Pelvic arthropathy during pregnancy

Reviewed by Dr Philip Owen, consultant obstetrician and gynaecologist

What is pelvic arthropathy?

The joints of the pelvis can cause pain during pregnancy. The diagnosis is not hard to make when you are aware of the existence of this condition and its symptoms. Pelvic arthropathy causes such pain that movement is limited and the ability to walk is impaired.

A woman with pelvic arthropathy will feel pain mostly around her pubic area spreading out to the groin and the front and back of the thighs.

Some kinds of movement, such as lying on her back and trying to turn onto her side, worsens the pain. When she walks, her steps will get shorter until she is almost waddling. Walking up and down stairs is especially difficult.

Some degree of pelvic joint pain affects most women in the later stages of pregnancy but the discomfort for a small group of women is often underestimated. For these women, pelvic arthropathy might develop early in pregnancy and last well after delivery.

What causes pelvic arthropathy?

The pelvis is made up of several bones that are jointed in a way that usually does not allow any movement. Under the influence of hormones produced in pregnancy, the cartilage of the joints becomes softer and allows the bones to move. It is this movement and displacement of the bones that causes the pain. In addition, the weight of the growing uterus and baby causes a shift in the pregnant woman's centre of gravity. This often causes lower backache.

What can be done about pelvic arthropathy?

If a woman experiences the kinds of pain described above, she should consult her doctor or midwife. Pain relief is often appropriate but the best source of advice and support will be from a specially trained physiotherapist (obstetric physiotherapist).

The physiotherapist will explain the condition and offer advice about certain exercises and postures that should be adopted and others that should be avoided.

Occasionally, a support garment such as a corset can be helpful and walking sticks are sometimes necessary. You may be advised regarding the most appropriate position in which to give birth.

What happens after the birth?

If pelvic arthropathy is diagnosed and treated correctly the chances of a successful delivery and an easier time afterwards are increased. The discomfort does not disappear immediately after delivery but a gradual improvement over the first few weeks can be expected.

It is impossible to predict whether a woman will be troubled to the same degree in any future pregnancies or not.

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