Can Pelvic Pain During Pregnancy be Predicted?

Katja-Bergin

Katja Bergin PT, MScPT

Registered Physiotherapist
Pelvic Health Physiotherapist

As talked about previously in our blogs, pelvic girdle pain during pregnancy is common but should not be considered “normal”. However, 50% of women will experience pelvic girdle pain during pregnancy, with approximately a quarter of them experiencing severe pain.

A recent 2018 study, determined that there are two clinical tests that therapists can use to determine the likelihood of persistent pelvic girdle pain during pregnancy. These two tests are called the active straight leg raise (ASLR) test and the posterior pelvic pain provocation (P4) test. The ASLR tests looks at someones ability to load through their pelvis and the P4 test assess sacroiliac joint dysfunction (the joint at the back of your pelvis). The P4 test is often used to distinguish between pelvic girdle pain and low back pain in pregnancy.

After assessing 503 pregnant women, the study determined that if both of these tests were positive at the 18 week mark of pregnancy, there was a much higher likelihood of persistent, bothersome pelvic pain during pregnancy. In addition, these women also reported a higher incidence of workload, depression, a higher BMI and reported less frequency of exercise.

So … what does this mean exactly?

It’s not a surprise that the body goes through significant physical changes during pregnancy. However, external factors such as the frequency of exercise and stress management can be controlled. This study, as well as others, emphasize that exercise during pregnancy can increase pain tolerance, improve physical fitness and improve the body’s ability to adapt to the changes that incur during pregnancy.

How can a pelvic health physiotherapist help?

Most often, during a Pelvic Health Physiotherapy appointment, these two tests (amongst others – i.e. strength, range of motion etc.) will be performed. This will help the therapist determine an appropriate treatment plan which can help lead to a more comfortable, pain-free pregnancy. This includes developing a strengthening / stretching program as well as give tips on managing stress and workload during pregnancy.

In summary, these two tests can help a Physiotherapist to predict the likelihood of pain during pregnancy but that doesn’t mean that nothing can be done about it! There are many ways to ensure the body is strong enough and ready enough to adapt to all the wonderful changes that happen during pregnancy!

If you’re interested in reading the entire article about predicting pelvic girdle pain in pregnancy – the link can be found here: https://bmjopen.bmj.com/content/bmjopen/8/7/e021378.full.pdf