Wednesday, November 16, 2011

A bit about pelvic girdle pain

When I was about five months pregnant with Marko, my back started to hurt. Right at the very lowest joint of my lower back, hovering around my right hip. It hurt when I was on my feet a lot (which I always was), when I drove a lot (which I always did), and when I carried any heavy weights (which I didn't do). It hurt at work and during choir practice. It hurt when I tried to roll over in bed. It got so John had to help me get out of bed in the morning. I couldn't stand on one foot to put my socks on or lie on my back, at all, ever. And the further along I got, the worse it got.

I asked my Ob/Gyn about it. I asked each new doctor (there were eight) at each visit. One said to ask my mom. One said it was sciatica. The nicest one said that I might try wearing different shoes and that she could write me a referral to a physical therapist. The shoes helped a little. I couldn't afford the therapist.

I asked Facebook about it. My aunt gave me a few stretches, which helped a tiny bit. Some suggested belly support girdles, which I never did try. Some suggested hot pads and hot water bottles and hot baths, which were all heaven. And everyone else told me to try to stay off my feet, which I did as best as I could.

I asked the internet about it. It said, "It's not sciatica, that's a misnomer. It's something else. 20% of women suffer from it. Suck it up."

When I was in labor, the most excruciating pain was in my pelvis. It hurt worse than the contractions, and of course got worse with the contractions. Then I had a baby, and no pain! At least, none that I noticed while staying off my feet recovering.

But when I got up again and started doing things, it started hurting again. Not a lot. Just a little twinge here and there. I adjusted the way I was wearing my Moby wrap, and it mostly went away. But if I walked too long or carried the baby too much, there it was again. Just a twinge. Nothing to worry about or even restrict what I was doing. Just enough to notice.

So I went back to Google and found more things out. Google said I had SPD -- symphysis pubis dysfunction. All the symptoms sounded about right. The discouraging part was where it said, "DO NOT by any means give birth in stirrups! That could cause permanent damage!" Great. SO GLAD Dr. Pushy took the time to do a Google search, find out what I had, and take precautions. Not. It always makes me mad when I find out something from five minutes of Googling that the doctors don't know. But then again, it took me awhile to find it, too, so whatever.

So I went along my merry way until one day a few months ago when I was walking home from the park and my back started to hurt. It's only a two-block walk. I thought, "This shouldn't be hurting. I wonder if I'm pregnant?" And I was. Little sprout was two weeks old and I was already beginning to hurt.

I'm 15 weeks pregnant now and it hurts about as bad as it did at 30 weeks last time. This makes me really nervous, thinking about the possibility of it getting worse. Every time I rake the leaves, do more than a little housework at a time, or take a walk, I'm pretty much out of commission for the rest of the day. I yelp when I turn over in bed, and I spend my time trying to figure out ways to avoid picking Marko up. I can lift him into his high chair, or carry him to bed. But I can't really rock him standing up, or bring him places he doesn't want to go, or let him come "UP UP UP" every time he demands it, without hurting a lot afterward.

I asked one of the midwives about it, briefly, at our appointment, and she said, "Well, you're pregnant now. You can't expect to be able to cart around a 25-pound toddler everywhere you go anymore. It's time to practice letting him walk." Which was good advice. Sooner or later he's going to have to learn to hold my hand and not dart into the street. We may as well practice now. Then the midwife showed me a couple of stretches, suggested yoga, and told me that the patients she's had with back pain in the past all found chiropractic work helpful.

So there I am. I decided to do more research on SPD to see if there was anything I could do myself, or anything I could avoid doing, that would help. And there is a lot of advice out there. The only thing that isn't quite right is that SPD affects that symphysis pubis -- the joint at the front of the pelvis, where the pubic bone is. And that isn't where the pain is for me. My symphysis pubis has always felt fine. And as a result, the advice to keep my legs together all the time to avoid those twinges has never helped at all.

Finally I landed on a page about pelvic girdle pain, also known as pelvic girdle instability, which actually IS, I'm almost sure, what I have. See, the pelvis has three joints: the symphysis pubis in the front and the sacroiliac joints in the back, on either side of the spine. My sacroiliac joints are the ones that hurt. SPD is just one kind of pelvic girdle pain, and I have another.

PGP is caused loosening ligaments in the pelvis. Of course this is completely natural, because the pelvis needs to loosen up to let the baby out. But it gets too floppy and unstable, and so the muscles take over to keep it steady. Those muscles get really, really sore from doing the pelvis's job. That's why a muscle right over my sacroiliac joint, on one side or the other, is always hurting. Heat and massage help, like they would for any tight, sore muscle.

I found two support pages for women with PGP: the Pelvic Instability Network Support page, and Pelvic Partnership. They both had some good tips. And they both agreed on one thing: the main thing that will make me feel better is to go to a chiropractor or physical therapist and get an adjustment to restore the symmetry of my pelvis. If it's relaxing symmetrically, the muscles shouldn't be called upon to do too much of the work.

So, that's a goal for whenever we have the time and money to do it. Meanwhile, I skip my walks (hardly healthy of me), lead Marko by the hand, and demand a backrub every night.

Anyone else suffer from this? I really recommend following the links in this post; I learned a lot.


Meredith said...

Wow, I'm really sorry you've had to deal with this, Sheila. Isn't the internet wonderful, though? I don't see how you could go wrong with physical therapy and backrubs.

I'm kind of wondering about the support girdle now. I'm sure it sounds dorky, but perhaps it would hold things together?

Keep letting us know how you're doing.

Fidelio said...

Yes, get a medical-grade support band (it will be very large, very ugly, and look more like a knee brace than a stretchy belt). That will help.

Aside from that, don't trash the doctor just because "Google said" in 5 minutes what the M.D. couldn't answer for you. There's not anything he can do for you medically, so what exactly did you want him to say?

Did you want to be offered medication, or told to see a physical therapist, or (the only truly helpful medical advice) told not to ever get pregnant again? I don't think so. Just be grateful that there's a few places left where the secular world will actually tell you to suck it up and deal with something, instead of trying to drug your body's natural reactions out of existence.

Sheila said...

It just seems to me that, if 20% of pregnant women suffer from this condition, the doctor should have at least heard of it and been able to point me in the right direction.

You probably would have loved my doctors, though. While so many are obsessed with risk ("Oh no! You gained one pound too many! You probably have GD! You're definitely high-risk!"), mine were more old-fashioned. They seemed to think that any symptom I had or question I asked was just an attempt to get attention because all women just LOVE to be high-risk. So the answer was more often, "There's nothing special about you. Suck it up," rather than "let's order twenty million tests."

My ideal, though, is someone who would give me actual advice, like my midwife did. Plus being a heck of a lot more personable than 8 doctors, one of whom I met in the delivery room and one of whom I never met at all.

Fidelio said...
This comment has been removed by the author.
Fidelio said...

I think I saw 23 different physicians, LPNs, and/or CNMs during my last pregnancy. I lost count during the weekend I Eight doesn't sound so bad!

And hopefully not ALL women love to be high-risk!! I actually am high risk (real high risk, not omg-you're-fat-risk)...maybe people without issues wish they had them, but when you have a real problem, all you want is for it to go away.

Sheila said...

Woah, 23. I did lose count of the residents who came into the room to reach up ... well, you know. I do wish they'd give you their name or something before doing that.

As far as I know, nobody wants to be high risk. Everyone would like to be healthy and normal! A friend of mine who is overweight fought tooth and nail against being labeled high-risk because she is perfectly healthy. But they took her blood pressure one time after telling her her baby might be dead, and whaddya know, it was elevated. So they labeled her high-risk and hypertensive and in the end she ended up with a c-section. So yeah, overly risk-focused doctors can be trouble, and nobody *wants* to have a problem. The doctors just seemed to think I did.

The one doctor I really liked won my heart forever when, after I told her about my back pain, she actually helped me off the table. Every other doctor would listen while I said it was excruciatingly painful for me to lie on my back, and then tell me to lie on my back for them to measure my belly without thinking about it. A doctor who bothers to remember to be considerate wins major points in my book!

Sarah said...

I second a previous poster' recommendation of a support band. I scoffed at them as a gimmick but as my own pain has gotten worse with the third trimester in this pregnancy, I finally caved and bought one after my OB recommended it (he said each subsequent pregnancy I would need more and much sooner). While I do not have PGP as far as I know, I can say that the support has done wonders for me.

ivy ingram said...

I gave birth 19 months ago and mine separated not during pregnancy but during delivery during which I was almost immediately paralyzed temporarily and it excruciating pain on and off since. I just had surgery to fuse the bones together as after seeing orthopedic after orthopedic they finally all agreed they would never go back and I would always be in pain and continue to do more damage to my pelvis. I would recommend having an xray as soon as your next child is born as they told me the worst thing I could have done is waiting for 18 months ( I blame the orthopedic who saw me in the birthing center). It is an awful thing to live with. I am hoping this pubic symphasis fusion will help but I am still on bed rest post surgery. Best of luck.

guisela said...

Hi my name is Guisela and I have Pelvic Girdle pain. Everything you describe I have, the funny part in which I disagree with some of the comments about doctors...Doctors aren't GODS! Doctors do not know your body better than you do! My Gyno pretty much told me I was crazy, he said my pain was NORMAL??? I looked at him and shook my head and wasn't! I read and read and researched and came up with the same result PSD or Pelvic girdle pain.. etc... My question to my doctor was...if you have a patient in your office in tears, unable to walk and has come into you office for the same complaints and is pleading for help... ISN'T your job to heal the sick... or at least attempt to???? All I did was pray... and if you believe in God, Karma, or anything spiritual... another Gyno was brought into my life after numerous phone calls...I found ONE gyno that had experience with this condition. The first thing he said was" you are NOT crazy"! I was so joyful to hear him say that. I was sent to a physical therapist that has experience with this condition and is assisting me. The BAD NEWS IS THAT SOME WOMAN EXPERIENCE SUCH DRAMATIC SEPARATION THAT CAN BECOME PARALYZED. I am working extra hard to being careful and doing everything possible to rest and take it easy. My friend went through this also and was temporarily paralyzed for 7 months after having the baby. She is walking now, has no pain and has totally recovered. Thank God, but not all of us are that lucky. Sometimes we have to wait it out. Sometimes I wish there was a support group that I could join to discuss the mental anguish I go through. I am so independent and also a single Ex hubby has actually stepped in and is helping me...that is a blessing.
All I can say to any of you reading this is BE STRONG! It's hard, it hurts...but you aren't crazy. I am a new yorker on the run, independent, I have a very important position at my job and cannot afford to stop...But the lesson here is sometimes you HAVE TO. You will have Good days and you will have bad day at a time and no lifting, do not cross your legs, keep your legs together, good posture, get massages as often as you can and breathe!
Good luck to all of you and I am here to answer any questions.
take care.

Sheila said...

In case anyone else stumbles on this, here's an update.

After my second pregnancy, the pain did go away. And with my third, it hasn't returned much at all -- certainly not the way it was in my second!

I could put it down to a number of things. First, I got a lot of exercise between pregnancies -- lots of walks with the double stroller, lots of lifting my enormous children, and finally mastering squats. Second, I have discovered a few things that really set it off: kneeling down and getting down on all fours in particular. Usually I do those a lot, picking up toys and gardening, but every time I do it for five minutes, I am sore all the rest of the day. I no longer worry about keeping my legs together because my pubis symphysis doesn't hurt, and my sacroiliac joint seems to prefer my legs somewhat apart. In fact, when my back is stiff in the morning, a few careful squats seem to settle things back into the right place.

Lying on my back sets it off, so I never do, even for a moment, but tilt to the left or right if I have to be on my back. Back rubs actually seem to make it worse too, maybe because they relax the muscles that are holding my pelvis together.

The most important thing is steady amounts of exercise. If I do more than I'm used to, I will be sore. If I do less, I will soon find I am able to do less. But if I do roughly the same amount every day, I am able to keep up with it. I can walk a few blocks to the park, pick up Michael (36 pounds!) for short amounts of time, and do yard work, no problem. I can be on my feet for several hours a day, but I get sore if I try to stay on my feet all day.

I have never been able to afford to see a physical therapist or chiropractor, but of course that's a good recommendation.

Mostly I am just thankful as all get-out .... I thought having had it once, I was doomed forever, and it turns out for whatever reason I am not. I hope this helps others.

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