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Reframing beliefs and instiling facts for contemporary management of pregnancy-related pelvic girdle pain
  1. Jodie Pulsifer1,
  2. Susannah Britnell1,
  3. Adrienne Sim2,
  4. Jessica Adaszynski3,
  5. Sinead Dufour4
  1. 1Full Circle Physiotherapy, Vancouver, British Columbia, Canada
  2. 2Full Circle Physiotherapy, Langley, British Columbia, Canada
  3. 3Full Circle Physiotherapy, Coquitlam, British Columbia, Canada
  4. 4School of Rehabilitation Science, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
  1. Correspondence to Jodie Pulsifer, Full Circle Physiotherapy, Burnaby, British Columbia, V5G1E5, Canada; jodie{at}fullcirclephysiotherapy.com

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Understanding pregnancy-related pelvic girdle pain (PPGP)

PPGP is a specific category of pelvic girdle pain (PGP) impacting those in the perinatal period and differs in its aetiology as it is related to pregnancy and associated biopsychosocial influences. PGP in pregnancy and through the first postpartum year is common and combined with low back pain is estimated to occur in 56%–72% of antepartum people with 20% reporting severe symptoms during 20–30 weeks’ gestation and 33%–50% reporting symptoms before 20 weeks’ gestation.1 2 PPGP is a significant cause of disability, reduced quality of life and early medical leave from work. People who experience more persistent symptoms in pregnancy can be at risk for poorer long-term outcomes.3 Lack of belief in resolution, increased emotional distress and pain severity have potential for persistent PGP after pregnancy.1 4 Early intervention in pregnancy and instiling the belief that it can improve will create a better long-term prognosis.

The challenge of biomechanical bias

Despite mounting evidence of the role that psychosocial and physiological factors play, PGP continues to be mainly understood and treated as a purely biomechanical issue. However, congruent with broader literature examining lumbopelvic pain more globally, PPGP must be understood along with the evolution of contemporary pain science regarding the multifaceted nature of pain and the context of each pregnant person’s unique lived experience.5 6 The 2017 Antepartum PGP …

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Footnotes

  • Correction notice This article has been corrected since it published Online First. Figure 1 has been increased in size for readability.

  • Contributors JA, JP and SD identified a need for this work and conceptualised the original idea for this infographic. JP, AS, SB and JA brainstormed the original myths and facts. JP and AS drafted the original manuscript with significant supporting research from all authors. JP, AS, SB, JA and SD all made substantial contributions to the revision of the manuscript prior to submission. JP created the infographic with the supporting research of all authors and digital icon creation by Josh Pulsifer. All authors consented to the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests SB and SD deliver privately hosted educational courses on Pregnancy-Related Pelvic Girdle Pain.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.