Pinpointing Prenatal Pelvic Pain

By Riva Preil

As any expectant or previously pregnant woman can attest, the body undergoes major changes during the nine glorious months of pregnancy.  One noteworthy change involves a particular hormone called relaxin. Relaxin is a very appropriately named hormone- it’s job is to relax the pelvic ligaments to allow for widening of the pelvis. This is required in order to accommodate the growing fetus during pregnancy and in preparation for labor and delivery. Additional relaxin is produced during the first trimester of pregnancy, and it peaks at 14 weeks of pregnancy and at delivery.

The results of increased relaxin include hemodynamic changes that occur during pregnancy, such as increased cardiac output, increased renal blood flow, and increased arterial compliance. It also softens the pubic symphysis.  This makes the pelvic region more susceptible to shifting out of alignment which can produce pain.

A recent study conducted at Gothenburg’s Institute for the Health of Women and children analyzed the effect of acupuncture on pregnancy related pelvic pain. Participants were divided into three groups:

  1. Standard home exercise program
  2. Standard home exercise program with acupuncture (three six-week treatments)
  3. Specialized exercise program aimed at improving mobility and strength, no acupuncture

Pain levels were recorded every morning and evening in all three groups.

The group that experienced the greatest pain relief was the group which received acupuncture, followed by the group which received a specialized exercise program.  Acupuncture is believed to release the body’s natural pain killers, an obvious perk considering that many women are hesitant to ingest extraneous medication during pregnancy.

Therefore, in addition to pelvic floor physical therapy, acupuncture is a highly recommended avenue for the approximate 33% of expectant mothers who experience severe pain. If you think that you or someone you know may benefit from this approach, please speak to your medical care provider. We here at Beyond Basics are pleased to offer both skilled physical therapy intervention for pregnant women as well as acupuncture with our experienced acupuncturist, Paula Haberman!  Please contact us if we can help you in any way.

When “Relaxin” Can Be Disturbing

By Riva Preil

Pregnant women experience many anatomical changes, in large part due to the various hormones circulating through the bloodstream while pregnant. One of these hormones, relaxin, causes a loosening of the ligaments, the structures in the body that keep bones securely connected to one another. On the one hand, this ligament laxity is important because it allows for widening of the pelvic bones in order to allow room for the fetus to grow, develop, and eventually emerge from the mother. However, just like chocolate cake, too much of anything, even something good, can actually be harmful. If there is too much ligament laxity, the pelvic bones may move out of alignment and the pubic bones may separate from one another which can be very painful. This separation, known as pubic symphysis diastasis (or pubic bone pain), may cause a pregnant women to feel pain just above the mons pubis, especially during prolonged walking, standing, and during activities that involve separating the legs (ex. stairs, donning pants).

Several helpful hints to help alleviate this type of pain are to stabilize the pelvic bones with a pregnancy belt. The belt can help provide the extra support which the lax ligaments are not providing as efficiently. In addition, a pregnant woman experiencing pubic bone pain should try to avoid activities that involve separating the legs or reciprocal movement (ex. when entering a bathtub or getting up from bed, swing both legs together over the edge rather than one at a time). In addition, prolonged standing and walking should be avoided, and she should take rests as needed. If pain persists, one should seek advice from their ob/gyn and a skilled physical therapist trained in prenatal/postpartum rehabilitation.