This question may be on your mind if you’ve been reading this blog or if you’ve been struggling with pain somewhere ‘down there’. One of my dear friends, whom I’ve known since childhood (6th grade to be exact) just had a baby several months ago. And she posed this question to me after I asked her to take a peek at the blog for me when it first launched. She posed a question related to the label of ‘pelvic girdle pain’ vs simply ‘pelvic pain’. What’s the difference? Or are they the same thing? Do I have that? (all such good questions!) Being that this blog tends towards opening discussion surrounding ‘pelvic girdle pain’ and ‘pelvic pain’, let’s do some clarifying.
Long story short, pelvic girdle pain (PGP for short) related to pregnancy involves a myriad of uncomfortable symptoms that all affect the pelvis (including the front, the sides, the back, and the undercarriage). Pregnancy-related PGP looks different for all women, especially depending on your pregnancy and birthing histories. It might be pain over your pubic bone (ie, the front and center part), pain across one or both sides of your lower back, and even pain in the area between your vagina and anus (perineum or undercarriage). PGP can also radiate to your thighs and legs, making movement, sitting, and standing all the more uncomfortable.
PGP is usually most noticeable when you are walking, going up or down stairs, standing on one leg (ie, when you’re getting dressed or donning shoes), and turning over in bed. It can also be difficult to move your legs apart, such when you’re getting out of a car. Pelvic girdle pain (well, PGP and/or urinary incontinence…two common but NOT normal things) that limits movement and exercise is usually one of the main reasons why prenatal/postpartum women seek pelvic PT (*side note – In most states, you can refer yourself to the pelvic floor PT, so no referral needed! But this varies state-to-state and insurance-plan-to-insurance-plan.*).
Pelvic pain (vs the broadly defined ‘pelvic girdle pain’) is a little more specific to pain in the area surrounding your vagina and/or anus. It often occurs with sitting and especially during intercourse or any type of vaginal penetration (this can include intercourse, inserting tampons or menstrual cups, or pain with annual pelvic exams). There are many sub-types of pelvic pain, which we’ll get into at a later time.
Discerning the root cause of both PGP and pelvic pain is important in the evaluation and treatment of the pain because root causes vary so far and wide. Root causes can be anything from hormonal fluctuations to musculoskeletal changes (ie, posture, muscles, bones, and connective tissue) to scar tissue to infections (ie, urinary tract infections or skin disorders). Both PGP and pelvic pain can arise from your digestive, reproductive, musculoskeletal (including pelvic floor), and/or urinary system. So, lots of systems to screen and check out in order to get to the bottom of your pain so as to improve your function!
The pelvis is a closed system (*see photo above*). The spine on the back articulates with hip bones on the sides, which then articulate with the pubic bone on the front. Because the pelvis is a closed circuit, there’s so much that can go on. In other words, when one part of the loop is out of whack, other parts tend to follow. Example: you’re 25 weeks pregnant and your pubic bone (front side) starts to really hurt, preventing you from going on your daily walks or doing your usual household duties, which then translates to back pain and stiffness (and possibly urinary leakage since the pelvic floor muscles usually end up being affected one way or another). Eek! What a cascading of events! This why it is an important topic of conversation, so we can stop the cycle and reduce the feedback loop before things (pain, urinary leakage, etc) get too far out of hand.
No matter what we call it, pain can be sneaky, frustrating, and fickle. If you are experiencing pain around your pelvic area, tell your midwife, doctor or obstetrician, and/or your pelvic floor PT. Slowly but surely, with the right help, those things that used to be so routine (dressing, turning over in bed, getting out of a car) will now be small victories along your pathway of healing and your rediscovery of pain-lessened movement!