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PELVIC GIRDLE PAIN (PGP)
Pregnancy related Pelvic Girdle Pain (PGP) causes pain,
instability and limitation of mobility and functioning in any of the
three pelvic joints. PGP has a long history of recognition,
mentioned by Hippocrates [1]
and later described in medical literature by Snelling.[2]
Pregnancy related Pelvic Girdle Pain (PGP) can be either specific (trauma or injury to pelvic joints or genetical i.e. connective tissue disease) or non-specific.
PGP is complex and multi-factorial and likely to be also represented by a
series of sub-groups driven by pain varying from peripheral or central nervous system,
[3a] altered laxity/stiffness of muscles,
[4] laxity
to injury of tendinous/ligamentous structures [5] to ‘mal-adaptive’ body
mechanics. [3b]
"The classification between hormonal and mechanical pelvic girdle instability is no longer used.
For treatment and/or prognosis it makes no difference whether the complaints started during pregnancy or after
childbirth." (Mens, 2005) [6]
For most women PGP resolves in weeks after delivery but for some it can last for years
resulting in a reduced tolerance for weight bearing activities. Overall, about 45% of all pregnant women and 25%
of all women postpartum suffers from PGP. [7a]
During pregnancy, serious pain occurs in about 25%, and severe disability in about 8% of women. After
pregnancy, problems are serious in about 7%. [7b] There is no correlation
between age, culture, nationality and numbers of pregnancies that determine a higher incidence
of PGP.[8] [9]
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1. Pubic Symphysis Separation.
Fetal and Maternal Medicine Review (2002), 13: 141-155 Kelly
Owens, Anne Pearson, Gerald Mason
2. Pain In Childbearing, Key Issues In Management.Margaret Yerby, Lesly Page.
3a/b. Diagnosis and classification of pelvic girdle pain disorders—
Part 1: A mechanism based approach within a biopsychosocial framework.
Manual Therapy, Volume 12, Issue 2, May 2007, PB. O’Sullivan and DJ Beales.
4. European guidelines for the diagnosis and treatment of
pelvic girdle pain.Eur Spine J. 2008 Feb 8, A Vleeming, HB Albert, HC Ostgaard, B Sturesson, B Stuge.
5. Possible role of the long dorsal sacroiliac ligament in
women with peripartum pelvic pain.
Acta Obstetricia et Gynecologica Scandinavica, Volume 81, Issue 5 ,
Page 430-436, May 2002, A Vleeming, HJ de Vries, JM Mens, J-P van Wingerden
6. About Pelvic Girdle Instability. Definition and Concept.
Jan M.A. Mens, physician for Orthopaedic Medicine.
7a/b . Pregnancy-related pelvic girdle pain (PPP), I: Terminology,
clinical presentation, and prevalence.
European Spine Journal Vol 13, No. 7 / Nov. 2004, WH Wu, OG Meijer , K Uegaki, JM A Mens, JH van Dieën, PI J
Wuisman, HC Östgaard.
8. Is Pelvic Pain a Welfare Complaint?
Acta Obstet Gynecol Scand. 2000 Jan, 79(1):24-30 Department of Women’s and Children, HK Bjorklund, S Bergstrom.
9. Pelvic Girdle Pain in Pregnancy.
BMJ 2005, 331:249-250 (30 July), doi:10.1136/bmj.331.7511.249 Editorial, RW Stones, K Vits.
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