because you can stretch so much more easily with the relaxin.

Another suggestion is to try to sit upright as much as possible (facing backward on a chair with a back or on an exercise ball) instead of reclining. This will help put the baby in the best position both for birth and to relieve the pressure on your back. The website spinningbabies.com is full of information about positioning for comfort and easier labor, as well as an explanation of how to figure out which way your baby is turned in the womb.

You could also try acupuncture, which does really well at alleviating nausea and muscle pain, so you may want to give it a shot for this, too. SInce it's noninvasive you don't have much to lose in trying it.

Anyone else? Any specific recommendations for a brand of belly belt? Was there something that relieved your posterior pelvic pain?

Comments

[Ariella]

I am so impressed by your recommendation to go to a chiropractor! Before her death, my mother was a chiropractor who performed the Webster technique and worked on a lot of pregnant women and children. She was always appalled that even though doctors knew that chiropractic could help women with back pain in pregnancy (not to mention just regular old back pain), they would never recommend going to one.

[Jezer]

I had some heinous posterior pelvic pain (a REAL pain in the butt!) and I found that sleeping on my side with one leg draped over a body pillow helped some. It didn't totally eliminate the pain, but it lessened it dramatically. If I had known of a good prenatal chiropractor in my area, I would have been knocking her/his door in!

I bought a belly belt and I found it to be useless. Maybe I got the wrong brand, but it didn't help me one iota.

Hopefully some other readers will offer more help. That PPP can be excruciating.

[Wendy]

Oh, I had this problem too--I found it to be the worst part of my pregnancy. I never could find a cure-all. I think it just affects some women more than others.

Three things helped: (1) I got an ergonomic footstool for under my desk at work so that when I was sitting all day it didn't put as much pressure on my back (2) sleeping on my side with one pillow between my knees and another underneath my hip/rear end, so I was slightly laying on the pillow behind me, and (3) yoga streches. I just used a tape but if you went to a class you could ask the instructor to help you lean specific poses that might target that area.

[Vilde]

It's not a belly belt (does not cover or even touch the belly) - a proper belt to treat pelvic pain in pregnancy sits on your hips, under the belly. The model I used (the name of which I don't remember, sorry!) also had straps to go under the crotch to make sure the belt didn't ride up. It's supposed to be used for short periods of time only, and it really did help me, but was a pain to put on and adjust during the day. It's also quite pricey, but worth the investment if it helps. You should feel a difference the minute you put it on, so go try one on!

Another tip I got from my doctor was to get silk sheets, because moving in bed becomes so painful.

A word of encouragement: The pain disappeared the moment the baby was out!

[Sara]

I had severe sacral inflammation in the last trimester and after the birth of my first child. I went to a chiropractor who screwed me up even further by doing big adjustments on me while my tendons were still loose, and telling me to put on the hip belt/brace in a way that actually strapped me into the damaging position! She was also very vague about just how long I would need to see her for - months, years, who could tell?

I then found a physical therapist who specialized in problems and injuries related to pregnancy and birth. She gave me a set of daily exercises to do (and used an ultrasound monitor to show me when I was engaging exactly the right muscles), explained when to use cold packs and when to use warm ones, showed me how to strap myself into the brace straight. I had no more pain at all after a month, and was rehabilitated and done with appointments in under three months. I went back to her for an evaluation during my second pregnancy to avoid a repeat experience and she gave me a few more exercises and told me to come back if I had any problems, which I didn't.

So I'd recommend a physical therapist, not a chiropractor, based on my experience and that of friends and family who have used both (and also found that chiropractor tended to mean endless appointments and the physical therapist meant being trained to help and maintain yourself). But I completely agree with the rest of the advice!

[Chris]

I have worked as a women's health physiotheraptist for 20 years and in that time have designed and now sell a support belt for pregnant women. It is very simple, comfortable and effective. There are plenty of self help things women can do to minimise pain. A fantastic exercise is to use your lower abdominal muscles to support yourself each time you change position eg sitting to standing, rolling over and lifting shopping toddlers or baby gear. To do this imagine you are using your lower abdominal muscles to hug your unborn child - do it gently. You will feel much lighter as you stand up and you should also feel your pelvic floor muscles contract as well. Smiley Belt is the name of the belt I have designed can be worn in 2 different ways depending on the cause of your pelvic and trunk pain. If you are interested look up www.pelvicbelt.com