Pelvic Girdle Pain (Pregnancy-Associated)
Basics
Description
- Persistent musculoskeletal pain localized from the level of the posterior iliac crest and gluteal fold over the anterior and posterior elements of the bony pelvis
- May radiate across hip joint and thigh bones
- Usually starts around the 18th week of pregnancy; can start in 1st trimester or present as late as 3 weeks postpartum
- Pelvic girdle pain (PGP) is a separate entity from pregnancy-related lower back pain.
- Synonyms: pelvic arthropathy; osteitis pubis; pelvic insufficiency; pelvic instability; pelvic relaxation pain; pelvic girdle relaxation; posterior pelvic pain; pregnancy-related PGP (PPGP); symphysis pubis dysfunction; lumbopelvic pain; peripartum pelvic pain; pelvic girdle syndrome
Epidemiology
Incidence
45% of all pregnant women; 25% of all postpartum women suffer from PGP, although likely underreported.
Prevalence
4–76%; wide range may be based on varying criteria and designs of studies.
Etiology and Pathophysiology
Generally agreed up pathophysiology hypothesis involves both hormonal and biomechanical factors.
- Increased amounts of relaxin produced by the corpus luteum and uterine decidua during pregnancy
- Relaxin acts on connective tissue, leading to greater ligament laxity especially in joints of the pelvis that normally serve to provide pelvic stability.
- Increased laxity causes widening and separation of the symphysis pubis as well as sacroiliac joints.
- Increased motion in pelvic joints decreases efficiency of load bearing and increases shearing forces across the joints.
Risk Factors
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Citation
Domino, Frank J., et al., editors. "Pelvic Girdle Pain (Pregnancy-Associated)." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688457/all/Pelvic_Girdle_Pain__Pregnancy_Associated_.
Pelvic Girdle Pain (Pregnancy-Associated). In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688457/all/Pelvic_Girdle_Pain__Pregnancy_Associated_. Accessed December 6, 2024.
Pelvic Girdle Pain (Pregnancy-Associated). (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688457/all/Pelvic_Girdle_Pain__Pregnancy_Associated_
Pelvic Girdle Pain (Pregnancy-Associated) [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 06]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688457/all/Pelvic_Girdle_Pain__Pregnancy_Associated_.
* Article titles in AMA citation format should be in sentence-case
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BT - 5-Minute Clinical Consult, Updating
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