Home > Blog > Women's Health Physio > Sacroiliac Joint Pain or Posterior Pelvic Pain During Pregnancy

Sacroiliac Joint Pain or Posterior Pelvic Pain During Pregnancy



Posterior pelvic pain (PPP) is a specific pain that is experienced near your pelvis/pelvic sacroiliac joints, and is caused by sacroiliac joint (SIJ) dysfunction.

These joints are the joints that is located at the two dimples of your lower back, and posterior pelvic pain (PPP) is usually very deep inside the lower back and can occur on one of both sides of the back. Sometimes, the pain can travel down to the buttock too.

For some pregnant ladies, it may happen anytime during the pregnancy, but generally, posterior pelvic pain begins on the 18th week of pregnancy and usually becomes more intense as pregnancy progresses. Good news is that this pain usually spontaneously disappears/resolves within three (3) months of delivery.

...but in some cases, the pain may linger and becomes long term, and in some cases, disabling.

What are the Sacroiliac joints?

So our sacroiliac joints are the joints that connect the:

  1. sacrum (it's a triangular-shaped bone at the bottom tip of the spine)
  2. left ileum (of the pelvis)
  3. right ileum (of the pelvis)

Our sacroiliac joint is a very strong and stable weight/load-bearing joint that doesn't allow much movement (due to its structure, location, function), and it's main function is to allow loads, weight and forces to be transferred, transmitted safely through the body (it absorbs/transmits force safely from legs to spine during activities).

Our sacroiliac joint is kept stable with two main mechanisms:

  • The rough connecting surfaces of the sacrum and ileum interlock and help to stabilize the sacroiliac joint (sort of like jigsaw puzzle/Lego)
  • The complex ligaments and muscles such as core stabilizers (transversus abdominis and multifidus) that surrounds the SIJ and behaves as active stabilizers, like if you hold a golf ball in your hand and grip it tightly.

Posterior pelvic pain is caused by sacroiliac joint dysfunction ie when the stability of SIJ is compromised.

Why does posterior pelvic pain occur?

So during pregnancy, the two mechanisms that supports/stabilizes the sacroiliac joint can be destabilized, which increases mobility in the SIJ (a detrimental effect). This is caused by a double whammy of:

  • pregnancy hormones that are exuded by the body to prepare the body for pregnancy and delivery, will/may cause ligaments to become lax, and this may cause the SIJ ligaments to also become lax, hence increasing its instability
  • the growing baby and uterus stretches out and weakens the core muscles, weakening the pelvis and core muscles.

This is further compounded if

  • pregnant mother doesn't exercise as much or is more sedentary in nature
  • the additional weight alters the walking pattern to be more unnatural load on the SIJ

What are the symptoms of posterior pelvic pain?

Posterior pelvic pain is the most common type of pain related to pregnancy, and some of the usual symptoms include:

  • Deep pain in the back of the pelvis (near the dimples of sacroiliac joints)
  • Pain may occasionally travel to buttock and thigh.
  • This pain is generally aggravated with load/weight eg activities that involve standing, walking, climbing stairs, resting on one leg, getting in and out of a low chair, rolling over and twisting in bed, and lifting. The pain improved when sitting, resting or lying down.

If you have inflammation in your sacroiliac joint, you may experience stiffness in your back and/or pelvis.

Diagnosing Sacroiliac Joint Dysfunction in pregnancy

Your

  • gynae and/or
  • women's health physiotherapist

will do a thorough series of clinical, historical and physical exam to diagnose and determine the core problems and its severity.

That may include trying to understand you:

  • symptoms and its intensity/frequency
  • test sacroiliac stability/movement/pain

The doctor may request for imaging such as X-ray or CT scan to diagnose better, however, any procedures or imaging that may expose you and baby to radiation is generally to be avoided.

Treatment and Management of posterior pelvic pain

Gynae, doctors and women's health physiotherapist will often recommend women's health physiotherapy and exercises that targets

  • core strengthening
  • pelvic girdle stability
  • trunk stability

We may sometimes prescribe a specific sacroiliac belt to help provide quick pain relief and give some support, but compliance to exercise will be most of the treatment. Sometimes, our women's health physio may prescribe gentle joint/soft tissue mobilization of your:

  • hip
  • back
  • pelvis

to loosen any tight joints and to correct any dysfunctions. Sometimes we may employ myofascial release too to release tight/very tight muscles which may cause deep ache and pains.

Please note that you are highly recommended to see a women's health physiotherapist (a skilled/experienced senior physiotherapist who is experienced in dealing/treating pregnancy-related pains) to ensure that she is able to treat your condition very specificly and effectively.

There are two other options eg direct injections into the sacroiliac joint or oral anti-inflammation medicine, but during pregnancy, is again generally avoided. Consulting a women's health physiotherapist is the best option moving forward.



Back to Top

book an appointment today
(or check your pains / injuries)

Phoenix Rehab Physio Services

Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.



HAND THERAPY & CUSTOMIZED SPLINTING

Patients who sustained injuries to their elbows, forearms, hands, wrists (sprains and fractures) and fingers, usually will benefit / require Hand Therapy to

  1. manage and decrease hand pains
  2. improve range of motion, strength and dexterity
  3. increase the function of their hand following injuries or post-operations

Commonly treated hand pain injuries includes



REFORMER CLINICAL PILATES & WELLNESS PILATES

Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.

It is a system of safe and effective exercises, which meet specific individual needs, to treat a wide range of injuries and conditions.

You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.



TRADITIONAL CHINESE MEDICINE (TCM)

  • Cupping TCM
  • Auricular Therapy TCM
  • Herbal TCM Medicine & Supplementation



DEEP TISSUE RELEASE & SPORTS MASSAGE THERAPY

Sports and deep tissue release massage helps to increase nutrient-rich blood flow to tired, tight and tense muscles to accelerate recovery and  shorten downtime / recovery period required.

It also prevents muscles from scar tissue micro-tears (and potential ruptures), and increases muscle performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.

Read the benefits of regular deep tissue release therapy here.



ALTERNATIVE THERAPIES

All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).

See our entire team here with introductions and their specializations.

At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.

Follow up sessions are inline to provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.

do Tell Your Family, Friends And Colleagues About Us =)

We appreciate you as our valued clients and want you to know that the # 1 way we grow as a clinic / brand is through word of mouth referrals from valued patients like yourself.

We prefer not to rely on advertising - instead, we prefer and appreciate the goodwill and positive reinforcement from patients. When you have the chance, please tell your family, friends and physicians about the positive results and experience you have had in our physio clinics.

book an appointment today
(or check your pains / injuries)

Recent Articles

  1. Physiotherapy and Hand Therapy at Tampines Singapore

    Jan 18, 23 03:01 AM

    Phoenix Rehab Physiotherapy and Hand Therapy at Tampines Singapore

    Read More

  2. Germaine Sim Hand Therapist

    Dec 11, 22 03:43 AM

    Germain Sim is a hand therapist practicing hand therapy, splinting, assessing and treating finger, hand and elbow pains in Phoenix Rehab

    Read More

  3. Adele Ang Principal Physiotherapist Singapore

    Jun 29, 22 08:32 AM

    Adele is a registered physiotherapist with over 25 years of experience including treating national athletes as well as recreational athletes having worked in Singapore Sports Council and Singapore Spo…

    Read More

  4. Achilles Tendon Pain Physiotherapy

    Feb 03, 22 04:05 AM

    Achilles tendon pain is very common among recreational and elite sportspeople. But it is also common among sedentary individuals

    Read More

  5. Tendonitis Physiotherapy & Hand Therapy

    Feb 03, 22 12:16 AM

    Tendonitis, tendinopathy and tendinosis are all tendon injuries and treated by physiotherapists and hand therapists

    Read More

  6. Cervical Spondylosis Physiotherapy

    Jan 11, 22 02:01 AM

    Cervical spondylosis is a general term to describe the degenerative condition in the neck which results in pain and other symptoms

    Read More

  7. Tendon Pain Tendinopathy Physiotherapy

    Jan 07, 22 12:28 AM

    Tendinopathy (tendon injuries) can develop in any tendon of the body and has many names such as tendinitis and it can be treated with good tendon physiotherapy

    Read More

  8. The importance of staging and compression in tendinopathy physio

    Dec 15, 21 01:47 AM

    Tendon problems are common in runners and can become a persistent issue if not properly treated.

    Read More

  9. Tendon Pain Physiotherapy and Hand Therapy

    Dec 14, 21 11:23 PM

    Pain and pathology in a tendon, known as tendinopathy, is a common injury in athletes that can be difficult to manage. Physio and hand therapy can help healing

    Read More

  10. Tendon Injuries Physiotherapy, Hand Therapy, TCM & Massage

    Dec 07, 21 01:31 AM

    We use the world’s best tendon recovery programs through cutting edge treatment techniques for all tendon injuries (and tendon injuries differ accordingly)

    Read More